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Bank your cord blood and gift your family with a lifetime of health. 
C 
ord Blood 
Banking 
FA 
Q’s 
FAQ booklet A5_FINAL.indd 1 4/24/2010 10:41:43 AM
FAQ booklet A5_FINAL.indd 2 4/24/2010 10:41:50 AM
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W 
e are sure there are a lot of doubts plaguing your mind about cord blood banking and stem cell therapy. Let us help you erase these doubts. This book contains answers to all your questions and aims to put your mind at ease. If you want to know more, feel free to call us. 
- The ReeLabs Team. 
FAQ booklet A5_FINAL.indd 1 4/24/2010 10:41:53 AM
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What are stem cells? 
Stem Cells are young, primitive and unspecialized cells with a remarkable potential to renew, differentiate and develop into any desired tissue or organ of the body. They retain the ability to self-renew and differentiate into a variety of tissues. Recent research shows that stem cells are not restricted to one lineage, but can differentiate along different lineages. This means hematopoietic (blood forming) stem cells may form heart tissues or lung tissues when subjected to suitable conditions. Further stem cells have the unique ability to integrate with the parent tissue, thus opening up a plethora of stem cell application while treating various disorders. 
What are the sources of stem cells? 
T 
here are various sources of stem cells. The prominent ones are: 
• Embryonic stem cells from aborted foetuses: 
T 
hese 
cells are supposedly the most primitive and potentially the best source of stem cells for treatment of various disorders. They are derived from embryos or to be precise blastocysts, as their inner cell mass. 
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FAQ booklet A5_FINAL.indd 2 4/24/2010 10:42:16 AM
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T 
here are numerous ethical issues related to the use of embryonic stem cells. The primitive nature of these cells has resulted in speculations that it can cause large number of unwanted side effects including juvenile malignancies if indiscriminately used. 
• Umbilical stem cells from umbilical cord blood at birth: 
U 
mbilical 
cord blood stem cells are derived from the umbilical cord during childbirth. Once the baby is born the umbilical cord is clamped and the child is separated from the mother, after which the blood from the umbilical vessel is collected in a specialized blood bag. 
U 
mbilical 
cord blood is a readily available source of stem cells for treatments of routinely encountered disorders and is now used with increasing frequency as an alternative to bone marrow or peripheral stem cells for transplantation. 
• Adult stem cells: 
i) Bone marrow 
Stem cells derived from the bone marrow had been the most widely practiced form of transplants till the advent of the cord blood derived stem cells. 
T 
hey can be obtained by a procedure called bone marrow puncture from the iliac crest of the hip bone. The procedure is painful and invasive as compared to umbilical cord blood collection. 
ii] Peripheral Blood 
T 
he stem cells in this case are collected by a procedure called “apheresis”. It requires the aid of a well-programmed cell separator that would provide the desired stem cells from the blood stream. This procedure is generally utilized for autologous (self) use only. 
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when you discard your umbilical cord & cord blood, you are discarding with it the chance to safeguard your family’s health for 
a lifetime. 
FAQ booklet A5_FINAL.indd 3 4/24/2010 10:42:19 AM
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T 
he limitation of this procedure is that it is lengthy, the total cell yield is suspect and the procured stem cells are obviously less plastic, thus making the homing and engraftment a big problem in most cases. 
iii] Adult tissues 
Stem cells can also be extracted from tissues like skin, cornea, fat, teeth, small intestine, and liver. These stem cells would also be generally utilized for autologous (for self) use. 
What is umbilical cord & the umbilical cord blood? 
T 
he umbilical cord is the connecting cord from the developing embryo or foetus to the placenta. The umbilical cord normally contains two arteries (the umbilical arteries) and one vein (the umbilical vein), buried within a 
jelly like substance called Wharton’s jelly. The function 
of the umbilical cord is to supply the foetus with oxygenated, nutrient-rich blood from the placenta and remove the deoxygenated and nutrient-depleted blood. The blood derived from the umbilical vein is called the umbilical cord blood. Both umbilical cord and umbilical cord blood are required for the procurement of stem cells 
in clinical practice. 
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FAQ booklet A5_FINAL.indd 4 4/24/2010 10:42:35 AM
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In what way are the umbilical cord blood 
stem cells different from the umbilical cord stem cells? 
T 
he 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 (WBCs), 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 a variety of tissues. This means HSCs may form heart tissues or lung tissues when subjected to suitable conditions, thus opening up a plethora of stem cell applications in the treatment of various disorders. 
T 
he umbilical cord lining contains a jelly like substance supporting the umbilical vein and arteries. This is called Wharton’s jelly. It is an extremely rich source of Mesenchymal Stem Cells (MSCs). These MSCs 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 MSCs in various degenerative disorders. 
How are umbilical cord stem cells different from bone marrow stem cells? 
U 
mbilical cord blood stem cells carry a distinct and significant advantage over bone marrow stem cells for the following reasons: 
Cord blood stem cells 
have been used effectively for treating over 70 diseases since 1988. 
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FAQ booklet A5_FINAL.indd 5 4/24/2010 10:42:35 AM
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• Umbilical cord blood stem cells are easy to collect, non-invasive and painless as compared to bone 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 a 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 which 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 transplants since recent reports of unmatched cord blood being used for transplantation have 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. 
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Since the establishment of the first cord blood bank in 1995, millions have realised its potential and opted for banking their cord and 
cord blood 
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FAQ booklet A5_FINAL.indd 6 4/24/2010 10:42:40 AM
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W 
hen 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. 
T 
here 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? 
G 
raft-versus-host disease (GvHD) is a common complication in 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 
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FAQ booklet A5_FINAL.indd 7 4/24/2010 10:42:48 AM
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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. 
G 
vHD is characterized by selective damage to the liver, skin, 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”. It points to the ability of the 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 while retrieving 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 ReeCord 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, ReeCord with this careful, concerted approach towards isolation, processing and storage of stem cells is committed to accomplish all the important parameters required for successful transplants and thereby guarantee maximum potency of stem cells. The extent of potency is determined by: 
1. Capacity of the procured stem cells for extensive proliferation and multiplication. 
2. Differentiation into the desired cell type or tissue. 
3. Integration into the surrounding tissue after transplant. 
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ReeCord offers both public as well as 
private banking. 
