18 April 2008
Patients at risk from critical shortfall in cord blood stem cells
Over 4000 people are dying every year from a critical shortfall in umbilical cord blood donations required for stem cell treatments of leukaemia and a number of other rare blood disorders.
Dr Paul Veys, Bone Marrow Transplant Consultant at Great Ormond Street, told a meeting of the foremost UK cord blood organisations this week: “We are only able to meet the needs of about 50% of cases of diseases like leukaemia that would benefit from a bone marrow or cord blood transplant from UK donors at the moment.
“However if the current resource of around 11,000 cord blood units was more like 100,000 finding a matched donor would be easier and we would be able to successfully treat more of these critically ill people.”
Attending the private meeting, held at the Royal Society for Medicine in London, were a newly formed working group consisting of the NHS Cord Blood Service, Anthony Nolan Trust, The Cord Blood Charity and Virgin Health Bank. The working group has been specifically convened to address issues surrounding cord blood banking in the UK and the shortage of donations.
The roles of public and private organisations in supporting cord blood banking have been brought sharply into focus with the release this month of a book by author and academic Donna Dickenson, entitled ‘Body Shopping: the economy fuelled by flesh and blood’, which explores the philosophical, ethical and legal concerns surrounding the practice of commercial companies operating within the field of biomedical sciences.
The NHS Cord blood service was established 12 years ago to harvest cord blood samples from willing donors to be made available via public registers for use in treating patients across the country. Cord blood is taken at the end of labour if consent has been obtained and it is safe to do so.
Dr Veys continued, “There are several important and exciting initiatives in the UK at the moment that are attempting to increase the numbers of publicly available cord blood units stored in the UK; the NHS cord blood bank, the Anthony Nolan Trust cord bank and also Virgin Health Bank. Virgin's model is different in that families retain part of their cord blood stem cells for their own use in the future, but the 80% which could be released for public use make a valuable contribution to our treatment options.”
The emergence of a two-tiered public – private system has sparked much controversy, particularly regarding whether private companies are exploiting mothers, and offering a service in return for benefits that are largely speculative – a point made by Dickenson in ‘Body Shopping’.
As Professor Colin McGuckin, Professor of Regenerative Medicine at Newcastle University and President of the newly formed Novus Sanguis ("New Blood") charity explains, "Your own stem cells can be used within families to treat certain conditions today, for example B-Thalassemia, but it is true to say that the majority of current applications involve cord blood transplants between unrelated individuals.
“However, breakthroughs are on the horizon. One of many examples of promising work with cord blood is a study in Florida where Type 1 diabetes has been treated using related cord blood, so there is a real benefit to having cord blood available for shared and for personal use."
Traditionally private cord blood banks have been painted in a poor light. Virgin Health Bank is unlike most companies, who offer to bank cord blood stem cells at a fee, for use only by the individuals donating.
As the only private company at the recent meeting, Virgin Health Bank has a unique business model which it believes can actively contribute to the solution and create an appropriate role for private companies in supporting cord blood banking in the UK.
“Virgin Health Bank was created as a way to break down the public, private divide which has characterised the cord blood banking sector to date.” said Michael Le Brocq Chief Operating Officer of Virgin Health Bank.
“Our service is unique in that we make collections that contribute both to public need and to private demand. Participants pay for a personal service that allows them to donate 80% of the cord blood sample taken to the public registry, while retaining 20% for potential use by their own child should they need it in the future. We provide a gold-standard service at hospitals throughout the UK.”
“It is critical that we address the concerns surrounding private banking of cord blood cells so that we do not deter donors at the expense of public need. At present there is a vital role for the private sector in supporting and promoting cord blood donations both for current and potential future treatment needs. As long as the service is impeccable and communication with mothers and families about the risks and benefits is clear and honest, private companies can make a valuable contribution to the greater good.”