Title: Statistics of Autologous Cord Blood Storage and Use
1Statistics of AutologousCord Blood Storage and
Use
- J.J. Nietfeld, Ph.D.
- University Medical Center
- Utrecht, The Netherlands
- Frances Verter, Ph.D.
- www.ParentsGuideCordBlood.com
2Contents
- Introduction to authors
- Review of cord blood industry
- Inventory of stored cord blood in USA
- Previous opinions and estimates re usage
- Calculate lifetime probability of autologous
transplant - Forecast lifetime probability of autologous use
for regenerative medicine - Implications
3J.J. Nietfeld, Ph.D., Biography
- Biochemist Pathobiologist
- Associate Professor, UMC Utrecht, The Netherlands
- P.I. 2003 ZonMw report
- Desirability and feasability of a Personal Cell
Bank
Netherlands Report proposes 3-way split of
stored cord blood 1-
private portion 2-
public portion 3-
research portion
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5ParentsGuideCordBlood.com
- Mission Statement
- Impartial review of cord blood storage
options
6Website Readership
67,494 36.03 .net 38,656 23.51 .com
38,590 21.20 (numerical IP) 3,837
2.85 .br (Brazil) 4,338 2.81 .edu
(USA Edu) 1,930 1.24 .org (Non-Profits)
2,140 1.19 .de (Germany) 1,938
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(Australia) 2,468 1.03 .mx (Mexico)
14,716 8.03 ALL OTHERS
- Hits from over 70 foreign countries in the past
month - Average monthly hits over past year 158,933
7Types of Cord Blood Banks
8USA Cord Blood Inventory
9Investments in CB Banking
10Previous Opinions Against Autologous Cord Blood
Banking
- American College of Ob and Gyn (ACOG)
- 1997 Int J Gyn Ob, 58(2)257-259
- American Academy of Pediatrics
- July 1999 Pediatrics, 104116-118
- Royal College of Ob and Gyn
- Oct. 2001 Opinion Paper 2
- European Group on Ethics in Science and New
Technologies - March 2004 Opinion No.19
11Previously Published Chancesfor Autologous
Transplant Use
- 74 200,000 (lt 20 yrs) F.L. Johnson, 1997
J Ped Hem Onc 19(3) 183-186. (based on
statistics of diseases and treatments) - 1 20,000 ( lt 20 yrs)
- G.J. Annas, 1999 NEJM 340 1521-1524. (not
substantiated) - 1 10,000 1 200,000 (lifetime) R.M. Kline,
April 2001 Sci Amer 4 30-37. (not
substantiated)
12Lifetime storage of Cord Bloodsource of
autologous stem cells
- At 196 C it takes thousands of years for
- cosmic radiation to damage cells
- Cord Blood Transplants on adults have been
successful in clinical trials - Numerous companies are expanding cord blood
cell counts - Current research focus is speeding cord blood
engraftment
13Probability of an autologous transplant during
ones lifetime
-
- P is a function of n and p
- Where
- n maximum age for treatment
- p probability / year of autologous transplant
The probability P depends on a formula which the
authors wish to reserve until it is published.
14Data for North America 2002
15Autologous Transplant Lifetime Odds North
America 2002
- Probability P 0.25
- Using
- n maximum age for treatment 70
- p probability / year of autologous transplant
- ( autol. transplants per year) /
(population lt 70) - (10,500)/(290 million)
-
16Autologous Transplant Lifetime Chances up to age
70
Chance in
17Forecast of cord blood use for regenerative
medicine
- Given long shelf life of cord blood,
todays babies can use autologous cord blood for
future regenerative medicine - Auto CB carries advantages over Auto BM
- Stem cells have more plasticity (under study)
- No surgical harvest
- Lower cost (depending on storage time)
- Lifetime probability of diagnosis gives an
- UPPER LIMIT for treatment
18Example autologous stem cells for Cellular
Cardiomyoplasty
- ie stem cell
- transplantation
- for cardiac repair.
- Indications
- Myocardial
- Infarction,
- Congestive
- Heart Failure
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20Cellular Cardiomyoplasty Lifetime Odds USA 2001
- Probability P 14
-
- Example USA inpatient PCI up to age n75
- Yearly rate p (571,000/ 264,818,014) 0.002
- (Ref American Heart Association Statistics)
21 Probability per Lifetime
Autologous transplant
or
Diagnosis
22Implications
- Autologous cord blood storage outnumbers
- public donations and is growing faster.
- USA National Cord Blood Program will invest less
towards growth than private companies. - Correct probability of autologous stem cell use
is much higher than standard assumptions. - Regenerative medicine dramatically increases
opportunities for autologous use of stem cells. - Private cord blood banking is here to stay.
23Future harness private inventory for public good?
- Need 150,000 CB for all USA transplants
- (Ref Pablo Rubinstein, M.D., NYBC)
- Private banks will add that much to inventory in
less than 2 years. - Instead of the USA government funding
- a program of public banks ---
- Why not offer parents in private banks
- a REGISTRY OPTION?
- (with quality standards)