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FAQ booklet A5_FINAL.indd 8 4/24/2010 10:42:48 AM
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4. Ability to function well for approximately the duration of the recipient’s life. 
5. Avoid harming the recipient in any way. 
How does early processing help improve the quality of stem cells? 
T 
he cardinal rule in case of stem cell processing all over the globe remains the same. It says “Earlier the processing, greater is the final yield and quality of stem cells”. After thorough validation, it is now conclusively proven that the quality of stem cells rapidly and progressively diminishes with each passing hour after the first six hours of collection. Hence, ReeCord has relentlessly pursued to ensure receipt of the sample in the central processing facility within six hours of collection. This inevitably ensures extraction of the finest caliber of stem cells with respect to the yield, quantity, viability, potency and sterility. 
What is stem cell banking? 
“Cord blood banking is a misnomer.” The relevant term should be stem cell banking. The reason for this is that the cord blood (or any other source of stem cells) is essentially processed after collection and stem cells that are isolated are stored or “banked”, under cryogenic conditions with the help of an adequate liquid nitrogen backup system. Most cord blood banks store the stem cells for twenty one years after processing. However research has given ample evidence in suggesting 
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FAQ booklet A5_FINAL.indd 9 4/24/2010 10:42:58 AM
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that stem cells can be stored beyond twenty one years, even indefinitely, provided they are processed and stored under appropriate storage conditions. 
Why should I bank my baby’s stem cells? 
Y 
our baby’s stem cells may provide numerous benefits to 
the baby, its siblings and the family. The application of stem cells in disorders like blood cancer, thallasemia, many immune diseases, storage disorders and numerous cancers is already established. There is a tremendous amount of excitement within the medical and scientific community regarding the potential uses of stem cells. Saving your baby’s stem cells would be useful in treating a host of ailments, ranging from innocuous to ominous and life threatening. If your child ever needs to use their cord blood as part of a life saving treatment, his/her stem cells shall provide an exact match. Siblings have up to a 50% chance of becoming a match. If you have a family history of certain types of cancer or blood disorders, cord blood banking may be a prudent decision. Stem cell research is a growing at a rapid rate with a spate of discoveries made on a regular basis. The list of diseases for which stem cell treatments are available is also growing at a fast clip. The role of stem cells in “no hope disorders” like spinal cord injuries, stroke, Parkinson’s Disease, Alzheimer’s Disease, Muscular Dystrophies, ALS, Multiple Sclerosis, Liver Cirrhosis and many more is especially noteworthy. 
Which diseases are currently being treated with stem cell therapy? 
T 
he following diseases are currently being treated with the help of stem cell therapy: 
• Acute Leukemias 
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Cryobags are the USFDA approved option for storing cord blood. 
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FAQ booklet A5_FINAL.indd 10 4/24/2010 10:42:58 AM
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• Chronic Leukemias 
• Myelodysplastic Syndrome 
• Marrow Failure 
• Thallasemia 
• Myeloproliferative Disorders 
• Lymphoproliferative Disorders 
• Phagocyte Disorders 
• Inherited Platelet Abnormalities 
• Other Inherited Disorders 
• Inherited Metabolic Disorders 
• Histiocytic Disorders 
• Inherited Erythrocyte Abnormalities 
• Inherited Immune System Disorders 
• Plasma Cell Disorders 
• Storage Disorders 
• Various Cancers 
Is it necessary to bank both the umbilical cord as well as the umbilical cord blood stem cells? 
I 
t is beneficial to bank both cord and cord blood due to the different types of stem cells they can provide. While cord blood is rich in HSCs, cord lining is rich in MSCs. The further classification of stem cells depend upon the surface markers that the family of both HSCs and MSCs possess. The markers of relevance in current clinical practice are: 
H 
SC family: CD34+; CD45; CD133. 
MSC: CD73; CD90; CD106. 
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FAQ booklet A5_FINAL.indd 11 4/24/2010 10:43:05 AM
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F 
urther the vessels within the Warthon’s jelly provide a rich source of vascular endothelial precursor stem cells that promote the formation of new blood vessels. 
H 
ence 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 a nutshell, if a person can afford it then he should bank all types of available stem cells as health insurance. 
Why should I bank my stem cells with ReeCord? 
R 
eeCord has a state-of-the-art processing facility in the heart of Mumbai replete with the most sophisticated technology. 
The laboratory is staffed 24 hours a day, 7 days a week to receive and process cord blood specimens. 
W 
e ensure that after blood collection, the processing commences within six hours, a timeframe that, recent research has shown, ensures maximum yield of stem cells. 
O 
ur facility conforms to international standards in terms of quality, sterility and hygiene which are fundamental to stem cell processing and banking. While the entire lab premise is Class 100,000, the processing area or the clean room is Class 10,000 and the safety work bench where the stem cells are actually harvested in Class 100. We strictly adhere to GLP (Good Laboratory Practices) 
and AABB (American Association of Blood Banks) norms. 
A 
ll cord blood samples are tested for bacterial contamination, total nucleated, CD34 and viability cell counts. The samples of stem cells bear barcoded cryolabels which include an identifier code, mother’s 
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FAQ booklet A5_FINAL.indd 12 4/24/2010 10:43:05 AM
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name, date of storage and assigned inventory number. The accompanying software aids in tracking of samples during retrieval. 
T 
he cryo-preservation is strictly maintained at controlled temperatures using liquid nitrogen (-196 deg Celsius) or its vapour (-175 deg Celsius). 
R 
eeCord has employed the universally prevalent and AABB approved vapour phase as the desired mode for storage of samples. 
T 
he 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. 
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. 
Over the years, the concept of banking cord blood has evolved rapidly, as millions around the world realise its potential. 
