- In what way are the umbilical cord blood stem cells different from the umbilical cord stem cells?
The umbilical cord blood stem cells carry predominantly Hematopoietic stem cells (HSCs). These cells are unspecialized and Blood Forming by nature. They generally give rise to blood forming cells like Red blood cells (RBCs), White Blood Cells (RBCs), Platelets etc. Recent research shows that in suitable conditions they have the ability to change their lineage i.e. though they are blood forming they can give rise to variety of tissues. This means Hematopoietic (blood forming) stem cells may form heart tissue or lung tissue when subjected to suitable conditions, thus opening up a plethora of applications of stem cells in treatment of various disorders.
Umbilical cord lining contains a jelly like substance supporting the umbilical vein & arteries. This is called Wharton’s jelly. It is an extremely rich source of Mesenchymal Stem Cells (MSCs). These Mesenchymal stem cells possess an extensive proliferative potential and ability to differentiate into various cell types. Thus, they play pivotal roles in the formation of nerves, muscles, fat, blood vessels, bones, cartilage and various vital organs of the body. This explains the wide scope of mesenchymal stem cells in various degenerative disorders.
- How are umbilical cord stem cells different from bone marrow stem cells?
Umbilical cord blood stem cells carry a distinct & significant advantage over bone marrow stem cells for the following reasons:
- Umbilical cord blood stem cells are easy to collect, non-invasive and painless as compared to bones marrow stem cells.
- Umbilical cord blood stem cells are younger and undifferentiated as compared to bone marrow stem cells; hence there is a higher rate of engraftment.
- Umbilical cord blood stem cells when used for transplant result in lower rate of GvHD (graft vs host disease) which is one of the major causes of transplant failure.
- Umbilical cord blood stem cells are rarely contaminated with latent viruses and hence considered non infectious.
- Umbilical cord stem cells are young, naïve, primitive and unexposed to any disorders as opposed to bone marrow stem cells that would have withstood various diseases dusing the lifespan of the individual.
- Almost 70% of patients needing a bone marrow transplant are unable to find a donor using donor registries. This problem does not arise in umbilical cord blood transplant since recent reports of unmatched cord blood being used for transplantation has shown success.
- What is HLA-matching?
HLA-matching is the criteria used to determine the compatibility between the recipient and the donor. It refers to six proteins present that appear on the surface of white blood cells and other tissues in the body. A transplant can only be performed if at least 3 of the 6 proteins match.
When two people share the same Human Leukocyte Antigens (abbreviated as HLA), they are said to be a “match”, i.e. their tissues are immunologically compatible with each other. There is a basic rule in HLA inheritance. The rule mentions that there is a 25% possibility of an identical match amongst siblings.
- What is Graft-versus-Host-disease?
Graft-versus-host disease (GvHD) is a common complication any stem cell transplant. In case of bone marrow transplantation the immune cells from the transplanted marrow recognize the recipient as "foreign" and mount an immunological attack. In effect the body rejects the transplanted stem cells. Cord blood transplants have a reduced incidence of GvHD because the immune cells within the cord blood are less reactive as compared to stem cells derived from other sources. By using your own stem cells there is no chance of GvHD.
Graft-versus-host-disease (GvHD) is characterized by selective damage to the liver, skin and mucosa, and the gastrointestinal tract. In acute cases it can also cause death.
- What is the meaning of viability and potency of stem cells?
“Viability” means “being alive” hence points to the ability of stem cells to withstand processing and storage. The quantum or success of viability is determined by measuring the number of “living” stem cells after processing. The concept of “viability” also assumes tremendous significance at the time of retrieval of stem cells, post the thawing process. Hence the importance of viability works as an indirect testimony of the quality of processing and storage of stem cells, a pedigree that Ree is proud of.
Potency by definition means the strength or power of stem cells to successfully assume roles that are assigned to them. Being an assessment of the caliber of the processing facility, Ree with this careful, concerted approach towards isolation, processing and storage of stem cells is committed to accomplish the all important parameters required for successful transplants and hence guarantee maximum potency of stem cells. The extent of potency is determined by:
- Capacity of the procured stem cells for extensive proliferation and multiplication.
- Differentiation into desired cell type or tissue.
- Integrate into surrounding tissue after transplant.
- Function well for approximately the duration of the recipient’s life.
- Avoid harming the recipient in any way.
- Is it necessary to bank both the umbilical cord as well as the umbilical cord blood stem cells?
