AABB stands for American Association of Blood Banks, which is an international organization that provides accreditation. It is important for cord blood samples to be stored at AABB accredited cord blood banks, which are recognized by the USA’s National Marrow Donor Program (NMDP) and to our knowledge, by all transplant centres. AABB accreditation is, therefore, a basic requirement that a quality cord blood bank should meet.

Allogeneic stem cell transplants involve two people: the (healthy) donor and the (patient) recipient. Allogeneic stem cell donors must have a tissue (HLA) type that matches the recipient. Matching is performed on the basis of variability at three or more loci of the (HLA) gene, and a perfect match at these loci is preferred. Even if there is a good match at these critical alleles, the recipient will require immunosuppressive medications to mitigate graft-versus-host disease (damage to recipient’s body).

For Bone marrow or peripheral blood stem cells, an autologous stem cell transplant requires the extraction of haematopoietic stem cells (HSC) from the patient and storage of the harvested cells in a freezer. The patient is then treated with high-dose chemotherapy, with or without radiotherapy, with the intent of eradicating the patient's malignant cell population at the cost of partial or complete bone marrow ablation (destruction of the ability of the patient's bone marrow to grow new blood cells). The patient's own stored stem cells are then returned to his/her body, where they replace destroyed tissue and resume the patient's normal blood cell production.
One advantage of autologous stem cell transplantation is that you are getting your own cells back. This means there is no risk that your immune system will reject the transplant or that the transplanted cells will attack or reject your body.
A possible disadvantage is that cancer cells may be harvested along with the stem cells and then put back into your body.
For cord blood stem cells, cord blood is processed and stored when the baby is born and the cells are used either for the baby later in life, or for a family member of the baby. Cord blood stem cells do not have this disadvantage since it is very rare for a baby to have cancer cells at birth.

Bone marrow is the flexible tissue found in the interior of bones. In humans, bone marrow in large bones produces new blood cells.

Cell viability is a determination of whether cells are living or dead, based on a total cell sample. The viability of cells is evaluated by either measurement of cell membrane integrity or by measuring certain functions of the cells from a total cell sample. For cord blood, normally the viability of cells is indicated by the viability of TNC (CD45+ cells), which is assessed by measurement of membrane integrity with a flow cytometer; however, there is no correlation of the viability of TNC and stem cells (CD34+ cells). The viability of CD34+ cells must, therefore, be assessed if the viability of TNC is low, since the viability of CD34+ cells is more accurate than the viability of TNC but cannot be performed routinely.

Chemotherapy (also called chemo) is a type of cancer treatment that uses drugs to destroy cancer cells.

This is the final product of cord blood that is left after processing, and which is banked for future transplantation. The component contains nucleated cells, including stem cells, and some red blood cells and plasma. The standard volume of the final product is about 22 millilitres. To obtain the best final product after processing, all or nearly all nucleated cells must be extracted from the processed whole blood, and there should be less contamination of the nucleated cells with red blood cells.

During cord blood processing, all red blood cells should be removed and only nucleated cells should be left in the final product of cord blood that is cryopreserved and stored for future transplant to treat patients. However, it is impossible to remove all red blood cells and in fact, red blood cells are always mixed with nucleated cells in the final product. The number of red blood cells in the final product depends on the quality of processing. The number of red blood cells, therefore, indicates the quality of processing (the fewer red blood cells, the better).

C-section stands for Caesarean section, which is a surgical procedure in which one or more incisions are made through a mother's abdomen and uterus to deliver one or more babies.

Cryopreservation is a process in which cells or whole tissues are preserved by cooling to sub-zero temperatures (< −180 °C). At these low temperatures, any biological activity, including the biochemical reactions that would lead to cell death, is effectively stopped.

Change from relatively generalized to specialized types during development.

DMSO is an organosulfur compound and is used as a cryoprotectant, a substance that is used to protect biological tissue from freezing damage. It is toxic to humans, so cryopreserved cord blood must be washed before being transplanted to a patient.  Washing may be done due to too many red blood cells left in the cord blood component or due to a large volume, which cannot be saved in one freezing bag.

This technique was developed by our Laboratory and Scientific Director (Dr. Yang) in 1996 and was published in Bone Marrow Transplantation in 2001. It was modified later and was published in Transfusion in 2011. Double processing is critical to ensure the quality of each cord blood sample. Using this technique, only 1/1000 samples yields lower than 80% and less than 5/100 samples yields less than 95%.

The process in which transplanted stem cells produce new cells.

Act of counting.

Transfusion. 2011 Feb;51(2):284-92. doi: 10.1111/j.1537-2995.2010.02826.x. Epub 2010 Aug 16.
Factors affecting banking quality of umbilical cord blood for transplantation.
Yang H, Loutfy MR, Mayerhofer S, Shuen P.

