Ten reasons to make cord blood stem cells a public good

Ken Flegel

doi:10.1503/cmaj.090972

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Cord blood banking
John A Smyth

Posted on: 22 July 2009
Support for a Canadian Public Cord Blood Bank
Gary C Jackson

Posted on: 07 July 2009

Posted on: (22 July 2009)
Page navigation anchor for Cord blood banking
Cord blood banking
John A Smyth
A News feature(1) and an Editorial(2) in the June 23, 2009 issue argue for a national program for cord blood banking in Canada. The Executive Director of OneMatch Stem Cell and Marrow Network, a division of the Canadian Blood Services, is quoted as saying “This is something that is otherwise medical waste that can truly save lives.” One should be aware that the collection process entails early clamping of the umbilical...
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A News feature(1) and an Editorial(2) in the June 23, 2009 issue argue for a national program for cord blood banking in Canada. The Executive Director of OneMatch Stem Cell and Marrow Network, a division of the Canadian Blood Services, is quoted as saying “This is something that is otherwise medical waste that can truly save lives.” One should be aware that the collection process entails early clamping of the umbilical cord, in order to recover an adequate volume of blood, a practice that may not be in the best interests of the newborn donor. Compared to early cord clamping, delaying for a sufficient time to allow the physiologic placental transfusion has been shown to reduce the incidence of anemia in full-term infants and to improve their iron status in infancy.(3) In preterm infants, albeit not candidates for cord blood banking, delayed cord clamping has also been associated with reductions in transfusion requirements and in the incidence of intraventricular hemorrhage.(4)
While not denying the potential benefits of cord blood banking, the product in the bank should not be regarded as “medical waste” and, in consenting to its collection, parents should be fully informed of the costs.
John A. Smyth LRCPSI Department of Pediatrics, University of British Columbia, Vancouver, BC jsmyth@cw.bc.ca
Eileen K. Hutton PhD Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON huttone@mcmaster.ca
References:
1. Silversides A. Cord blood bank plans evolve with "glacial speed." CMAJ 2009;180:1295-1296.
2. Flegel K. Ten reasons to make cord blood stem cells a public good. CMAJ 2009;180:1279.
3. Hutton EK, Hassan ES. Late vs Early Clamping of the Umbilical Cord in Full-term Neonates: Systematic Review and Meta-analysis of Controlled Trials. JAMA 2007;297:1241-1252
4. Rabe H, Reynolds GJ, Diaz-Rosello JL. Early versus delayed umbilical cord clamping in preterm infants. Cochrane Database of Systematic Reviews 2004;(4):CD003248.
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (7 July 2009)
Page navigation anchor for Support for a Canadian Public Cord Blood Bank
Support for a Canadian Public Cord Blood Bank
Gary C Jackson
Thank you for supporting this important topic in your recent editorial. Since 2005,the BC Cord Blood Bank Task Group has worked towards achieving the goal of a Canadian Public Cord Blood Bank. Our task group is composed of obstetricians and gynecologists, adult and pediatric transplanters, family physicians, and a haematopathologist. With support from the Multiethnic Marrow Transplant Society, we produced an 88 page F...
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Thank you for supporting this important topic in your recent editorial. Since 2005,the BC Cord Blood Bank Task Group has worked towards achieving the goal of a Canadian Public Cord Blood Bank. Our task group is composed of obstetricians and gynecologists, adult and pediatric transplanters, family physicians, and a haematopathologist. With support from the Multiethnic Marrow Transplant Society, we produced an 88 page Feasibility Study which was presented to the Provincial Health Services Authority (PHSA) in June of 2007. This document outlines the background of cord blood transplantation, as well as the cost involved in establishing a public cord blood bank in British Columbia. This study also emphasizes the importance of obtaining HLA types which are poorly represented in bone marrow registries. Vancouver with its ethnic diversity is an ideal site to begin to obtain these types. In fact, by 2017, ethnic 'minorities' in the greater Vancouver area will no longer be a 'minority'.
With support and encouragement from the PHSA we produced an Options Paper to look at the various ways in which a public cord blood bank could be established. We have also had encouragement from ethnic philanthropic groups in British Columbia.
In June of 2008, we met with the then Provincial health minister, Hon. George Abbott in order to provide the government with this information. Then on May 4, 2009 we also met with the CBS in Vancouver to hear their proposal and to present some of our data. The deputy ministers were to have met this June to decide upon the course to be taken to establish a Canadian Public Cord Blood Bank. We have yet to hear the plans from CBS but hope that their time line is more expedient than the plan presented to us in May. We do not feel that there is any reason why public cord blood donation could not start by the end of this year or early 2010 at the latest.
Yours truly,
Gary C. Jackson M.D. Co-Chair, BC Cord Blood Bank Task Group
Conflict of Interest:
None declared
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Competing Interests: None declared.