Stem cells are "mother cells" (undifferentiated or immature) that have not yet undergone the processes of transformation into specialized cells of which are made different human tissues and organs. Stem cells remain undifferentiated or immature until a stimulus intervenes to encourage them to develop into specialized cells to fulfill a specific function (to become cells of organs or tissues).
Stem cells can be embryonic or adult:
embryonic stem cells, which are found in the embryo from conception until the 4th day of gestation, are totipotent, that is, capable of giving life to all the specialized cell types adult stem cells present in umbilical cord blood, bone marrow, peripheral blood and adipose tissue, are multipotent, that are able to transform in some specialized cell types.
Stem cells from the umbilical cord
Are adult stem cells that have the ability to transform into all cells of the blood. They are gathered on the occasion of the birth, whether natural or c-section, drawing the blood from the umbilical cord just cut off. The collection procedure is safe and painless, for both the mother and the baby, since it occurs after birth, in the period preceding the disposal of the cord.
Childbirth is the only occasion in the course of an individual's life, in which it is possible to collect the own stem cells in a non-invasive and to preserve them for the use dedicated to the baby or to a family member. The blood contained in the umbilical cord blood, rich in stem cells, can be harvested with a simple and risk-free procedure, before the cord will finish in the "special waste" of the hospital. Stored stem cells from umbilical cord blood can be used in the event of outbreaks of serious diseases, on the unborn child or on any compatible relative, after evaluation of clinical pertinence. More than 20,000 transplants of cord blood stem cells (Source: Gluckman et al., Cord blood transplantation: state of the art. Haematol.2009) performed worldwide for the treatment of many diseases, confirm the importance and the scientific validity of the conservation. The most part of investments in research, that were once engaged in the pharmaceutical industry, are now diverted in the field of stem cells, making possible the further development of clinical applications.
Conservation is defined as autologous when the stem cells contained in umbilical cord blood are preserved for the benefit of the newborn (autologous use) or its compatible relatives (use heterologous among blood relatives). This type of conservation is defined dedicated and can be obtained at no cost to the National Health Service when at birth or prenatal stage, the baby or a blood relative are infected by a disease, or in the case of relatives at risk of having children affected by genetically determined diseases. Source (OJ General Series n. 303, 31 December 2009 - DECREE 18 November 2009). The data reported by the National Blood Centre indicate 2176 of performed dedicated preservations (of which 242 in 2010). For preventive purposes, however, you can make the storage dedicated to the baby or to relatives at private facilities, such as Bioscience Institute.
The donation consists of making available to the public stem cells extracted from umbilical cord blood. In this case, after verification of suitability of parents, the umbilical cord blood is collected at the time of birth and the extracted cells are preserved at a public bank Italian for free. In case of necessity, they are given to anyone who might need it for a transplant, after verification of compatibility. In 2009 and 2010 donations of cord blood were approximately 17,000 (per year), of which about 4,000 (per year) actually stored in public banks. The numerical disparity between donations and stem cell samples actually stored depends on the specific requirements that those samples, intended for transplantation on subjects unrelated to the donor, must necessarily have. Most of these requirements do not apply in the case of autologous, because the cells are intended to be preserved on the donor (the baby) or on a compatible relative (f.e. Sibling).
Hematopoietic stem cells are used in the treatment of severe hematological, immunological, metabolic, genetic and oncological diseases. To date, in fact, more than 20,000 heterologous and autologous stem cell cord blood transplants have been performed (Source: Gluckman et al., Cord blood transplantation: state of the art. Haematol.2009). Recent developments in the field of scientific research have allowed the recovery of patients affected by serious genetic diseases for which there was no cure.