Source
Progenics Cord Blood Cryobank, Toronto, Ontario, Canada. hyang@progenicscryobank.com

Abstract

BACKGROUND:
The most important objective for cord blood banks is to store cord blood units of high quality, which is determined by total nucleated cells (TNCs) and CD34+ cells. Determining the factors affecting the stored life-saving cells would be beneficial to the field.

STUDY DESIGN AND METHODS:
A total of 4930 cord blood units were collected between January 2007 and October 2009 and processed using a double extraction technique to sediment red blood cells with variable centrifugation time determined by the formula CT = KL - M, where CT is centrifuge time, K is 7.7227, M is 29.742, and L is ln (volume of cord blood with anticoagulant). The recovery rate of TNCs and other relevant factors affecting banking quality were analyzed.

RESULTS:
The mean recovery rate of TNCs was 97.7 ± 2.5% with 0.04% (2/4930) units below 80% and 10.8% (532/4930) units below 95%. The TNCs per unit was affected by gestation duration (p < 0.01), sex of infant (p < 0.01), mode of delivery (p < 0.01), collection method (p < 0.01), and ethnicity (p < 0.001). The number of postprocessing CD34+ cells was affected only by sex of the infant (p < 0.05). The viability of nucleated cells after processing was 94.8 ± 4.8% and was affected by the number of hours between collection and processing (p < 0.01). In contrast, the viability of CD34+ cells was 99.5 ± 1.0% (n = 30) when samples with low viability of TNCs were assessed. The results did not reveal a significant correlation (r = 0.07, p = 0.38).

CONCLUSION:
The double extraction technique provides a high and consistent recovery of TNCs, which ensures that more life-saving cells will be banked for transplants.

GvHD is a common complication of allogeneic stem cell transplantation in which functional immune cells in the transplanted stem cells recognize the recipient as "foreign" and mount an immunologic attack on the transplant recipient's body.

GTA stands for Greater Toronto Area.

The hematocrit is the proportion of the blood, by volume, that consists of red blood cells. The hematocrit (hct) is expressed as a percentage.
For example, a hematocrit of 25% means that there are 25 millilitres of red blood cells in 100 millilitres of blood. A quarter of the blood consists of red blood cells. For cord blood, it refers to the volume of red blood cells as a percentage (%) that the cord blood component is contaminated with (the cord blood component is the portion that is banked for future transplantation).  

Ice is formed in the cells during warming, which is lethal for the cells.

This is the mother’s peripheral blood, which is drawn from the vein of an arm the same day that the baby is born, or within 7 days after the baby is born.

Next flight out is the highest level of courier service. It means the cord blood will be shipped on the next available flight and is completely different from “next day service,” which means cord blood will be shipped on the next day’s flight if the flight on the same day is missed, so there will be an additional 24 hour delay before cord blood arrives at the lab for processing. This will affect the viability significantly. Certainly next flight out service costs much more and may not be affordable for some clients; therefore, some banks offer a lower level of service. Progenics, however, will pay a portion of the fee for our clients in order to make the highest level of courier service more affordable. Quality is most important for you and Progenics!

This is a bag that is sealed around a freezing bag to protect cord blood stem cells from cross contamination by bacteria and viruses during long-term storage. 

Hematopoietic (blood-forming) stem cells are present in circulating (peripheral) blood. Normally there are not enough stem cells in circulating blood for a transplant. To obtain enough stem cells, the stem cells are lured out of the bone marrow by a special regimen of drugs. The blood is then filtered through a machine and the stem cells are skimmed off. The removal of the cells is termed pheresis or apheresis.

The placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply.

Capable of differentiating into one of many cell types.

The processing success rate is defined mainly by public cord blood banks to determine if the processed cord blood should be discarded. Private cord blood banks, which bank cord blood for family use, normally do not provide such information. Progenics defines processing success as a yield of TNC that is ≥80%. 80% is the average yield for most cord blood banks, implying that up to 50% of cord blood samples processed at those banks have a recovery rate of total nucleated cells that is <80%.  

Radiotherapy is the treatment of disease with ionizing radiation. It is also called radiation therapy. In radiotherapy, high-energy rays are often used to damage cancer cells and stop them from growing and dividing.

Self-renewal is the process by which stem cells divide to make more stem cells, perpetuating the stem cell pool throughout life. Self-renewal is division with maintenance of the undifferentiated state.

TNC includes all nucleated cells (white blood cells and nucleated red blood cells). Stem cells in cord blood are nucleated cells.

Gas phase of liquid nitrogen.

Yield of total nucleated cells (TNC) is also called the recovery rate of TNC. The yield of total nucleated cells is the percentage of TNC that is extracted during processing. The higher the yield, the better.

The yield of TNC is the most important processing quality indicator because it indicates how well a cord blood sample has been processed, regardless of the volume of the cord blood that was collected from the baby at birth.

Note: Total nucleated cells (TNC) are the most reliable indicator for a successful transplant (Moroff G et al. Transplantation and Cellular Engineering (2006) 46:507-515).