All stem cells are in one bank
According to international rulesMarina Astvatsaturyan, Mednovosti
The unified Russian blood stem cell donor Bank, the creation of which was first discussed this summer, will be opened in 2012. This decision was made by the Ministry of Health and Social Development. The bank will be a computer database that takes into account typed cell samples from different sources. It is the typed samples that are necessary for unrelated transplantation of hematopoietic cells.
Professor Alexander Rumyantsev, Director of the Federal Research and Clinical Center for Pediatric Hematology, Oncology and Immunology (FNCC DGOI), announced the creation of a Single blood stem cell donor bank at a press conference "The Future of Russian Medical Science" in RIA Novosti.
According to Professor Rumyantsev, according to the agreement with the Ministry of Health, such a bank will appear in 2012. Its central organ will be in St. Petersburg. All federal institutions that carry out transplantation or have blood banks will transfer their data to a common database.
The donor bank is a computer database that takes into account typed samples of cells suitable for transplantation to patients who need complete restoration of the hematopoiesis system and do not have a related donor compatible in a certain parameter (HLA–phenotype).
As a rule, patients with oncological and pathological diseases need hematopoietic cell transplantation. In particular, five thousand children get sick with blood cancer in Russia every year. Given certain conditions, and first of all, suitable donor material, 80 percent of them could be cured.
More than two million people are registered as voluntary bone marrow donors in the world. Since only a part of donors are fully typed by HLA, it is not always possible to contact the donor at the right time, and also due to the fact that various immunological, viral and hematopoietic checks are required, the period between the request and the actual transplantation can sometimes be more than six months. Finding a suitable bone marrow donor is an expensive and long way, and sometimes the patient does not live to see the transplant.
The need to create a single hematopoietic stem cell (HSC) donor bank on a Russian scale has been long overdue. Until now, potential donors of typed cells have been counted only by disparate regional (including commercial) donor registers.
What is typing?On the surface of almost all cells of the body there are protein molecules that are called antigens of the main histocompatibility complex (HLA – antigens, HLA – human leucocyte antigens, human leukocyte antigens).
The name HLA – antigens was given due to the fact that these molecules are most fully represented on the surface of leukocytes. Each person has an individual set of HLA antigens.
HLA molecules act as a kind of "antennas" on the cell surface, allowing the body to recognize its own and foreign cells (bacteria, viruses, cancer cells, etc.) and, if necessary, trigger an immune response that ensures the production of specific antibodies and the removal of a foreign agent from the body.
The individual combination of HLA antigens in a particular person is determined by the individual combination of HLA genes. To determine the compatibility of the donor and the patient in need of HSC transplantation, HLA typing is performed. For this purpose, blood is taken from a vein from a potential donor, leukocytes are isolated from this sample, and then the HLA phenotype is determined by PCR (polymerase chain reaction). According to these data, at the request of the recipient, it is possible to find suitable material for transplantation.
Three sourcesAs Professor Rumyantsev noted, "there are now small donor banks at medical institutions in Russia, in addition, some private banks harvest umbilical cord blood from which stem cells can be isolated."
But this material is not typed, and therefore cannot be considered as a reliable source for transplantation.
A single bank of stem cell donors will be replenished from various sources. One of them is volunteers, potential donors of hematopoietic stem cells, who provide samples of their blood for typing. These volunteers are not subject to the body weight restrictions that exist for plasma donors and shaped blood elements. Five milliliters of venous blood is enough to donate blood for typing, and this procedure is similar to a regular blood donation.
The second is the donors who come to the blood donation points. Professor Rumyantsev noted the particular importance of connecting all blood services that work to provide transfusion therapy in the country to the creation of a single bank of stem cell donors. Donors who come to donate blood will be offered to be examined with typing, and after that they will get into a common database.
The third is umbilical cord blood, which is collected in maternity hospitals. This is currently the main source of GSK. "Now there are two state-owned banks of umbilical cord stem cells in Russia, which are collected from women after childbirth in maternity hospitals in Moscow and Samara. There are about 10 thousand typed samples that can be used in transplantation," Rumyantsev explained. But in addition, the service of storing cord blood samples is offered by some commercial clinics. After defrosting, such samples can also be typed, and the data obtained can be transferred to a single bank.
The main disease that doctors fight with the help of cord blood is acute leukemia (47% of children and 20% of adults).
The Russian bank being created will have to cooperate with the international donor bank, which has about seven million cell samples. In this regard, it is planned to register it according to international rules, which should ensure the full integration of the domestic bank into the international system of hematopoietic cell donation and timely assistance to patients.
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15.12.2011