Cord blood technologist Greta Taber adds DMSO, a cryoprotectant, to prevent water molecules from damaging delicate stem cells during storage in extremely cold temperatures.

The past year has seen progress on several fronts for the Cord Blood Program at Northwest Tissue Services. A new source of funding, changing criteria, support for research, cord blood units sent far and wide for transplant, new partner hospitals, and efforts to achieve international standardization have kept the program’s research, coordinator, and technologist staffs challenged and even busier than usual.

The most recent development came in December when the Tissue Services began listing cord blood units that qualify for “assistance funding” from the National Marrow Donor Program (NMDP). These units have both high total nucleated cell counts (TNC) and high percentages of viable cells. A unit with high TNC and high viability is more likely to take a strong hold in the recipient’s marrow and start generating a new immune system.

The NMDP initiated its funding assistance program to help with the expense of building the national cord blood inventory and to insure that banks store units that are most likely to be used in transplant. The funding provided for qualifying units underwrites some of the costs of collecting and processing the
cord blood.

So far, all of the Tissue Services cord blood units that have been used in unrelated transplants have come from matches found through the NMDP, a fact that underscores the value of the NTC-NMDP partnership.

Increasingly, cord blood is considered
a viable treatment option for a
wider variety of patients...due,
in part, to developments in
collection, testing and processing
standardization...

Supporting Research
Cord Blood Program staff is now developing plans to provide cord blood for use in research outside the Blood Center. Many mothers who volunteer to donate cord blood also agree to its use for research, if it cannot be banked. As criteria for banking become stricter and fewer units qualify, making these resources available for research will increase the benefits they provide.

Many researchers are interested in using this relatively new source of stem cells to develop new therapies and improve patient outcomes. An approved study will have access to cord blood units that do not meet the criteria for banking and would otherwise be discarded.

Beyond the Shores
In October, the Tissue Services shipped a unit of cord blood to Spain for a patient with leukemia. This month, the Cord Blood Program is holding a matching cord blood unit for a patient in Belgium. Another unit, identified as a potential match for a patient in France, is being held pending further testing.

In all, the Cord Blood Program provided six cord blood units for use in unrelated transplants last year. Hawaii Cord Blood Bank, a program partner since 1998, collected three of the units and Swedish Medical Center, another long-time partner, collected the other three units.

After processing, the stem cells are deposited into a storage bag for cryopreservation, which can last for up to 10 years.

Partnerships
The Cord Blood Program was the first umbilical cord blood bank in the Northwest. The partnership with the Hawaii Cord Blood Program has resulted in many of the 1,200 units having been donated by Asian Pacific Islanders. The growing number of units banked by the program, coupled with the racial diversity of the cord blood, led to a surge in matches in 2004.

This year, in the Seattle metropolitan area, the University of Washington Medical Center and Overlake Medical Center joined Swedish and Swedish Ballard as donation centers.

Increasingly, cord blood is considered a viable treatment option for a wider variety of patients. This is due, in part, to developments in collection, testing and processing standardization, giving transplant physicians more confidence in cord blood’s efficacy.

In addition, the use of cord blood stem cells is often more advantageous than using bone marrow stem cells. (see Cord Blood Research: Offering Hope).

Leadership Here and Abroad
The Cord Blood Program is one of three NMDP cord blood banks spearheading efforts to standardize tests used to evaluate the ability of the stem cells to reproduce and reestablish an immune system.

Physicians selecting cord blood units want reliable and predictive results from assays used to measure their cells’ reproductive abilities. Higher regenerative rates can translate to higher success rates in actual transplantation.

In addition, the Cord Blood Program is taking part in the Biomedical Excellence in Safer Transfusion (BEST) Study, a multi-national effort to determine optimal processing, testing, and storage of cord blood.

At times the study requires simultaneous multi-site testing of samples distributed to programs as far away as Germany, Italy, Japan, and the Netherlands. Although accommodating many different time zones can make for some late nights for our dedicated technologists, sharing data with other countries should have a positive impact on the consistency and effectiveness of cord blood transplantation.

These studies and the addition of two new collection sites in 2004—Overlake Hospital and University of Washington Medical Center—are some examples of Puget Sound Blood Center’s ongoing commitment to building a nationally-respected bank and supporting cord blood stem cell research.