It is beneficial to bank both cord and cord blood due to the virtue of different type of stem cells they can provide. While cord blood is rich in Hematopoietic stem cells or HSCs, cord lining is rich in Mesenchymal stem cells or MSCs .The further classification of stem cells depend upon the surface markers that the family of both HSCs and MSCs possess. The markers of relevant in current clinical practice are:
Hematopoeitic Stem Cells [HSC] family: CD34+; CD45; CD133
Mesenchymal stem cell [MSC]: CD73; CD90; CD106.
Further the vessels within the Warthon’s jelly provide a rich source of vascular endothelial precursor stem cells that promote formation of new blood vessels.
Hence all these stem cells in unison, forge an exceptional combination and in doing so play a pivotal role in providing protection to patients against an array of congenital, degenerative and malignant diseases. In nutshell if a person can afford then he should bank all types of available stem cells as health insurance.
- Will the stored stem cells be able to help the rest of my family?
Stem cells banked are form of health insurance in providing protection to patients against an array of congenital, developmental, malignant and degenerative disorders. The possibility of obtaining a match for the affected sibling is obviously higher. Further the chances of procuring the right match for a near or distant relative is also present, given the fact that the family would have a similar genetic configuration. Given the immunological naivety of stem cells from cord Blood, the chances of successful engraftment are higher compared to bone marrow. Researchers say using stem cells from cord blood with a 3/5 or even a 2/5 match could lead to successful transplantation and hence optimize the use of stem cells for the entire family. There have also been cases of using totally unmatched cord blood, with wonderful results.
- How long can the stem cells be preserved?
The stem cells are currently preserved for a period of 21 years. The contract is renewable after the said period. This practice is followed all over the globe; provided the cells are stored in cryogenic conditions with full-proof liquid nitrogen back up systems. Researchers are now investigating the possibility of storing stem cells for longer periods, possibly indefinitely under optimum storage conditions. However, the validation of the process can only occur once the period of storage exceeds 21 years. The oldest cord blood bank is approximately only 12 years old.
- What happens to the stem cells if I do not require them during the 20 year storage period?
Stem cells are essentially stored for a period of 21 years by most cord blood banks. The advent of exhaustive research indicates that there is a fair possibility of requiring stem cells if you do bank them. Even if u haven’t banked stem cells there is a strong possibility of requiring stem cell therapy at some stage in life, especially in degenerative disorders. However incase, for whatever reason your banked stem cells are not retrieved in the 20 year storage period, the option of extending the tenure is provided at a prescribed fee prevailing at that time. At this stage, the ownership of stem cells shall be legally transferred to the child.
- What is the possibility of requiring stem cells if I bank them?
With the advent of exhaustive research in the field of stem cell medicine, there is an ample possibility of requiring the banked stem cells. At this moment, there is established application of stem cells in numerous bone marrow (leukemia, thallasemia, sickle cell disease etc.), metabolic and storage disorders (Gaucher’s disease, Neuman Pick’s disease etc). However, dispute tall claims by most cord blood banks, admittedly there is at best a mild possibility of the child or his family suffering from these disorders and requiring stem cells for the purpose. However, recent research has shown promise with notable stem cell applications in host of chronic, degenerative, malignant disorders and “numerous no hope diseases” viz. Diabetes, Chronic Lung Disease, Osteoarthritis, Spinal Cord Injuries, Stroke, Parkinson’s Disease, Alzheimer’s disease, ALS, Multiple sclerosis, Dystrophies, Non-Healing Fractures of bone, Liver Cirrhosis and many more and with passage of time their role is bound to be more and more pronounced if not indispensible. Ree with help of ReeCure, shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate therapy this professionally.
- What happens to the cord and cord blood after it is collected?
- Do you test the cord and cord blood for infections? if so, is there any additional cost involved?
- HIV I & II by ELIZA and PCR
- HBSAG (Hepatitis B) by ELIZA and PCR
- HCV (Hepatitis C) by ELIZA and PCR
- CMV
- Syphillis
- Blood Culture for infection
- Malaria
- Rh grouping/Typing
After the processing and before cry-opreservation part of the sample is tested for (using a in-house Flow Cytometer):
- Mononuclear count
- CD34+ counts and Mesenchymal Cell Counts
- Cell viability
HLA typing can be performed at the clients request for an additional cost at the time of processing.
- Are my baby’s stem cells being stored in vials or bags?