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FAQ booklet A5_FINAL.indd 13 4/24/2010 10:43:05 AM
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How long can the stem cells be preserved? 
T 
he 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 if 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? 
W 
ith the advent of exhaustive research in the field of stem cell medicine, there is an ample possibility of 
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ReeCure has affiliations with renowned institutes and doctors and will initiate stem cell therapy 
for you. 
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FAQ booklet A5_FINAL.indd 14 4/24/2010 10:43:05 AM
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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, despite 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 a 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 the passage of time their role is bound to be more and more pronounced if not indispensible. ReeCord with help of ReeCure, shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate this therapy professionally. 
Does the quantity of collected cord & cord blood matter? 
Y 
es, there is a minimum quantity required; which is about 20 ml of cord blood and 1 inch of cord. The yield of stem cells should ideally be proportional to the quantity of blood collected, but research has proven that beyond a particular amount of cord blood (60 to 80 ml) and cord tissue 
(10 to 12 inches), there is no significant improvement in the same. Further, another striking feature is that there is no sacrosanct connection between the yield of stem cells even with identical amounts of cord blood/cord lining collected. The actual quantum of stem cells collected solely depends on the genetic constitution of the person. Hence, a seemingly 
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FAQ booklet A5_FINAL.indd 15 4/24/2010 10:43:22 AM
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inadequate cord blood/cord collection may also provide a rich yield of stem cells. The crux of stem cell yield is the quality of processing. Further with the advent of in-vitro amplifications of stem cells it is possible to multiply the immunologically “precious” stem cells. ReeCord boasts of the finest processing techniques and possibility of in-vitro amplification, thus relatively neutralizing the disadvantage of inadequate cord blood/cord collection. 
When and how is the cord blood collected during child birth? 
T 
his process does not harm you or your baby. After the delivery of your baby, the umbilical cord is clamped and cut. Your newborn is no longer attached to the umbilical cord. The remaining blood, which is normally discarded, is now collected by experts. 
T 
he cord is cleaned with alcohol and betadine to prevent bacterial and fungal contamination, and the needle end of the collection bag is inserted into the umbilical cord. This procedure is safe, painless, and does not harm the mother or her baby. The blood flows by gravity into the collection bag. The entire process takes less than 10 minutes. After the cord blood collection is over, approximately 10 to 12 inches of umbilical cord is collected in a sterile container containing Ringer Lactate and an antibiotic. ReeCord supplies you with the cord and cord blood collection kit prior to delivery. 
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FAQ booklet A5_FINAL.indd 16 4/24/2010 10:43:25 AM
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Is the collection procedure risky, painful or time consuming? 
T 
here is absolutely no risk associated with the procedure to either the mother or the baby. 
T 
he entire procedure is painless. 
It takes approximately 5 to 7 minutes for the entire procedure of cord and cord blood collection. 
What do I do with the collection kit once 
I receive it? 
T 
he collection kit is sent to you about two months before your due date. It is extremely important to carry this kit with you to the hospital as it contains a unique barcode that helps us identify your baby’s cord and cord blood. We advise you to keep it in your hospital bag so you won’t forget it. 
What happens to the cord and cord blood after it is collected? 
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STEP 1: The sample is collected in the barcoded kit and transported to our lab and the processing begins within 6 hours. 
STEP 2: The received sample is tested for transmissible diseases, viz. HIV, Hep B & C. 
STEP 3: Post-testing, the sample is processed in the clean room adhering to international standards of sterility and hygiene. 
STEP 6: Before cryo-preservation, their temperature is reduced at the rate of 1ºC per minute till they reach -90ºC. 
STEP 4: The sample is processed using our proprietary technology and the stem cells are isolated. 
STEP 5: The stem cells are subjected to a quality control analysis for count, viability, purity and potency. 
STEP 7: The stem cells are stored in imported cryo-containers with Data logging for recording temperatures and Liquid Nitrogen back-up systems. 
FAQ booklet A5_FINAL.indd 17 4/24/2010 10:43:25 AM
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Do you test the cord and cord blood for infections? If so, is there any additional cost involved? 
T 
he following tests are performed on each and every sample that comes in the facility for processing: 
• 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 
A 
fter the processing and before cryo-preservation, 
a 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? 
R 
eeCord 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 
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FAQ booklet A5_FINAL.indd 18 4/24/2010 10:43:26 AM
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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. 
R 
eeCord 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. 
How will ReeCord help me if I require my 
baby’s stem cells for myself or any other relative who needs treatment? 
R 
eeCord is steadfast in assisting you in case you ever need the banked stem cells. This can be achieved in two ways. Firstly if the patient needs transplantation with his own physician, then a requisition letter mentioning detailed medical history shall have to be provided to ReeCord. Relevant tests, if any, may have to be performed on the stem cells prior to dispatch. The second option of treatment is exclusive to ReeLabs and is called ReeCure. ReeCure stands committed to optimizing 
stem cell therapy. Besides providing you banked stem cells, ReeCure shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate therapy. 
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Ree is steadfast in assisting you in case you ever need the banked stem cells. 
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FAQ booklet A5_FINAL.indd 19 4/24/2010 10:43:26 AM
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Is stem cell banking expensive? 
N 
o. Stem cell banking is not expensive at all. Further, multiple payment options are available to reduce any concerns of affordability. Compared to the peace of mind that stem cell banking provides, the cost is negligible. 
Will my family really need stem cell therapy in future? 
T 
here is a remote possibility of the requirement of stem cells for a bone marrow, metabolic or storage disorder. The satisfying outcome of stem cells 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 and 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 
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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. 
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FAQ booklet A5_FINAL.indd 20 4/24/2010 10:43:27 AM
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these stem cells are non-toxic and devoid of side effects compared to their toxic drug counterparts, viz. 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? 
A 
fter the processing and before cryo-preservation a part of the sample is tested for: 
• Mononuclear (MNC) count 
• Absolute CD34+ count 
• Mesenchymal Cell Count 
• Stem cell viability 
T 
hese 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. 
