The other topic targeted by ARTHIQS is Haematopoietic Stem Cells for Transplantation.
To guide you through the field of Haematopoietic Stem Cells, let’s start the story from the beginning. Blood cells are vital to the human body: red cells transport oxygen, while white cells play an essential role in the immune system by fighting infection, foreign particles or tumours, and that platelets prevent from bleeding out.
When these cells are challenged by a malignant (leukaemia, lymphoma, etc.) or a non-malignant haematological disease (inherited disorders, autoimmune diseases, etc.), Haematopoietic Stem Cells Transplantation (HSCT) represents a potential curative treatment to restore the patient's normal blood cell production and immunity.
Haematopoietic Stem Cells (HSC) are immature cells that retain the potential to turn into the different types of blood cells and that can mostly be found in the “bone marrow” (located in the centre of certain bones), where originally dividing themselves to produce the body blood cells. Once these blood cells are mature, they leave the bone to enter the bloodstream.
|Bone marrow collection from the iliac crest from a volunteer donor, under strict quality and safety criteria (Photos Benoit Rajau for the Agence de la biomédecine).|
A small number of HSC also get into the bloodstream, and can be collected (apheresis) after stimulation by a synthetic growth factor and used for transplantation. Those cells are called “peripheral blood stem cells”.
|Peripheral Blood Stem cell Collection, under strict quality and safety criteria (Photos Benoit Rajau for the Agence de la biomédecine).|
Finally, HSC are also present in the foetal blood remaining in the umbilical cord after delivery.
|Cord blood collection right after the birth, tests, quality criteria, storage (Photos Benoit Rajau for the Agence de la biomédecine).|
Although, HSC can be collected from the bone marrow, the bloodstream or the umbilical cord to be transplanted, clinical indications only (underlying disease, patient age and clinical condition, donor availability, etc.) are driving the choice for the right HCS source to be transplanted to the right patient at the right time.
HCST saves lives. However, since the degree of compatibility required is considerably higher than for organs, only a third of patients requiring HSCT find a compatible donor within their family, relying then on unrelated compatible donors.
Despite the establishment of large registries of volunteer donors (for bone marrow and PBSC) and banks of cord blood, finding unrelated compatible donors continues to be difficult. Facing the growing number of patients to be transplanted, the European Union aims to facilitate patients a secure, efficient and egalitarian access to HSCT from unrelated compatible donors.
Regarding Haematopoietic Stem Cells for Transplantation, the development of new sources (mobilized peripheral Haematopoietic Stem Cells, cord blood) contributed to increase both the number and the age of patients receiving Haematopoietic Stem Cells transplants and modified medical practices.
Therefore, ARTHIQS also aims to develop guidelines for key aspects of service provision and regulation in Haematopoietic Stem Cells for Transplantation regarding the main characteristics for Haematopoietic Stem Cells donor follow-up registries to be implemented both locally and nationally, and guidelines for cord blood banking i.e. covering all stages and including the minimum requirements for authorising/re-authorising Cord Blood Banks along with guidelines for Cord Blood Banks inspectors.
Candide FONT-SALA, ARTHIQS Coordinator, Agence de la biomédecine