Cord Blood Banking

Question 1

What are the 2 main options for cord blood banking in Australia?

Answer 1

Altruistic / non-directed cord banking (public system)
- Taken and stored by Auscord into a national cord blood bank, which can then be used to treat patients nationally requiring stem cell transplants .

Directed cord blood banking (privately funded)
- Taken for a specific purpose - namely to provide stem cell transplant for an affected sibling.

Question 2

What are the benefits for cord blood banking?

Answer 2

• Availability
• extension of the donor pool
• lower incidence of graft versus host disease
• can be transplanted even with a higher degree of HLA mismatch
• lower incidence of viral transmission
• more ethical source HSC for research than embryological stem cells

==========================

• Around 70% patients requiring bone marrow transplants do not have a relative with suitable HLA matching to be a donor. Only 25% of these find a donor on current donor waiting lists.
• Cord blood can be used to meet this demand - estimates suggest may be able to meet up to 90% of this demand
• Lower level of HLA compatibility required for cord blood stem cell transplants than allogenic bone marrow transplant, due to lower risk host-graft rejection
• It can also be used to treat family members requiring BM transplant
• It can be used for stem cell research and avoids the ethical dilemma about destroying embryos to obtain stem cell

Question 3

What are the down sides to cord blood banking?

Answer 3

• Few hospitals have facility for altruistic cord blood banking
• Collection and storage technical and expensive
• Cord blood sample is often not enough for older child or adult transfusions, thus bone marrow transplants are often still required anyway
• Cord blood often not useful for use within the same child as it was donated from, as the condition requiring transplant may affect the cord blood sample.

Question 4

How is cord blood banking done?

Answer 4

The umbilical cord is double clamped and cannulated and a maximum volume of cord blood collected to a bag.
Not compatible with delayed cord clamping.
Blood is then stored either in public or private facility.
Family contacted at a year to ensure childs health and suitability of use for donation.

Question 5

What are the uses/applications of cord blood?

Answer 5

• Uptimes to 20% stem cell transplants in children are from cord blood
• Main use is for relapsed acute lymphoblastic leukaemia in children.
• Other haematological malignancies requiring bone marrow transplant
• Haemoglobinopathies requiring frequent transfusions
• Stem cell research

Question 6

What is special about cord blood?

Answer 6

Haematopoetic stem cells; they have pluripotent potential to differentiate into other cell lines (e.g. neurones).

They do not require the same degree of HLA matching as donor samples, which means each sample can be used by a wider group of the population.