Ree has the facility to store cord blood in either vials or blood bags. Each has advantages and disadvantages and, there's no scientific research proving that one method is better than the other. The main advantage of using blood bags is that the same bag is used to collect and store the cord blood. This limits blood handling and, therefore, possible contamination. Other experts say that blood bags can break during long-term storage. Vials are less likely to break and they seal cord blood in two layers of protection, reducing the chances of contamination by viruses.
Ree Cord stores stem cells in multiple vials or compartmentalized bags, rather than a single vial or bag. This storage procedure gives you the potential to use your baby's cord blood on more than one occasion. If you choose multiple-vial or compartmented-bag storage today, you may someday be able to use the cord blood from one child to treat multiple people and diseases if the expansion techniques are perfected over a period of time.
- What is ReeCure?
ReeCure is one indispensable arm of ReeLabs that has conclusively ventured into evaluating the prospects of application of stem cells in a wide array of disorders ranging from haematological, developmental and degenerative ones. Special emphasis is on application of stem cells in regenerative medicine.
- What are Degenerative Disorders?
Degenerative disorders are disorders that arise from degeneration or wear and tear of bone, cartilage, muscle, fat or any other tissue, cell or organ. This could occur due to a variety of reasons with the biological aging process being the biggest culprit. The disorders have a slow and insidious onset but once contracted can be long-standing, pain-staking and lifelong. These disorders can affect any organ of the body. The common degenerative disorders are diabetes, osteoarthritis, stroke, chronic renal failure, congestive cardiac failure, myocardial infarction, Alzheimer’s disease, Parkinson’s disease etc.
- What is the role of stem cells in regeneration of Degenerative Disorders?
Stem cells have an integral, indispensable role in many common Degenerative disorders that have afflicted mankind since ages. They have a logical application in the healing process of these disorders by virtue of the properties of homing, plasticity and engraftment they possess. Homing means the ability of stem cells to reach the site of injury; plasticity means ability of stem cells to transform into the parent tissue or organ and engraftment means the ability to appropriately integrate with the parent tissue or organ. Thus the damaged organ or tissue can be potentially treated with stem cell therapies.
- How shall ReeCure help me in therapy?
ReeCure has pioneered its own comprehensive treatment protocols that look at providing “curative” as opposed to “supportive” therapies and has provided “hope” in many no “hope disorders”. Before administering stem cell therapy the patient’s medical history is thoroughly studied by an eminent panel of doctors with few pertinent eligibility criteria that need to be met. Thereafter, once the application of stem cell therapy is determined, the patient is appropriately counselled by our doctors regarding the correct dose, mode and duration of administration and more specifically time lines between administration of stem cell therapy and achieving favourable results. Further, ReeCure shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate therapy.
- Is it possible to get stem cell therapy from ReeCure even if I am not from India and cannot come to India for therapy?
Yes, it is possible to get stem cell therapy even if the patient cannot come down to India for the same. However, to successfully accomplish the stem cell therapy, one need to first get in touch with ReeCure and furnish all relevant details and investigations regarding his/her illness. This could be done via our website or post. Next, our eminent panel of doctors shall evaluate the possibility of using stem cells in the patient for the illness in question. After satisfactorily consensus on the same by ReeCure, the patient’s doctor (whoever he is and wherever he is located) shall be comprehensively educated about the impending stem cell therapy before he can administer the same to you. The relevant stem cells shall be sent to the patient’s location using specifically cryo-shippers for stem cell therapy. In the unlikely scenario of the patient not having his own personal physician and also cannot come to India for therapy, ReeCure shall try and make all possible efforts to provide the contact of a doctor closest to his place of stay.
- What are the disorders that have been treated by ReeCure?
ReeCure has the unbeatable track record of actually having provided stem cell therapy to a variety of disorders with excellent results. The diseases treated by ReeCure using stem cells are Cerebral Palsy, Duchene Muscular Dystrophy, Chronic Renal Failure, Diabetes, Rheumatic Arthritis, Osteoarthritis, Spinal Cord Injury, Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, Motor Neuron disease, Spinal Muscular Atrophy, Post encephalitis cerebral atrophy, liver cirrhosis, anti-aging etc.
- What is special about stem cell therapy instituted by ReeCure?