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Where and how are the stem cells stored? 
T 
he samples of stem cells bear barcoded cryolabels which include an identifier code, the mother’s name, date of storage and an assigned inventory number. The accompanying software aids in tracking samples during retrieval. 
T 
he stem cells are stored in vacuum insulated Liquid Nitrogen containers filled with an 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. 
T 
he cryo-preservation is strictly maintained at controlled temperatures using liquid nitrogen (-196 deg Celsius) or its vapour (-175 deg Celsius). 
R 
eeCord has employed the universally prevalent and AABB approved vapour phase as the desired mode for the storage of samples. 
T 
he 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. 
Who will collect my baby’s cord and cord blood? 
R 
eeCord has a formidable network of trained nurses all over Mumbai. The option of using ReeCord’s trained nurses rests with the client. Most hospitals and Gynaecologists are efficient in collecting the cord and cord blood. Also many hospitals have their own work ethics that prohibit outsiders to participate in any 
in-house activity. In any case, adequate training and know- how is passed on to the Gynaecologist prior to delivery. 
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Is there a cost to retrieve my baby’s cord and cord blood stem cells if I need them in the future? 
N 
o, there is no cost for retrieval of the baby’s stem cells. However, HLA testing, if required is chargeable. 
If I wish to migrate, can I shift my stem cells to another stem cell bank? 
Y 
es, that is possible. Few nominal formalities shall have to be completed. The processing charges are non- refundable. The storage fee up-to the year of retrieval shall be charged and the rest of the charges shall be refunded. If the task of shipping the stem cells is also assigned to ReeCord, then the said charges shall also be borne by the client. 
I have already stored my first child’s stem cells with another stem cell bank. Do I need to store my second baby’s stem cells as well. If so, why cant I just store it with the first bank? 
I 
t is important to store your second baby’s stem cells as well. This makes sure you have additional help at hand if the need ever arises. By storing in a different bank, you are increasing the chances of protecting your stem cells against any calamity. That is, if any one bank was affected by a natural calamity, at least the other sample would be safe in a different bank. 
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It is important to store your second baby’s stem cells as well. This makes sure you have additional help at hand if the need ever arises. 
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Shall I be notified when my stem cells are processed and stored? 
Y 
es, once the cord and cord blood have been processed and stored, we will notify you of the same. There would be a Certificate Of Analysis (COA) sent to you after processing that shall give a detailed account of your baby’s stem cells. Further this COA shall come immensely handy at 
the time of retrieval; hence it would be prudent to preserve it carefully. 
How and when do I have to register? 
A 
s soon as you decide to bank your stem cells, you need to contact us. A ReeCord representative will get in touch with you and help you complete the necessary documentation. We suggest you contact us as soon as possible so the formalities can be dealt with at a relaxed pace, leaving you with ample time to enjoy your pregnancy without any hassles. 
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Why should I trust ReeLabs? 
T 
he strength of any organization is determined by the quality of the facility and caliber of the workforce, both aspects that ReeLabs is extremely proud of. ReeLabs has a state-of-the-art cord and 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 in you. 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 cell banking, research and therapy. The company is debt free with no encumbrances. Also ReeLabs, 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, ReeLabs 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. 
Which diseases can be treated by stem cell therapy? 
T 
he following diseases can be treated with the help of stem cell therapy - 
Vascular Disorders 
• Chronic Heart Failure 
• Acute Myocardial Infarction 
• Cardiomyopathy 
• Buerger’s Disease 
37 
38 
ReeLabs 
has a state-of- the-art 
cord & cord blood processing lab with the latest and most sophisticated technology in the heart of Mumbai. 
“ 
“ 
FAQ booklet A5_FINAL.indd 25 4/24/2010 10:44:01 AM
26 
Liver Disorders 
• Liver Cirrhosis 
Bone and Cartilage Disorders 
• Osteoarthritis 
• Non-healing fractures 
• Osteogenesis Imperfecta 
• Achondrodysplasia 
Neuro-muscular Disorders 
• Cerebral Palsy 
• Multiple Sclerosis 
• Parkinson’s Disease 
• Spinal Cord Injury 
• Stroke 
• Alzheimer’s Disease 
• Muscular Dystrophy 
• Spinal Muscular Atrophy 
• ALS 
• Autism 
Haematological Disorders 
• Acute Leukemias 
• Chronic Leukemias 
• Myelodysplastic Syndromes 
• Marrow Failure 
• Thallasemia 
• Myeloproliferative Disorders 
• Lymphoproliferative Disorders 
• Phagocyte Disorders 
• Inherited Platelet Abnormalities 
• Other Inherited Disorders 
FAQ booklet A5_FINAL.indd 26 4/24/2010 10:44:01 AM
27 
• Inherited Metabolic Disorders 
• Histiocytic Disorders 
• Inherited Erythrocyte Abnormalities 
• Inherited Immune System Disorders 
• Plasma Cell Disorders 
• Other Malignancies 
Cancers 
• Brain Tumors 
• Ewing Sarcoma 
• Neuroblastoma 
• Ovarian Cancer 
• Renal Cell Carcinoma 
• Rhabdomyosarcoma 
• Small-Cell Lung Cancer 
• Testicular Cancer 
• Thymoma (Thymic Carcinoma) 
Diabetes 
Eye Disorders 
Anti-ageing 
FAQ booklet A5_FINAL.indd 27 4/24/2010 10:44:01 AM
Notes 
FAQ booklet A5_FINAL.indd 28 4/24/2010 10:44:03 AM
FAQ booklet A5_FINAL.indd 29 4/24/2010 10:44:06 AM
Corporate office: 
K.K. Chambers, Sir P.T. Road, Fort, Mumbai - 400 001. 
Tel.: 022-22072526; Fax: 022-22072527 
F 
acility: 
Unit No. 3, Andheri Industrial Estate, Veera Desai Road, Andheri (W), Mumbai - 400 053. 
