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. 2009 Mar;123(3):1011-7.
doi: 10.1542/peds.2008-0436.

Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians

Ian Thornley  1 , Mary Eapen, Lillian Sung, Stephanie J Lee, Stella M Davies, Steven Joffe
Affiliations

Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians

Ian Thornley et al. Pediatrics. 2009 Mar.

Abstract

Objective: Private cord blood banks are for-profit companies that facilitate storage of umbilical cord blood for personal or family use. Pediatric hematopoietic cell transplantation physicians are currently best situated to use cord blood therapeutically. We sought to describe the experiences and views of these physicians regarding private cord blood banking.

Participants and methods: We e-mailed a cross-sectional survey to pediatric hematopoietic cell transplantation physicians in the United States and Canada; 93 of 152 potentially eligible physicians (93 of 130 confirmed survey recipients) from 57 centers responded. Questions addressed the number of transplants performed by using privately banked cord blood, willingness to use banked autologous cord blood in specific clinical settings, and recommendations to parents regarding private cord blood banking.

Results: Respondents reported having performed 9 autologous and 41 allogeneic transplants using privately banked cord blood. In 36 of 40 allogeneic cases for which data were available, the cord blood had been collected because of a known indication in the recipient. Few respondents would choose autologous cord blood over alternative stem cell sources for treatment of acute lymphoblastic leukemia in second remission. In contrast, 55% would choose autologous cord blood to treat high-risk neuroblastoma, or to treat severe aplastic anemia in the absence of an available sibling donor. No respondent would recommend private cord blood banking for a newborn with 1 healthy sibling when both parents were of northern European descent; 11% would recommend banking when parents were of different minority ethnicities.

Conclusions: Few transplants have been performed by using cord blood stored in the absence of a known indication in the recipient. Willingness to use banked autologous cord blood varies depending on disease and availability of alternative stem cell sources. Few pediatric hematopoietic cell transplantation physicians endorse private cord blood banking in the absence of an identified recipient, even for mixed-ethnicity children for whom finding a suitably matched unrelated donor may be difficult.

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Conflict of interest statement

Financial disclosures and conflict of interest:

The authors have no financial conflicts of interest. Dr. Eapen is the Associate Scientific Director, CIBMTR, and Scientific Director of the Pediatric Cancer, Immune and Metabolic Disease, Non-malignant Marrow Disease, and Graft Sources and Manipulation Committees of the CIBMTR. Dr. Lee is the Scientific Director of the Immunobiology Committee, CIBMTR, and Co-Chair of the Health Policy Working Committee, CIBMTR. Dr. Davies is a member of the Board and of the Executive Committee of the NMDP, Chair-elect of the CIBMTR Advisory Committee, and a member of the CIBMTR Executive Committee.

Figures

Figure
Figure. Pediatric hematopoietic stem cell transplant physicians’ recommendations regarding prophylactic private cord blood banking
“Parents are expecting their second child. Their first child is a healthy three-year-old. They ask your advice about private cord blood banking. What would you recommend?” In the first scenario, both parents are of Northern European origin. In the second scenario, one parent is African-American and the other is Japanese-American.
See this image and copyright information in PMC

References

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    1. Viacord. [Accessed June 5, 2008];Viacord pricing and storage plans. http://www.viacord.com/pricing-storage-plans.htm.
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    1. Ferreira E, Pasternak J, Bacal N, de Campos Guerra JC, Mitie Watanabe F. Autologous cord blood transplantation. Bone Marrow Transplant. 1999;24:1041. - PubMed
    1. Hayani A, Lampeter E, Viswanatha D, Morgan D, Salvi SN. First report of autologous cord blood transplantation in the treatment of a child with leukemia. Pediatrics. 2007;119:e296–300. - PubMed

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