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Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians. Pediatrics 2009 Mar;123(3):1011-7

Date

03/04/2009

Pubmed ID

19255033

Pubmed Central ID

PMC3120215

DOI

10.1542/peds.2008-0436

Scopus ID

2-s2.0-63149124868 (requires institutional sign-in at Scopus site)   46 Citations

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.

Author List

Thornley I, Eapen M, Sung L, Lee SJ, Davies SM, Joffe S

Author

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Anemia, Aplastic
Attitude of Health Personnel
Blood Banks
Brain Neoplasms
Cross-Sectional Studies
Directed Tissue Donation
Ethics, Medical
Fetal Blood
Graft Survival
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Infant, Newborn
Minority Groups
Neuroblastoma
Pediatrics
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Privatization
Remission Induction
Retinoblastoma