Leukemia and lymphoma
• Acute lymphoblastic leukemia
• Acute myeloid leukemia
• Acute biphenotypic leukemia
• Acute undifferentiated leukemia
• Leukemia / T-cell lymphoma of adult
• Hodgkin's Lymphoma
• Non-Hodgkin's Lymphoma
• Chronic lymphocytic leukemia
• Prolymphocytic leukemia
• Beta Thalassemia
• Sickle cell anemia
• Transfusion-dependent pyruvate kinase deficiency
• Hemophagocytic lymphohistiocytosis family
• Chediak-higashi syndrome<
• Langerhans cell histiocytosis (histiocytosis x)
• Ewing's Sarcoma
• Clear cell carcinoma of the kidney
• Evans Syndrome
• Lymphoproliferative syndrome autoimmune
• Progressive systemic sclerosis
• Neoplasms in children treated with chemo / radiotherapy
Myeloproliferative disorders myelodysplastic
Myelodysplastic syndromes, including:
• Refractory anemia (RA)
• Refractory anemia with ringed sideroblasts (RARS)
• Refractory anemia with excess blasts (RAEB)
• Refractory anemia with excess blasts in transformation (RAEB-t)
• Chronic myelomonocytic leukemia
• Juvenile myelomonocytic leukemia
• Refractory cytopenia
Philadelphia-chromosome positive chronic myeloid leukemia
Congenital disorders of the immune system
Chronic granulomatous disease
Deficiency of leukocyte adhesion proteins
Severe combined immunodeficiency (SCID), including:
• Deficiency of adenosine deaminase
• Defect of HLA class I and II
• Lack of Zap70
• Omenn syndrome
• Deficit of purine-nucleoside phosphorylase
• reticular dysgenesis
• Defect of the common gamma chain cytokines in multiple
• Lack of JAK3
Duncan syndrome or syndrome Purtillo
Other inherited disorders
• Gunther Disease
Plasma cell disorders
• Multiple Myeloma
• Plasma cell leukemia
• Waldenstrom's Macroglobulinemia
Bone marrow deficiencies mono / plurilineari
• Acquired Aplastic anemia
• Fanconi anemia
• Dyskeratosis congenita
• Paroxysmal nocturnal hemoglobinuria
• Diamond-Blackfan Anemia
• Anemia, congenital dyserythropoietic
• Acquired pure erythroid aplasia
• Purple Congenital amegakaryocytic
• Disease-Bernard Soullier, thrombasthenia Glanzmann's
• Congenital agranulocytosis (syndrome Kostmann)
• Shwachman-Diamond Syndrome
Inborn errors of metabolism
• Hurler syndrome (MPS-IH)
• Scheie syndrome (MPS IS)
• Maroteaux-Lamy Syndrome (MPS VI)
• Sly syndrome (MPS VII)
• Gaucher Disease
• Krabbe disease
• Metachromatic leukodystrophy
• Mucolipidosis II (I-cell disease)
• Batten disease
• Sandhoff disease
Source: G.U. General Series n. 303 of 31 December 2009
DECREE 18 November 2009 (Annex 1)
In Italy, the conservation for autologous use (in favor of the newborn) or allogeneic intra-family (in favor of relatives) can be obtained from the National Health Service only if the child or family member found to be infected by a disease, or in the event that the family are at risk of having children with genetically determined diseases, this type of storage is called "dedicated" (Dec.18/11/2009 - OJ of 31/12/2009) and is free of charge. The data reported by the National Blood Centre indicate 2176 of performed dedicated preservations (of which 242 in 2010).
In all other cases, the family can make a donation of cord blood or require the health department of the hospital where the birth will take place the authorization to import stem cells from cord blood to keep them to a private company (State-Regions Agreement April 29, 2010).
Following the Agreement, the task to authorize exports of umbilical cord blood for autologous use has been entrusted to the health departments of the childbirth structures.
The task of verifying, as established in the Agreement referred above, certain requirements of citizens applicants, as well as the characteristics of the receiving exportation Bank, is in fact delegated to the Health Management. The Law 219 of 21 October 2005 also states that stem cells may not be the subject of profit and punishes any activity which, directly or indirectly, produces a profit from them if they were comparable to the blood and organs.
In the first 180 days of storage (quarantine period) stem cells are stored in a temporary container. After the quarantine period, the mother repeats the same tests carried out in the last 30 days of gestation:
► Anti HIV 1 e 2
► Anti HCV
► Anti HTLV 1 e 2
Once the negative results of the examinations have been confirmed, the cells are placed in a permanent storage container. The quarantine is a mandatory requirement by law, failure to observe the period of quarantine makes the preserved cells unusable because they are lacking the requirement of "biosafety".
Source: D.Lgs. n°16 del 2010.
Scientific Studies In order to facilitate a more comprehensive access to information related to current and future therapeutic perspectives of cord blood stem cells, this section collects works of scientific activity in this field of research The collection and regular updating of publications is prepared by the Scientific Committee of Bioscience Institute.