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Résumé: Les unités de sang placentaire sont maintenant largement utilisées comme source de cellules souches hématopoïétiques en situation d'allogreffe non apparentées. En France, les unités de sang placentaire sont collectées dans un réseau de plus de 70 maternités réparties sur l'ensemble du territoire national et rattachées à 11 banques publiques affiliées au Réseau français de sang placentaire. Cette collecte est réalisée sur le principe du don anonyme, gratuit et pour autrui. L'absence de contre-indication au don est vérifiée chez la parturiente. Seules les unités de sang placentaire répondant aux critères quantitatifs du Réseau français de sang placentaire (cellules nucléées >100×107 et cellules CD34+>1,8×106) sont cryopréservées. La qualification des unités sera complétée par des tests virologiques et fonctionnels sur les unités de sang placentaire ainsi que par le recueil de l'état de santé du nouveau-né donneur six semaines après le don. Le banking de sang placentaire a été encouragé ces cinq dernières années en France permettant d'enrichir le Registre français des donneurs de moelle osseuse en termes de diversité génétique HLA afin de les mettre à disposition des patients à greffer. [ABSTRACT FROM AUTHOR]

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Abstract: Despite the well-known therapeutic utility of cells derived from umbilical cord, the public health code still qualifies it as a simple operating waste what requires the adoption of an adapted legal status. This situation enabled the appearance of private commercial banks storing the blood of umbilical cord for autologous or intra-family purposes in spite of the absence of any authorization. This raises numerous questions of legal, ethical and social order. According to the French general principles in public health, only banks storing transplants for non-commercial allogeneic purposes are currently authorized in France. However, a bill would come to modify this situation by possibly allowing commercial banks. The Council of State, the Senate and the Government consider however that ethical requirements and public utility have to prevail in this domain. Recently, these principles have been resumed by a second bill. The next revision of the Bioethical law should revive the debate. [Copyright &y& Elsevier]

Abstract: Purpose: Today, haematopoietic stem cell graft from placental blood concerns more than 15 % of allogeneic grafts. An inter-laboratory study of the quality control of defrosted cord blood units has been coordinated by the French society for cell and tissue bioengineering (SFBCT), with the cord blood bank of Bourgogne Franche-Comté and controlled by the French health products safety agency (Afssaps). The aim of this study is to ensure the inter-laboratory reproducibility of the quality controls practised by the banks during defrosting. The cellular outputs were analyzed according to the defrosting techniques, according to the method used in flow cytometry: single-platform (SP) versus double-platform (DP), or the product nature, i.e. in total blood or miniaturized. Methods: Forty-two units of placental blood (USP), which were out of range were provided for defrosting to 14 participating sites. USP were defrosted and controlled according to the procedures of each bank. Once the USP is defrosted, a part of the product was controlled by the site and the other part by Afssaps. Following controls were carried out: numeration of the total nucleated cells (TNC) and of CD34+ cells (made by a SP method in Afssaps) and functional assay. Results: Concerning TNC, the defrosting sites obtained a cellular output of 94 %±28 in day 0 compared with an output of 72 %±24 in Afssaps showing a rather good stability of the USP transmitted with an average deviation of 23 %±22. The freezing process with or without reduction of volume does not affect this variation. Concerning the numeration of CD34+ cells, the average deviation between the participating sites and Afssaps was 29 %±23 compared with 21 %±16 for the sites using a SP method against 47 %±25 for those using a DP method. The CD34+ outputs are equal to 82 % ± 60 in day 0 for the participating sites against 52 %±20 for Afssaps. For the sites using a DP method, it is stressed that this output is particularly high with a rate of 126 %±90 (n =15) whereas it is 62 %±20 (n =32) for the sites using a SP method. Conclusion: These results underline a good stability of viable CD34+ cells and a greater reliability of the SP methods for the CD34+ cell numeration for these defrosted USP. Lastly, the results of the functional assay regarding the average clonogenicities (equal to 15 %) reinforce the conclusions on the quality of the defrosted products. [Copyright &y& Elsevier]

Abstract: Since 1988, allogeneic cord blood transplantations have been used in the hematology and oncology area. Cord blood banks, either public or from non-profit corporations, opened in several countries. They organized themselves into a world-wide network permitting broad and quick graft availability all over the world. Cryopreservation modalities and biological safety were strongly defined according to laboratory good practices. More recently, in the United States, Canada and some European and Asian countries, commercial companies created for-profit cord blood banks. They offer families the possibility of privately storing the cord blood of their children. Then, if a child gets sick and needs a hematopoietic stem cell transplantation, it is possible to use the cord blood for an autograft. These companies present this service, relatively expensive for the families, as a true biological insurance. Also, they capitalize on families’ hopes that scientific progress will increase cord blood autografts and other stem cell medical applications. In this work, we review available scientific data, ethical considerations and laws that can contribute to an informed reflection. [Copyright &y& Elsevier]