ReeCure’s patient care and cure proprietary treatment protocols are cutting edge, employing the latest, most effective techniques by various experts and specialists considered leaders in their fields. All this has been achieved after thorough, exhaustive research and numerous case studies (through its research division) over many years. The type, dosage and mode of administration of stem cells is decided after thorough deliberations, detailed medical history and meticulous counselling of patients. ReeCure has specially emphasized on providing safe, effective stem cell treatments to the hitherto incurable congenital, developmental and degenerative disorders viz. Cerebral Palsy, Muscular Dystrophy, Spinal cord injuries, multiple Sclerosis, ALS, stroke, osteoarthritis, congestive cardiac failures, chronic real failures, liver cirrhosis, diabetes etc. The ReeCure “Stem Cell Improvement System” has ensured the finest yield, quality, viability and potency of stem cells irrespective of its source. The results of stem cell therapies have thus instituted have ranged from “good and satisfactory” to “fascinating and unbelievable.”
- What is the advantage of taking stem cell therapy from ReeCure?
Stem cells offered by ReeCure are essentially safe, non-toxic, devoid of side effects and easy to administer while maximising its beneficial effects in repair and regeneration of the cell, tissue or organ. ReeCure uses proprietary technology to segregate stem cells from various sources like the bone marrow, cord blood, amniotic fluid, fat, bloodstream etc. A relevant certificate of analysis (COA) mentioning all details of stem cells is handed out prior to any transplant. Further each and every stem cell sample (in case of allogenic or unrelated transplant) is screened by Polymerase chain reaction (PCR) to neutralise the ubiquitous errors by conventional ELIZA systems in identifying window periods for HIV or Hepatitis infections and make transplants safe and convenient to unsuspecting patients. Most importantly ReeCure’s unique, proprietary treatment protocols have met with resounding success with numerous success stories to demonstrate. ReeCure’s unbeatable track record with success in over 500 diverse cases using stem cell therapy has only enhanced the company’s credibility as a global leader in this field.
- What are the various sources of stem cells offered by ReeCure?
In order of preference ReeCure advocates umbilical cord, cord blood and placental stem cells over autologous stem cells derived from sources like bone marrow, adipose tissue, peripheral blood, skin, cornea (limbus), small intestine, liver etc. However, the final decision is sought after comprehensively studying and deliberating the patients medical history. Hence the choice of stem cells, their dose, the exact route of administration and source of the same is pragmatically decided on case to case basis. Stem cells offered by Ree in the case of unrelated transplants are selectively immunodepleted (devoid of antigenic or disease producing potential and rendering the HLA impotent and ineffective) using its proprietary technology. These cells can be safely utilized for the entire gamut of disorders without any possibility of side effects or GvHD. Further, this is achieved without compromising the core function of stem cells and in fact optimising its beneficial effect in repair and regeneration of the affected cell, tissue or organ. This ensures successful unmatched stem cell therapies and in doing so exploit its usage manifold. Over 500 patients have been administered such unrelated stem cell therapies with excellent results and absolutely no side effects.
- Who are the doctors associated with Reecure?
The professionals at ReeCure represent more than a dozen different disciplines, including, but not limited to General Practitioners, Physicians, Neurologists, Cardiologists, Orthopaedic Surgeons, Paediatricians and General Surgeons. Early identification, intervention and treatment are essential in maximising the effect of stem cells therapies in these disorders, helping to prevent major problems in the future and avoiding lifelong expensive yet ineffective care. ReeCure offers proven therapies that attempts to first cure the patients of his disorder or if not then minimise the adverse impact of the disorder during his lifetime and improve quality of life manifold.
- What are the advantages of treatments with ReeCure?
Treatment offered by ReeCure is safe, easy to administer and speedy; most often completed in just a day or two. Yet, results are far better than the "long and ineffective" conventional therapies. Special emphasis is laid on for treatments in "no hope" or incurable diseases with absolutely no existing therapy. Further ReeCure has successfully provided the much desired "hope" in these numerous "no hope" disorders. ReeCure believes in "curative" as opposed to "supportive therapy" with enough justification.
- Can ReeCure provide its success stories?
ReeCure has treated various disorders using stem cells with resounding success. Few relevant success stories amongst many are enumerated below: A known case of Diabetes since last 12 years with concurrent congestive cardiac failure who improved tremendously with our stem cells therapies. He is totally off all medications and sugar controlled since past six months (blood sugar, fasting and post lunch less than 100 mg %) and his ejection fraction has increased from 20% to 60%. In all 15 out of 20 patients of Diabetes have responded magnificently to stem cell therapy and are totally off insulin therapy. A patient of Spinal Cord Injury who was totally in a vegetative state. He was given stem cells and his reflexes, deep pain and bladder/bowel control has significantly improved. Two patients of Chronic Renal Failure have significantly improved with their creatinine levels falling to 1.2 and 1.4 from 4 and 3.8 respectively. They are totally off dialysis. Ten patients of Duchenne’s Muscular Dystrophy have improved substantially with improved motor and sensory functions. The tone and reflexes have also improved substantially. Two patients of Rheumatoid Arthritis have improved tremendously after stem cell therapy. Their joint pain has reduced substantially, RA factor has become negative and rheumatic nodules disappeared from various locations in the body. Three patients of Cerebral palsy have also significantly improved with our stem cells with improved sensory, motor and cognitive skills. The results shall also be showcased in notable national and international publications in times to come. Few of our testimonials are already showcased on our website.