Tel.: 022-26736387; Fax: 022-26740371 
E-mail: ree@reelabs.com • Website: www.reelabs.com 
FAQ booklet A5_FINAL.indd 30 4/24/2010 10:44:07 AM

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FAQ Booklet - ReeLabs

  • 1. 1 Bank your cord blood and gift your family with a lifetime of health. C ord Blood Banking FA Q’s FAQ booklet A5_FINAL.indd 1 4/24/2010 10:41:43 AM
  • 2. FAQ booklet A5_FINAL.indd 2 4/24/2010 10:41:50 AM
  • 3. 1 W e are sure there are a lot of doubts plaguing your mind about cord blood banking and stem cell therapy. Let us help you erase these doubts. This book contains answers to all your questions and aims to put your mind at ease. If you want to know more, feel free to call us. - The ReeLabs Team. FAQ booklet A5_FINAL.indd 1 4/24/2010 10:41:53 AM
  • 4. 2 What are stem cells? Stem Cells are young, primitive and unspecialized cells with a remarkable potential to renew, differentiate and develop into any desired tissue or organ of the body. They retain the ability to self-renew and differentiate into a variety of tissues. Recent research shows that stem cells are not restricted to one lineage, but can differentiate along different lineages. This means hematopoietic (blood forming) stem cells may form heart tissues or lung tissues when subjected to suitable conditions. Further stem cells have the unique ability to integrate with the parent tissue, thus opening up a plethora of stem cell application while treating various disorders. What are the sources of stem cells? T here are various sources of stem cells. The prominent ones are: • Embryonic stem cells from aborted foetuses: T hese cells are supposedly the most primitive and potentially the best source of stem cells for treatment of various disorders. They are derived from embryos or to be precise blastocysts, as their inner cell mass. 2 1 FAQ booklet A5_FINAL.indd 2 4/24/2010 10:42:16 AM
  • 5. 3 T here are numerous ethical issues related to the use of embryonic stem cells. The primitive nature of these cells has resulted in speculations that it can cause large number of unwanted side effects including juvenile malignancies if indiscriminately used. • Umbilical stem cells from umbilical cord blood at birth: U mbilical cord blood stem cells are derived from the umbilical cord during childbirth. Once the baby is born the umbilical cord is clamped and the child is separated from the mother, after which the blood from the umbilical vessel is collected in a specialized blood bag. U mbilical cord blood is a readily available source of stem cells for treatments of routinely encountered disorders and is now used with increasing frequency as an alternative to bone marrow or peripheral stem cells for transplantation. • Adult stem cells: i) Bone marrow Stem cells derived from the bone marrow had been the most widely practiced form of transplants till the advent of the cord blood derived stem cells. T hey can be obtained by a procedure called bone marrow puncture from the iliac crest of the hip bone. The procedure is painful and invasive as compared to umbilical cord blood collection. ii] Peripheral Blood T he stem cells in this case are collected by a procedure called “apheresis”. It requires the aid of a well-programmed cell separator that would provide the desired stem cells from the blood stream. This procedure is generally utilized for autologous (self) use only. “ “ when you discard your umbilical cord & cord blood, you are discarding with it the chance to safeguard your family’s health for a lifetime. FAQ booklet A5_FINAL.indd 3 4/24/2010 10:42:19 AM
  • 6. 4 T he limitation of this procedure is that it is lengthy, the total cell yield is suspect and the procured stem cells are obviously less plastic, thus making the homing and engraftment a big problem in most cases. iii] Adult tissues Stem cells can also be extracted from tissues like skin, cornea, fat, teeth, small intestine, and liver. These stem cells would also be generally utilized for autologous (for self) use. What is umbilical cord & the umbilical cord blood? T he umbilical cord is the connecting cord from the developing embryo or foetus to the placenta. The umbilical cord normally contains two arteries (the umbilical arteries) and one vein (the umbilical vein), buried within a jelly like substance called Wharton’s jelly. The function of the umbilical cord is to supply the foetus with oxygenated, nutrient-rich blood from the placenta and remove the deoxygenated and nutrient-depleted blood. The blood derived from the umbilical vein is called the umbilical cord blood. Both umbilical cord and umbilical cord blood are required for the procurement of stem cells in clinical practice. 3 FAQ booklet A5_FINAL.indd 4 4/24/2010 10:42:35 AM
  • 7. 5 In what way are the umbilical cord blood stem cells different from the umbilical cord stem cells? T he 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 (WBCs), 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 a variety of tissues. This means HSCs may form heart tissues or lung tissues when subjected to suitable conditions, thus opening up a plethora of stem cell applications in the treatment of various disorders. T he umbilical cord lining contains a jelly like substance supporting the umbilical vein and arteries. This is called Wharton’s jelly. It is an extremely rich source of Mesenchymal Stem Cells (MSCs). These MSCs 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 MSCs in various degenerative disorders. How are umbilical cord stem cells different from bone marrow stem cells? U mbilical cord blood stem cells carry a distinct and significant advantage over bone marrow stem cells for the following reasons: Cord blood stem cells have been used effectively for treating over 70 diseases since 1988. “ “ 4 5 FAQ booklet A5_FINAL.indd 5 4/24/2010 10:42:35 AM
  • 8. 6 • Umbilical cord blood stem cells are easy to collect, non-invasive and painless as compared to bone 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 a 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 which 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 transplants since recent reports of unmatched cord blood being used for transplantation have 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. 6 Since the establishment of the first cord blood bank in 1995, millions have realised its potential and opted for banking their cord and cord blood “ “ FAQ booklet A5_FINAL.indd 6 4/24/2010 10:42:40 AM
  • 9. 7 W hen 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. T here 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? G raft-versus-host disease (GvHD) is a common complication in 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 7 FAQ booklet A5_FINAL.indd 7 4/24/2010 10:42:48 AM
