Statistics of Autologous Cord Blood Storage and Use

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Statistics of AutologousCord Blood Storage and
Use

• J.J. Nietfeld, Ph.D.
• University Medical Center
• Utrecht, The Netherlands
• Frances Verter, Ph.D.
• www.ParentsGuideCordBlood.com

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Contents

• 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

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J.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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ParentsGuideCordBlood.com

• Mission Statement
• Impartial review of cord blood storage
  options

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Website 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
1.06 .ca (Canada) 1,942 1.05 .au
(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

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Types of Cord Blood Banks
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USA Cord Blood Inventory
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Investments in CB Banking
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Previous 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

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Previously 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)

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Lifetime 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

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Probability 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.
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Data for North America 2002
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Autologous 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)

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Autologous Transplant Lifetime Chances up to age
70
Chance in
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Forecast 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

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Example autologous stem cells for Cellular
Cardiomyoplasty

• ie stem cell
• transplantation
• for cardiac repair.
• Indications
• Myocardial
• Infarction,
• Congestive
• Heart Failure

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Cellular 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)

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Probability per Lifetime
Autologous transplant
or
Diagnosis
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Implications

• 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.

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Future 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)