- Would it be possible to have a first hand account of patients who have benefited from ReeCure?
Yes, it would also be possible to meet/interact/correspond with the patients that have benefited with stem cell therapies offered by ReeCure. A prior appointment and/or notification shall be required to avoid any form of inconvenience to either. Do write to us at info@reelabs.com to enable us to facilitate the correspondence.
- Will my family really need stem cell therapy in future?
There is a remote possibility of requirement of stem cells for a bone marrow, metabolic or storage disorder. The satisfying outcome of stems in these conditions having been more or less ascertained, the emphasis has shifted in closely observing applications in other pertinent medical disorders, many of which have already been classified as “no hope diseases”. These disorders range from numerous congenital or neurodegenerative diseases like Multiple Sclerosis, ALS, Muscular Dystrophies to the more familiar and commonly occurring disorders like Stroke, Diabetes, Myocardial Infarctions, Osteoarthritis, Liver Cirrhosis etc. Years of extensive research have started yielding extremely encouraging results and stem cells have finally provided conclusive signs of assuming their rightful spot at the acme of clinical medicine. There is now a paradigm shift in the conceptualization of stem cell therapies by many researchers, doctors and scientists due to its significant impact in reversing many disease processes. The application of stem cells in disorders with no available treatment, like in the case of spinal cord injuries due to say vehicular accidents is especially noteworthy. Stem cell therapies in other prominent disorders with effective conventional therapies have also produced excellent results when used independently or in combination. The most heartening fact is that these stem cells are non-toxic and devoid of side effects compared to their toxic drug counterparts viz. medications, antibiotics, steroids and chemotherapeutic agents routinely used in medical practice, making its transplantation very safe and convenient.
- How do you measure the quality of stem cells?
After the processing and before cry-opreservation part of the sample is tested for:
- Mononuclear (MNC) count
- Absolute CD34+ count
- Mesenchymal Cell Count
- Stem cell Cell viability
These studies are carried out on an in house Flow Cytometer which gives accurate results.
A preservation certificate or Certificate of analysis which mentions all the results is sent to the mother within 15 to 20 days of processing the sample.
- Where and how are the stem cells stored?
The samples of stem cells bear barcoded cryolabels which include an identifier code, mother's name, date of storage and assigned inventory number. The accompanying software aids in tracking of samples during retrieval.
The stem cells are stored in vacuum insulated Liquid Nitrogen containers filled with ample amount of liquid Nitrogen specifically designed to withstand cryogenic conditions for long durations. The storage can be in 5 ml vials or multi-compartmentalized cryobags.
The cry-opreservation is strictly maintained at controlled temperatures using liquid nitrogen (-196 deg℃) or its vapour (-175 deg℃)
Ree have employed the universally prevalent and AABB approved vapour phase as the desired mode for storage of samples.
The liquid nitrogen levels are monitored with the help of requisite alarm systems and daily temperatures are carefully recorded using computerized data loggers. The tanks are replenished at regular intervals and are also equipped with inherent liquid nitrogen back up systems.
- Why should I trust Ree ?
The strength of any organization is determined by quality of the facility and caliber of the workforce, both aspects that Ree are extremely proud of. Ree has set up its state of the art cord & cord blood processing lab with the latest and most sophisticated technology in the heart of Mumbai. The laboratory is manned by a well qualified, highly competent and skilled staff 24 hours a day, 7 days a week to receive and process cord blood specimens. Secondly, one look at the list of founders, promoters and directors of the company is adequate to instill confidence into the consumer. The promoters collectively have a remarkable track record in pharmaceuticals, FMCG, Pathology, Blood banking and clinical research, fields that have a close relation to the field of stem blood banking, research and therapy. The company is debt free with no encumbrances. Also Ree, unlike its competitors has endeavored to comprehensively encompass all aspects of this fascinating field including both stem cell banking (through ReeCord) and treatment (through ReeCure). Further, Ree with the able assistance of an outstanding panel of doctors, scientists and researchers is committed to carry the baton of stem cell research and therapy forward.
