Only half a dozen years later, leaving a margin of safety that would prevent the creation of expectations in the parents of other people with the disease, the procedure, carried out on children of 15 and 24 months, was made public. In Portugal, the first cryopreserved stem cell transplant took place at the Portuguese Oncology Institute (IPO) in Porto in 2007. It saved the life of a 14-month-old child.
From harvest to storage
The harvesting process occurs at the time of delivery. It is made using a specific kit, which must be previously purchased. The collection is done immediately after the umbilical cord is cut. This means that neither the mother nor the baby will be put in danger and neither will feel any kind of pain. The person responsible for the harvest is an element of the medical team present at birth.
From here, the company that markets the service, a private bank, previously chosen by the parents, should be alerted to proceed immediately to the collection, transport in time to the laboratory and then to the processing of cryopreservation of the blood sample of the umbilical cord, which follows a series of rules. Mário Sousa, a geneticist, warned, however, in statements to Saber Viver that "only one out of every ten harvests of umbilical cord blood is of sufficient quality to be cryopreserved."
"We only proceed to the cryopreservation of the blood if it is free from contamination," he insisted, to underline the specialist's review. However, these cells are found not only in umbilical cord blood, but also in the bone marrow. In case an individual needs them for the therapy of a leukemia, for example, it is possible to resort to the world bank of bone marrow.
How do these cells help save lives?
In Portugal, at the beginning of the decade, there were more than 100,000. Cryopreservation of umbilical cord blood is sold to parents who want to use it in case their child develops a disease in which bone marrow transplantation can be curative. "But the probability of this happening is extremely remote," said Dr. Manuel Abecasis, a hematologist.
"It is important not to forget that, in children's acute leukemias, umbilical cord blood often contains leukemic cells," he explained at the time, in statements to the women's magazine Saber Viver, as director of the Bone Marrow Transplantation Unit Bone of the Lisbon IPO, one who was one of the pioneers of bone marrow transplants in Portugal. However, the blood of a child's umbilical cord can not help save it only in the future. It can also help save the life of a close relative, such as a sibling or even one of the parents.
These hematopoietic stem cells have advantages over the bone marrow of adults. They are younger, more resistant, have a greater regeneration capacity (ten times higher), have higher rates of donor and recipient compatibility, and a lower incidence of transplant rejection when used in bone marrow restocking after chemotherapy and / or radiation therapy.
Private banks vs. public banks
Portugal and the United Kingdom were, at the beginning of the decade, the only member states of the European Union where there were private banks of umbilical cord blood. In the case of the United Kingdom, those that exist are subject to periodic certification by Netcord, the international certification body for public banks. "In Portugal, there is no regulation," complained Mário Sousa.
"And one of the consequences is that the information that these companies divulge is not always true and is not controlled", warned, at that time, one of the best known proponents of the creation of a public bank of umbilical cord blood in our country. Since then, the picture has changed. The available information, besides being larger, also tends to be clearer.
"We live in a free society with a market economy and people are free to give their money the fate they want.If you are correctly informed about the real value of freezing your child's umbilical cord blood, why not?", Manuel Abecasis questioned at the time. Cryopreservation of stem cells costs at least € 1,000. The storage period is at least 20 years.
Text: Alexandra Pereira with Mário Sousa (geneticist) and Manuel Abecasis (specialist in clinical hematology)