P63

Stem Cell and Immunotherapy Services, NHS Blood andTransplant, Birmingham, UKD. McDonald*, H. Deavall*, P. Moss�, J. Steele�, J. Thompson*

and V. Turner*

*National Blood Service, Birmingham, UK, �CRUK, Institute for

Cancer Studies, University of Birmingham, UK

Over 20 years ago, the Birmingham Blood Centre established a

facility for the cryopreservation of bone marrow (BM) for

patients in the West Midlands suffering from haematopoietic dis-

orders and for whom a bone marrow transplant was indicated.

Today, the use of mobilised peripheral blood (PBSC) has overta-

ken bone marrow as the source of stem cells for transplantation

and the numbers of patients benefitting and the diversity of con-

ditions being treated has increased enormously. Allogeneic trans-

plants, using stem cells from healthy donors, have become

increasingly successful as a result of an improving understanding

of the complexities of the HLA histocompatibility system. Addi-

tionally umbilical cord blood (HUC), which in the 1980s was

recognised as a source of stem cells, can now be collected and

used for transplantation. As scientific knowledge and the clinical

management of patients has advanced, so too have laboratory

methods for manipulating cell products to enrich or deplete cer-

tain cell populations (e.g. by CD34+cell selection) in order to

minimise potentially fatal graft-versus-host disease (GVHD) or

to eliminate tumour cells in the case of autologous patients.

Donor lymphocytes (DLI) may also be collected and used to aid

a graft-versus-leukaemia (GVL) effect. The laboratory is currently

developing protocols for immunotherapy using virus-specific T

cells which can be prepared and infused to combat potentially

fatal CMV disease post-transplant. Clinical trials of vaccines

employing tumour specific dendritic cells for treating patients

with hepatocellular carcinoma (HCC) and metastatic melanoma

(MM), which do not respond to conventional treatments, are also

underway. The advances and expansion in the Stem Cell and

Immunotherapy (SCI) service in Birmingham over the last

10 year period are reflected in the table below:

Year

Stem Cell Products received by

laboratory

Manipulated Stem Cell

Products

Total BM PBSC HUC Auto Allo CD34+ selection DLI

1995 409 76 333 0 400 9 2 1

2005 670 16 654 10 546 124 20 40

The laboratory is fully accredited by the Human Tissue Author-

ity (HTA), MHRA and JACIE. It occupies new purpose built

facilities with the most up to date equipment. Patients in the

West Midlands awaiting an haematopoietic stem cell transplant

or cellular therapy can be assured of receiving treatment equiva-

lent to the best that is available anywhere in the world.

P64

NHS Cord Blood Bank: Microbiological ScreeningResults of Cord Blood DonationsJ. Ellis*, C. Biggs�, S. Armitage*, C. McDonald� and

M. Contreras*

*NHS Cord Blood Bank, National Blood Service, Edgware, UK,

�National Bacteriology Laboratory, National Blood Service, Colin-

dale, UK

Following the world’s first umbilical cord blood transplant per-

formed by Gluckman et al in 1988, the NHS Cord Blood Bank

(NHS-CBB) was established in 1996 with the primary aim to

redress the ethnic imbalance of donors represented on the British

Bone Marrow Registry. The NHS-CBB collects cord blood fol-

lowing delivery of the placenta at a stage where it is considered a

waste product. This allows thorough decontamination of the

umbilical cord prior to venepuncture. All processing is performed

in a closed system or in a cleanroom environment. Microbiologi-

cal screening of all cord blood units is performed on the final

product for aerobic, anaerobic and fungal contaminants, prior to

cryopreservation. Contamination rate for the first year of bank-

ing was 10.5%. This high rate initiated development and valida-

tion of a new cleaning protocol in conjunction with the National

Bacteriology Laboratory (NBL). Following the introduction of

this system in March 1997 contamination rates subsequently

decreased to a median 0.8%. Species identification has elucidated

that 54.4% of contaminants were skin flora. Regular quality

monitoring of collection and processing indicates that the major

source of contamination is at collection. In comparison, contami-

nation of red blood cell collections within the NBS has been

found to be approximately 0.08%. This difference may be

explained by the inherent difficulties in decontaminating an entire

umbilical cord attached to the suspended placenta, use of a wider

bore needle and inclusion of the umbilical cord core sample into

the collection bag. The NHS-CBB has issued three bacteriology

positive units for transplantation (2.4% of total units issued) with

no adverse events reported. In line with current international

cord blood banking standards, the CBB now discards all micro-

bial positive donations. Collaboration with the NBL enables the

CBB to monitor contamination rates, minimise contamination,

thereby maximising efficiency and reduction of wastage.

P65

National Blood Service Directed Sibling Cord BloodBanking for TransplantationJ. Smythe, S. Armitage, D. McDonald, D. Pamphilon, A. Green,

M. Guttridge, C. Navarette, R. M. Warwick, C. Brown,

D. Briggs, A. Lankester, M. Contreras and S. M. Watt

National Blood Service, NHS Blood and Transplant, UK

Umbilical cord blood (UCB) is an important source of stem cells

for transplantation and may cause less GvHD than non-T-depleted

bone marrow (BM). Only 25% of paediatric patients have an HLA

matched sibling and for the remainder an unrelated BM or UCB

donation may also not be available. A directed UCB (DCB) collec-

tion from a newborn sibling may be the only opportunity for a

transplant until the sibling can donate BM. Matched DCB dona-

tions have been shown to give better long-term results than

matched unrelated UCB or BM but DCB collection is not as easy

to control as unrelated banking in hospitals established as collec-

tion sites. In the context of mandatory licensing under the Eur-

opean Union Tissues and Cells Directive introduced in April 2006,

we have reviewed NBS DCB banking. Over ten years, 268 DCB

collections were made, 233 (87%) for an existing sibling with a dis-

ease treatable by transplantation, and the remainder for families

with a history of an inherited high risk disease. Diagnoses included

114 haematological malignancies, 68 hereditary anaemias and 53

immune or metabolic deficiencies. Collections were cryopreserved

within 24 h without volume reduction.

Volume

mL

Total TNC

·108Total CD34

·106TNC

Viability %

Median 73 8.8 2.3 99.0

Mean ± S.D. 76 ± 32 9.9 ± 5.5 3.3 ± 3.4 98.2 +3.7

Range 14–173 1.0–31.0 0.13–26.7 73.0–100.0

52 Poster Sessions – Stem Cells and Tissue Banking