- In what way are the umbilical cord blood stem cells different from the umbilical cord stem cells?
The umbilical cord blood stem cells carry predominantly Hematopoietic stem cells (HSCs). These cells are unspecialized and Blood Forming by nature. They generally give rise to blood forming cells like Red blood cells (RBCs), White Blood Cells (RBCs), Platelets etc. Recent research shows that in suitable conditions they have the ability to change their lineage i.e. though they are blood forming they can give rise to variety of tissues. This means Hematopoietic (blood forming) stem cells may form heart tissue or lung tissue when subjected to suitable conditions, thus opening up a plethora of applications of stem cells in treatment of various disorders.
Umbilical cord lining contains a jelly like substance supporting the umbilical vein & arteries. This is called Wharton’s jelly. It is an extremely rich source of Mesenchymal Stem Cells (MSCs). These Mesenchymal stem cells possess an extensive proliferative potential and ability to differentiate into various cell types. Thus, they play pivotal roles in the formation of nerves, muscles, fat, blood vessels, bones, cartilage and various vital organs of the body. This explains the wide scope of mesenchymal stem cells in various degenerative disorders.
- How are umbilical cord stem cells different from bone marrow stem cells?
Umbilical cord blood stem cells carry a distinct & significant advantage over bone marrow stem cells for the following reasons:
- Umbilical cord blood stem cells are easy to collect, non-invasive and painless as compared to bones marrow stem cells.
- Umbilical cord blood stem cells are younger and undifferentiated as compared to bone marrow stem cells; hence there is a higher rate of engraftment.
- Umbilical cord blood stem cells when used for transplant result in lower rate of GvHD (graft-vs-host disease) which is one of the major causes of transplant failure.
- Umbilical cord blood stem cells are rarely contaminated with latent viruses and hence considered non-infectious.
- Umbilical cord stem cells are young, naïve, primitive and unexposed to any disorders as opposed to bone marrow stem cells that would have withstood various diseases during the lifespan of the individual.
- Almost 70% of patients needing a bone marrow transplant are unable to find a donor using donor registries. This problem does not arise in umbilical cord blood transplant since recent reports of unmatched cord blood being used for transplantation has shown success.
- What is HLA-matching?
HLA-matching is the criteria used to determine the compatibility between the recipient and the donor. It refers to six proteins present that appear on the surface of white blood cells and other tissues in the body. A transplant can only be performed if at least 3 of the 6 proteins match.
When two people share the same Human Leukocyte Antigens (abbreviated as HLA), they are said to be a “match”, i.e. their tissues are immunologically compatible with each other. There is a basic rule in HLA inheritance. The rule mentions that there is a 25% possibility of an identical match amongst siblings.
- What is Graft-versus-Host-disease?
Graft-versus-host disease (GvHD) is a common complication any stem cell transplant. In case of bone marrow transplantation the immune cells from the transplanted marrow recognize the recipient as "foreign" and mount an immunological attack. In effect the body rejects the transplanted stem cells. Cord blood transplants have a reduced incidence of GvHD because the immune cells within the cord blood are less reactive as compared to stem cells derived from other sources. By using your own stem cells there is no chance of GvHD.
Graft-versus-host-disease (GvHD) is characterized by selective damage to the liver, skin and mucosa, and the gastrointestinal tract. In acute cases it can also cause death.
- What is the meaning of viability and potency of stem cells?
“Viability” means “being alive” hence points to the ability of stem cells to withstand processing and storage. The quantum or success of viability is determined by measuring the number of “living” stem cells after processing. The concept of “viability” also assumes tremendous significance at the time of retrieval of stem cells, post the thawing process. Hence the importance of viability works as an indirect testimony of the quality of processing and storage of stem cells, a pedigree that Ree is proud of.
Potency by definition means the strength or power of stem cells to successfully assume roles that are assigned to them. Being an assessment of the caliber of the processing facility, Ree with this careful, concerted approach towards isolation, processing and storage of stem cells is committed to accomplish the all important parameters required for successful transplants and hence guarantee maximum potency of stem cells. The extent of potency is determined by:
- Capacity of the procured stem cells for extensive proliferation and multiplication.
- Differentiation into desired cell type or tissue.
- Integrate into surrounding tissue after transplant.
- Function well for approximately the duration of the recipient’s life.