  • 10. 8 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. G vHD is characterized by selective damage to the liver, skin, 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”. It points to the ability of the 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 while retrieving 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 ReeCord 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, ReeCord with this careful, concerted approach towards isolation, processing and storage of stem cells is committed to accomplish all the important parameters required for successful transplants and thereby guarantee maximum potency of stem cells. The extent of potency is determined by: 1. Capacity of the procured stem cells for extensive proliferation and multiplication. 2. Differentiation into the desired cell type or tissue. 3. Integration into the surrounding tissue after transplant. 8 ReeCord offers both public as well as private banking. “ “ FAQ booklet A5_FINAL.indd 8 4/24/2010 10:42:48 AM
  • 11. 9 4. Ability to function well for approximately the duration of the recipient’s life. 5. Avoid harming the recipient in any way. How does early processing help improve the quality of stem cells? T he cardinal rule in case of stem cell processing all over the globe remains the same. It says “Earlier the processing, greater is the final yield and quality of stem cells”. After thorough validation, it is now conclusively proven that the quality of stem cells rapidly and progressively diminishes with each passing hour after the first six hours of collection. Hence, ReeCord has relentlessly pursued to ensure receipt of the sample in the central processing facility within six hours of collection. This inevitably ensures extraction of the finest caliber of stem cells with respect to the yield, quantity, viability, potency and sterility. What is stem cell banking? “Cord blood banking is a misnomer.” The relevant term should be stem cell banking. The reason for this is that the cord blood (or any other source of stem cells) is essentially processed after collection and stem cells that are isolated are stored or “banked”, under cryogenic conditions with the help of an adequate liquid nitrogen backup system. Most cord blood banks store the stem cells for twenty one years after processing. However research has given ample evidence in suggesting 9 10 FAQ booklet A5_FINAL.indd 9 4/24/2010 10:42:58 AM
  • 12. 10 that stem cells can be stored beyond twenty one years, even indefinitely, provided they are processed and stored under appropriate storage conditions. Why should I bank my baby’s stem cells? Y our baby’s stem cells may provide numerous benefits to the baby, its siblings and the family. The application of stem cells in disorders like blood cancer, thallasemia, many immune diseases, storage disorders and numerous cancers is already established. There is a tremendous amount of excitement within the medical and scientific community regarding the potential uses of stem cells. Saving your baby’s stem cells would be useful in treating a host of ailments, ranging from innocuous to ominous and life threatening. If your child ever needs to use their cord blood as part of a life saving treatment, his/her stem cells shall provide an exact match. Siblings have up to a 50% chance of becoming a match. If you have a family history of certain types of cancer or blood disorders, cord blood banking may be a prudent decision. Stem cell research is a growing at a rapid rate with a spate of discoveries made on a regular basis. The list of diseases for which stem cell treatments are available is also growing at a fast clip. The role of stem cells in “no hope disorders” like spinal cord injuries, stroke, Parkinson’s Disease, Alzheimer’s Disease, Muscular Dystrophies, ALS, Multiple Sclerosis, Liver Cirrhosis and many more is especially noteworthy. Which diseases are currently being treated with stem cell therapy? T he following diseases are currently being treated with the help of stem cell therapy: • Acute Leukemias 11 12 Cryobags are the USFDA approved option for storing cord blood. “ “ FAQ booklet A5_FINAL.indd 10 4/24/2010 10:42:58 AM
  • 13. 11 • Chronic Leukemias • Myelodysplastic Syndrome • Marrow Failure • Thallasemia • Myeloproliferative Disorders • Lymphoproliferative Disorders • Phagocyte Disorders • Inherited Platelet Abnormalities • Other Inherited Disorders • Inherited Metabolic Disorders • Histiocytic Disorders • Inherited Erythrocyte Abnormalities • Inherited Immune System Disorders • Plasma Cell Disorders • Storage Disorders • Various Cancers Is it necessary to bank both the umbilical cord as well as the umbilical cord blood stem cells? I t is beneficial to bank both cord and cord blood due to the different types of stem cells they can provide. While cord blood is rich in HSCs, cord lining is rich in MSCs. The further classification of stem cells depend upon the surface markers that the family of both HSCs and MSCs possess. The markers of relevance in current clinical practice are: H SC family: CD34+; CD45; CD133. MSC: CD73; CD90; CD106. 13 FAQ booklet A5_FINAL.indd 11 4/24/2010 10:43:05 AM
  • 14. 12 F urther the vessels within the Warthon’s jelly provide a rich source of vascular endothelial precursor stem cells that promote the formation of new blood vessels. H ence 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 a nutshell, if a person can afford it then he should bank all types of available stem cells as health insurance. Why should I bank my stem cells with ReeCord? R eeCord has a state-of-the-art processing facility in the heart of Mumbai replete with the most sophisticated technology. The laboratory is staffed 24 hours a day, 7 days a week to receive and process cord blood specimens. W e ensure that after blood collection, the processing commences within six hours, a timeframe that, recent research has shown, ensures maximum yield of stem cells. O ur facility conforms to international standards in terms of quality, sterility and hygiene which are fundamental to stem cell processing and banking. While the entire lab premise is Class 100,000, the processing area or the clean room is Class 10,000 and the safety work bench where the stem cells are actually harvested in Class 100. We strictly adhere to GLP (Good Laboratory Practices) and AABB (American Association of Blood Banks) norms. A ll cord blood samples are tested for bacterial contamination, total nucleated, CD34 and viability cell counts. The samples of stem cells bear barcoded cryolabels which include an identifier code, mother’s 14 FAQ booklet A5_FINAL.indd 12 4/24/2010 10:43:05 AM
  • 15. 13 15 name, date of storage and assigned inventory number. The accompanying software aids in tracking of samples during retrieval. T he cryo-preservation is strictly maintained at controlled temperatures using liquid nitrogen (-196 deg Celsius) or its vapour (-175 deg Celsius). R eeCord has employed the universally prevalent and AABB approved vapour phase as the desired mode for storage of samples. T he 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. 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. Over the years, the concept of banking cord blood has evolved rapidly, as millions around the world realise its potential. “ “ FAQ booklet A5_FINAL.indd 13 4/24/2010 10:43:05 AM
