Two matching cord blood units were provided for transplant at no additional cost-saving lakhs of rupees for the family 

Community stem cell banking, LifeCell’s innovative initiative for the storage of cord blood stem cells has helped save the life of a seven-year-old suffering from aplastic anaemia – a rare and serious blood disorder in which the body stops making new red blood cells. 

It was two years ago that the child was diagnosed with aplastic anaemia. At the time of diagnosis, the doctors had suggested the need for a stem cell transplant as the best possible treatment in the future. Since the patient's parents were expecting another baby at the same time, on the medical recommendation, they decided to bank the sibling's umbilical cord blood stem cells with LifeCell’s Community banking. 

The child was recently admitted to Nashik’s well-known, LOTUS Institute of Haematology, Oncology and Bone Marrow Transplantation, and was in a very critical state. Despite receiving repeated platelet transfusions to control the bleeding, the health of the child kept deteriorating. Given the severity, the doctor advised an immediate stem cell transplant.

In such transplants, stem cells from a matched sibling or a related donor are preferably used. Unfortunately, when assessed, there was only a 50% (4/8) matchunacceptable for proceeding with the transplant. In absence of a suitable donor, transplantation using umbilical cord blood (UCB) stem cells from an unrelated donor has been a preferred fallback treatment strategy due to easier and rapid availability, and lower rates of complications (Graft versus host disease/GVHD)2

Community Stem Cell Banking Offers Hope 

While stem cells from the umbilical cord blood can be procured from global public banks, the probability of finding a match for a patient of Indian origin is less than 10% because of the low inventory of available units. Luckily, since the family was now part of LifeCell's community banking program, they could gain access to the huge inventory of over 50,000 units available at LifeCell which provide >97% probability of finding a match. Importantly, the parents could even withdraw the matched units at no additional expense, which otherwise would cost $45,000/unit for each withdrawal. 

As an additional hurdle for the transplant, the doctors recommended procuring not one but two cord blood units to meet the minimum cell dose requirement (for aplastic anaemia, cell dose requirement is greater than 40Mn/kg of body weight as opposed to a regular transplant which requires a cell dose of 25Mn/kg). 

Fortunately, when the parents placed a matching request at the LifeCell registry, two high-quality matches (⅞) were found, which fulfilled the requirement for UCB transplantation. Since the cord blood units retrieval process doesn’t require donor consent and the units are readily available, LifeCell promptly released and shipped two suitably matched cord blood units to the hospital. 

Interestingly, LifeCell’s community banking not only allows unlimited retrievals for the child's siblings but also protects the entire family including parents, and maternal & paternal grandparents. 

A Happy Beginning for the Child and the Family 

The child was able to receive a timely transplant thanks to the talented team of doctors and the prompt response by LifeCell. The initial outcome has been very encouraging with visible signs of improved quality of life. The doctors have been surprised at the speed of recovery following UCB transplantation. Just 18 days after the transplant, white blood cells have completely engrafted and platelets, and red blood cell production has also increased drastically. The child is now discharged from the hospital! 

Relieved and content with the speedy recovery of his child and pleasant experience with LifeCell, the father of the child was glad to have enrolled for the Community banking model. Witnessing the life-saving benefits of cord blood stem cells, he also makes it a point to educate and recommend others about this unique initiative. 

Also, this heart-warming story has been encouraging for the whole community! Not only did high-quality cord blood units expedited the recovery process but also this complex, double cord blood unit transplant was carried out at a low-volume transplant centre in a tier-two city. Commenting on this outcome, leading hemato-oncologist and transplant physician, Dr. Pritesh Junagade (Director, Lotus Hospital), said that he was pleasantly surprised that the retrieval process for two cord blood units was convenient and at no additional cost to the patient as compared to other banking models. Calling it a real social service, he is now a supporter of LifeCell’s community banking and would welcome the opportunity to further advance this initiative.  

Established in 2004, LifeCell is India’s first and largest stem cell bank, enjoying the trust of over 3,50,000+ parents who have banked their children’s stem cells with the company.

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References:

  1. de Latour RP, Purtill D, Ruggeri A, Sanz G, Michel G, Gandemer V, Maury S, Kurtzberg J, Bonfim C, Aljurf M, Gluckman E. Influence of nucleated cell dose on overall survival of unrelated cord blood transplantation for patients with severe acquired aplastic anemia: a study by eurocord and the aplastic anemia working party of the European group for blood and marrow transplantation. Biology of blood and marrow transplantation. 2011 Jan 1;17(1):78-85.
  2. Kindwall‐Keller TL, Ballen KK. Umbilical cord blood: The promise and the uncertainty. Stem Cells Translational Medicine. 2020 Oct;9(10):1153-62. 
  3. Ballen KK, Barker JN, Stewart SK, Greene MF, Lane TA. Collection and preservation of cord blood for personal use.
  4. Maiers M, Halagan M, Joshi S, Ballal HS, Jagannatthan L, Damodar S, Srinivasan P, Narayan S, Khattry N, Malhotra P, Minz RW. HLA match likelihoods for Indian patients seeking unrelated donor transplantation grafts: a population-based study. The Lancet Haematology. 2014 Nov 1;1(2):e57-63.