- Avoid harming the recipient in any way.
- Is it necessary to bank both the umbilical cord as well as the umbilical cord blood stem cells?
It is beneficial to bank both cord and cord blood due to the virtue of different type of stem cells they can provide. While cord blood is rich in Hematopoietic stem cells or HSCs, cord lining is rich in Mesenchymal stem cells or MSCs .The further classification of stem cells depend upon the surface markers that the family of both HSCs and MSCs possess. The markers of relevant in current clinical practice are:
Hematopoeitic Stem Cells [HSC] family: CD34+; CD45; CD133
Mesenchymal stem cell [MSC]: CD73; CD90; CD106.
Further the vessels within the Warthon’s jelly provide a rich source of vascular endothelial precursor stem cells that promote formation of new blood vessels.
Hence all these stem cells in unison, forge an exceptional combination and in doing so play a pivotal role in providing protection to patients against an array of congenital, degenerative and malignant diseases. In nutshell if a person can afford then he should bank all types of available stem cells as health insurance.
- Will the stored stem cells be able to help the rest of my family?
Stem cells banked are form of health insurance in providing protection to patients against an array of congenital, developmental, malignant and degenerative disorders. The possibility of obtaining a match for the affected sibling is obviously higher. Further the chances of procuring the right match for a near or distant relative is also present, given the fact that the family would have a similar genetic configuration. Given the immunological naivety of stem cells from cord Blood, the chances of successful engraftment are higher compared to bone marrow. Researchers say using stem cells from cord blood with a 3/5 or even a 2/5 match could lead to successful transplantation and hence optimize the use of stem cells for the entire family. There have also been cases of using totally unmatched cord blood, with wonderful results.
- How long can the stem cells be preserved?
The stem cells are currently preserved for a period of 21 years. The contract is renewable after the said period. This practice is followed all over the globe; provided the cells are stored in cryogenic conditions with full-proof liquid nitrogen back up systems. Researchers are now investigating the possibility of storing stem cells for longer periods, possibly indefinitely under optimum storage conditions. However, the validation of the process can only occur once the period of storage exceeds 21 years. The oldest cord blood bank is approximately only 12 years old.
- What happens to the stem cells if I do not require them during the 20 year storage period?
Stem cells are essentially stored for a period of 21 years by most cord blood banks. The advent of exhaustive research indicates that there is a fair possibility of requiring stem cells if you do bank them. Even if you haven’t banked stem cells there is a strong possibility of requiring stem cell therapy at some stage in life, especially in degenerative disorders. However incase, for whatever reason your banked stem cells are not retrieved in the 20 year storage period, the option of extending the tenure is provided at a prescribed fee prevailing at that time. At this stage, the ownership of stem cells shall be legally transferred to the child.
- What is the possibility of requiring stem cells if I bank them?
With the advent of exhaustive research in the field of stem cell medicine, there is an ample possibility of requiring the banked stem cells. At this moment, there is established application of stem cells in numerous bone marrow (leukemia, thallasemia, sickle cell disease etc.), metabolic and storage disorders (Gaucher’s disease, Neuman Pick’s disease etc.) However, dispute tall claims by most cord blood banks, admittedly there is at best a mild possibility of the child or his family suffering from these disorders and requiring stem cells for the purpose. However, recent research has shown promise with notable stem cell applications in host of chronic, degenerative, malignant disorders and “numerous no hope diseases” viz. Diabetes, Chronic Lung Disease, Osteoarthritis, Spinal Cord Injuries, Stroke, Parkinson’s Disease, Alzheimer’s disease, ALS, Multiple sclerosis, Dystrophies, Non-Healing Fractures of bone, Liver Cirrhosis and many more and with passage of time their role is bound to be more and more pronounced if not indispensible.Ree with help of ReeCure, shall shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate therapy this professionally.
- Do you test the cord and cord blood for infections? If so is there any additional cost involved?
- HIV I &II by ELIZA and PCR
- HBSAG (Hepatitis B) by ELIZA and PCR
- HCV (Hepatitis C) by ELIZA and PCR
- CMV
- Syphillis
- Blood Culture for infection
- Malaria
- Rh grouping/Typing
After the processing and before cry-opreservation part of the sample is tested for (using a in-house Flow Cytometer):
- Mononuclear count
- CD34+ counts and Mesenchymal Cell Counts
- Cell viability
HLA typing can be performed at the clients request for an additional cost at the time of processing.
- Are my baby’s stem cells being stored in vials or bags?