  • 16. 14 How long can the stem cells be preserved? T he 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 if 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? W ith the advent of exhaustive research in the field of stem cell medicine, there is an ample possibility of 16 17 18 ReeCure has affiliations with renowned institutes and doctors and will initiate stem cell therapy for you. “ “ FAQ booklet A5_FINAL.indd 14 4/24/2010 10:43:05 AM
  • 17. 15 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, despite 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 a 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 the passage of time their role is bound to be more and more pronounced if not indispensible. ReeCord with help of ReeCure, shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate this therapy professionally. Does the quantity of collected cord & cord blood matter? Y es, there is a minimum quantity required; which is about 20 ml of cord blood and 1 inch of cord. The yield of stem cells should ideally be proportional to the quantity of blood collected, but research has proven that beyond a particular amount of cord blood (60 to 80 ml) and cord tissue (10 to 12 inches), there is no significant improvement in the same. Further, another striking feature is that there is no sacrosanct connection between the yield of stem cells even with identical amounts of cord blood/cord lining collected. The actual quantum of stem cells collected solely depends on the genetic constitution of the person. Hence, a seemingly 19 FAQ booklet A5_FINAL.indd 15 4/24/2010 10:43:22 AM
  • 18. 16 inadequate cord blood/cord collection may also provide a rich yield of stem cells. The crux of stem cell yield is the quality of processing. Further with the advent of in-vitro amplifications of stem cells it is possible to multiply the immunologically “precious” stem cells. ReeCord boasts of the finest processing techniques and possibility of in-vitro amplification, thus relatively neutralizing the disadvantage of inadequate cord blood/cord collection. When and how is the cord blood collected during child birth? T his process does not harm you or your baby. After the delivery of your baby, the umbilical cord is clamped and cut. Your newborn is no longer attached to the umbilical cord. The remaining blood, which is normally discarded, is now collected by experts. T he cord is cleaned with alcohol and betadine to prevent bacterial and fungal contamination, and the needle end of the collection bag is inserted into the umbilical cord. This procedure is safe, painless, and does not harm the mother or her baby. The blood flows by gravity into the collection bag. The entire process takes less than 10 minutes. After the cord blood collection is over, approximately 10 to 12 inches of umbilical cord is collected in a sterile container containing Ringer Lactate and an antibiotic. ReeCord supplies you with the cord and cord blood collection kit prior to delivery. 20 FAQ booklet A5_FINAL.indd 16 4/24/2010 10:43:25 AM
  • 19. 17 Is the collection procedure risky, painful or time consuming? T here is absolutely no risk associated with the procedure to either the mother or the baby. T he entire procedure is painless. It takes approximately 5 to 7 minutes for the entire procedure of cord and cord blood collection. What do I do with the collection kit once I receive it? T he collection kit is sent to you about two months before your due date. It is extremely important to carry this kit with you to the hospital as it contains a unique barcode that helps us identify your baby’s cord and cord blood. We advise you to keep it in your hospital bag so you won’t forget it. What happens to the cord and cord blood after it is collected? 21 22 23 STEP 1: The sample is collected in the barcoded kit and transported to our lab and the processing begins within 6 hours. STEP 2: The received sample is tested for transmissible diseases, viz. HIV, Hep B & C. STEP 3: Post-testing, the sample is processed in the clean room adhering to international standards of sterility and hygiene. STEP 6: Before cryo-preservation, their temperature is reduced at the rate of 1ºC per minute till they reach -90ºC. STEP 4: The sample is processed using our proprietary technology and the stem cells are isolated. STEP 5: The stem cells are subjected to a quality control analysis for count, viability, purity and potency. STEP 7: The stem cells are stored in imported cryo-containers with Data logging for recording temperatures and Liquid Nitrogen back-up systems. FAQ booklet A5_FINAL.indd 17 4/24/2010 10:43:25 AM
  • 20. 18 Do you test the cord and cord blood for infections? If so, is there any additional cost involved? T he following tests are performed on each and every sample that comes in the facility for processing: • 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 A fter the processing and before cryo-preservation, a 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? R eeCord 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 24 25 FAQ booklet A5_FINAL.indd 18 4/24/2010 10:43:26 AM
  • 21. 19 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. R eeCord 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. How will ReeCord help me if I require my baby’s stem cells for myself or any other relative who needs treatment? R eeCord is steadfast in assisting you in case you ever need the banked stem cells. This can be achieved in two ways. Firstly if the patient needs transplantation with his own physician, then a requisition letter mentioning detailed medical history shall have to be provided to ReeCord. Relevant tests, if any, may have to be performed on the stem cells prior to dispatch. The second option of treatment is exclusive to ReeLabs and is called ReeCure. ReeCure stands committed to optimizing stem cell therapy. Besides providing you banked stem cells, ReeCure shall also assist you in creating liaisons with suitable transplant physicians and hospitals to facilitate therapy. 26 Ree is steadfast in assisting you in case you ever need the banked stem cells. “ “ FAQ booklet A5_FINAL.indd 19 4/24/2010 10:43:26 AM
  • 22. 20 Is stem cell banking expensive? N o. Stem cell banking is not expensive at all. Further, multiple payment options are available to reduce any concerns of affordability. Compared to the peace of mind that stem cell banking provides, the cost is negligible. Will my family really need stem cell therapy in future? T here is a remote possibility of the requirement of stem cells for a bone marrow, metabolic or storage disorder. The satisfying outcome of stem cells 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 and 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 27 28 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. “ “ FAQ booklet A5_FINAL.indd 20 4/24/2010 10:43:27 AM