Ree has the facility to store cord blood in either vials or blood bags. Each has advantages and disadvantages and, there's no scientific research proving that one method is better than the other. The main advantage of using blood bags is that the same bag is used to collect and store the cord blood. This limits blood handling and, therefore, possible contamination. Other experts say that blood bags can break during long-term storage. Vials are less likely to break and they seal cord blood in two layers of protection, reducing the chances of contamination by viruses.
Ree Cord stores stem cells in multiple vials or compartmentalized bags, rather than a single vial or bag. This storage procedure gives you the potential to use your baby's cord blood on more than one occasion. If you choose multiple-vial or compartmented-bag storage today, you may someday be able to use the cord blood from one child to treat multiple people and diseases if the expansion techniques are perfected over a period of time.
- Will my family really need stem cell therapy in future?
There is a remote possibility of requirement of stem cells for a bone marrow, metabolic or storage disorder. The satisfying outcome of stems in these conditions having been more or less ascertained, the emphasis has shifted in closely observing applications in other pertinent medical disorders, many of which have already been classified as “no hope diseases”. These disorders range from numerous congenital or neurodegenerative diseases like Multiple Sclerosis, ALS, Muscular Dystrophies to the more familiar and commonly occurring disorders like Stroke, Diabetes, Myocardial Infarctions, Osteoarthritis, Liver Cirrhosis etc. Years of extensive research have started yielding extremely encouraging results and stem cells have finally provided conclusive signs of assuming their rightful spot at the acme of clinical medicine. There is now a paradigm shift in the conceptualization of stem cell therapies by many researchers, doctors and scientists due to its significant impact in reversing many disease processes. The application of stem cells in disorders with no available treatment, like in the case of spinal cord injuries due to say vehicular accidents is especially noteworthy. Stem cell therapies in other prominent disorders with effective conventional therapies have also produced excellent results when used independently or in combination. The most heartening fact is that these stem cells are non-toxic and devoid of side effects compared to their toxic drug counterparts viz. medications, antibiotics, steroids and chemotherapeutic agents routinely used in medical practice, making its transplantation very safe and convenient.
- How do you measure the quality of stem cells?
After the processing and before cry-opreservation part of the sample is tested for:
- Mononuclear (MNC) count
- Absolute CD34+ count
- Mesenchymal Cell Count
- Stem cell Cell viability
These studies are carried out on an in house Flow Cytometer which gives accurate results.
A preservation certificate or Certificate of analysis which mentions all the results is sent to the mother within 15 to 20 days of processing the sample.
- Where and how are the stem cells stored?
The samples of stem cells bear barcoded cryolabels which include an identifier code, mother's name, date of storage and assigned inventory number. The accompanying software aids in tracking of samples during retrieval.
The stem cells are stored in vacuum insulated Liquid Nitrogen containers filled with ample amount of liquid Nitrogen specifically designed to withstand cryogenic conditions for long durations. The storage can be in 5 ml vials or multi-compartmentalized cryobags.
The cry-opreservation is strictly maintained at controlled temperatures using liquid nitrogen (-196 deg Celsius) or its vapour (-175 deg Celsius)
Ree have employed the universally prevalent and AABB approved vapour phase as the desired mode for storage of samples.
The liquid nitrogen levels are monitored with the help of requisite alarm systems and daily temperatures are carefully recorded using computerized data loggers. The tanks are replenished at regular intervals and are also equipped with inherent liquid nitrogen back up systems.
- Why should I trust Ree ?
The strength of any organization is determined by quality of the facility and caliber of the workforce, both aspects that Ree are extremely proud of. Ree has set up its state of the art cord & cord blood processing lab with the latest and most sophisticated technology in the heart of Mumbai. The laboratory is manned by a well qualified, highly competent and skilled staff 24 hours a day, 7 days a week to receive and process cord blood specimens. Secondly, one look at the list of founders, promoters and directors of the company is adequate to instill confidence into the consumer. The promoters collectively have a remarkable track record in pharmaceuticals, FMCG, Pathology, Blood banking and clinical research, fields that have a close relation to the field of stem blood banking, research and therapy. The company is debt free with no encumbrances. Also Ree, unlike its competitors has endeavored to comprehensively encompass all aspects of this fascinating field including both stem cell banking (through ReeCord) and treatment (through ReeCure). Further, Ree with the able assistance of an outstanding panel of doctors, scientists and researchers is committed to carry the baton of stem cell research and therapy forward.