  • 23. 21 these stem cells are non-toxic and devoid of side effects compared to their toxic drug counterparts, viz. 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? A fter the processing and before cryo-preservation a part of the sample is tested for: • Mononuclear (MNC) count • Absolute CD34+ count • Mesenchymal Cell Count • Stem cell viability T hese 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. 29 FAQ booklet A5_FINAL.indd 21 4/24/2010 10:43:31 AM
  • 24. 22 Where and how are the stem cells stored? T he samples of stem cells bear barcoded cryolabels which include an identifier code, the mother’s name, date of storage and an assigned inventory number. The accompanying software aids in tracking samples during retrieval. T he stem cells are stored in vacuum insulated Liquid Nitrogen containers filled with an 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. T he cryo-preservation is strictly maintained at controlled temperatures using liquid nitrogen (-196 deg Celsius) or its vapour (-175 deg Celsius). R eeCord has employed the universally prevalent and AABB approved vapour phase as the desired mode for the storage of samples. T he 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. Who will collect my baby’s cord and cord blood? R eeCord has a formidable network of trained nurses all over Mumbai. The option of using ReeCord’s trained nurses rests with the client. Most hospitals and Gynaecologists are efficient in collecting the cord and cord blood. Also many hospitals have their own work ethics that prohibit outsiders to participate in any in-house activity. In any case, adequate training and know- how is passed on to the Gynaecologist prior to delivery. 31 30 FAQ booklet A5_FINAL.indd 22 4/24/2010 10:43:31 AM
  • 25. 23 Is there a cost to retrieve my baby’s cord and cord blood stem cells if I need them in the future? N o, there is no cost for retrieval of the baby’s stem cells. However, HLA testing, if required is chargeable. If I wish to migrate, can I shift my stem cells to another stem cell bank? Y es, that is possible. Few nominal formalities shall have to be completed. The processing charges are non- refundable. The storage fee up-to the year of retrieval shall be charged and the rest of the charges shall be refunded. If the task of shipping the stem cells is also assigned to ReeCord, then the said charges shall also be borne by the client. I have already stored my first child’s stem cells with another stem cell bank. Do I need to store my second baby’s stem cells as well. If so, why cant I just store it with the first bank? I t is important to store your second baby’s stem cells as well. This makes sure you have additional help at hand if the need ever arises. By storing in a different bank, you are increasing the chances of protecting your stem cells against any calamity. That is, if any one bank was affected by a natural calamity, at least the other sample would be safe in a different bank. 32 33 34 It is important to store your second baby’s stem cells as well. This makes sure you have additional help at hand if the need ever arises. “ “ FAQ booklet A5_FINAL.indd 23 4/24/2010 10:43:31 AM
  • 26. 24 Shall I be notified when my stem cells are processed and stored? Y es, once the cord and cord blood have been processed and stored, we will notify you of the same. There would be a Certificate Of Analysis (COA) sent to you after processing that shall give a detailed account of your baby’s stem cells. Further this COA shall come immensely handy at the time of retrieval; hence it would be prudent to preserve it carefully. How and when do I have to register? A s soon as you decide to bank your stem cells, you need to contact us. A ReeCord representative will get in touch with you and help you complete the necessary documentation. We suggest you contact us as soon as possible so the formalities can be dealt with at a relaxed pace, leaving you with ample time to enjoy your pregnancy without any hassles. 35 36 FAQ booklet A5_FINAL.indd 24 4/24/2010 10:43:58 AM
  • 27. 25 Why should I trust ReeLabs? T he strength of any organization is determined by the quality of the facility and caliber of the workforce, both aspects that ReeLabs is extremely proud of. ReeLabs has a state-of-the-art cord and 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 in you. 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 cell banking, research and therapy. The company is debt free with no encumbrances. Also ReeLabs, 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, ReeLabs 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. Which diseases can be treated by stem cell therapy? T he following diseases can be treated with the help of stem cell therapy - Vascular Disorders • Chronic Heart Failure • Acute Myocardial Infarction • Cardiomyopathy • Buerger’s Disease 37 38 ReeLabs has a state-of- the-art cord & cord blood processing lab with the latest and most sophisticated technology in the heart of Mumbai. “ “ FAQ booklet A5_FINAL.indd 25 4/24/2010 10:44:01 AM
  • 28. 26 Liver Disorders • Liver Cirrhosis Bone and Cartilage Disorders • Osteoarthritis • Non-healing fractures • Osteogenesis Imperfecta • Achondrodysplasia Neuro-muscular Disorders • Cerebral Palsy • Multiple Sclerosis • Parkinson’s Disease • Spinal Cord Injury • Stroke • Alzheimer’s Disease • Muscular Dystrophy • Spinal Muscular Atrophy • ALS • Autism Haematological Disorders • Acute Leukemias • Chronic Leukemias • Myelodysplastic Syndromes • Marrow Failure • Thallasemia • Myeloproliferative Disorders • Lymphoproliferative Disorders • Phagocyte Disorders • Inherited Platelet Abnormalities • Other Inherited Disorders FAQ booklet A5_FINAL.indd 26 4/24/2010 10:44:01 AM
  • 29. 27 • Inherited Metabolic Disorders • Histiocytic Disorders • Inherited Erythrocyte Abnormalities • Inherited Immune System Disorders • Plasma Cell Disorders • Other Malignancies Cancers • Brain Tumors • Ewing Sarcoma • Neuroblastoma • Ovarian Cancer • Renal Cell Carcinoma • Rhabdomyosarcoma • Small-Cell Lung Cancer • Testicular Cancer • Thymoma (Thymic Carcinoma) Diabetes Eye Disorders Anti-ageing FAQ booklet A5_FINAL.indd 27 4/24/2010 10:44:01 AM
  • 30. Notes FAQ booklet A5_FINAL.indd 28 4/24/2010 10:44:03 AM
  • 31. FAQ booklet A5_FINAL.indd 29 4/24/2010 10:44:06 AM
  • 32. Corporate office: K.K. Chambers, Sir P.T. Road, Fort, Mumbai - 400 001. Tel.: 022-22072526; Fax: 022-22072527 F acility: Unit No. 3, Andheri Industrial Estate, Veera Desai Road, Andheri (W), Mumbai - 400 053. Tel.: 022-26736387; Fax: 022-26740371 E-mail: ree@reelabs.com • Website: www.reelabs.com FAQ booklet A5_FINAL.indd 30 4/24/2010 10:44:07 AM