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Cord blood banking - why aren't we doing it?

19 January 2010
By David Burrowes MP
Chairman All Party Parliamentary Group on Umbilical Cord Blood and Adult Stem Cells
Appeared in BioNews 541
In 2008 I was the first UK MP to raise the issue of umbilical cord blood (UCB) banking as a private members bill in Parliament and several MPs spoke to me of their previous ignorance of UCB. It is an ignorance I shared despite being a parent of six children and living close to one of the NHS hospitals that collects it.

Like the majority of parents in Britain we thought that the umbilical cord once clamped was simply a waste product. We were totally unaware of the potential benefits of donating our children's UCB. What inspires me to keep flying the flag for UCB is meeting those children who are still alive because of cord blood cell transplants.

Patients in the UK requiring a bone marrow donor currently have a one in four chance of survival. Only 50 per cent of those looking for a donor will find one and of these, only 50 per cent will survive.

For those who find a bone marrow donor, many get their donor too late in their disease for the treatment to achieve success - this contributes to the 50 per cent failure rate. Greater provision of cord blood could help these patients get treatment faster and improve their chances of survival. For those who currently have no bone marrow donor, a larger provision of cord blood would give many of them a potentially life-saving option.

Over the last 20 years collected UCB has been used for transplantation in the same way as bone marrow. It has been used to treat patients suffering from diseases such as leukaemia, sickle-cell diseases, immune deficiencies and others. Presently there are about 85 treatments based on cord blood and there are more in clinical trials. UCB is a natural, safe, ethical and sustainable resource. It offers many advantages over using traditional bone marrow transplants from adult donors and would offer researchers an alternative to using embryonic stem cells.

Presently 14,000 cord blood units are banked by the NHS and and provided 279 units of cord blood to British patients. The UK is falling behind its European neighbours and other developed countries. Our NHS cord blood bank is smaller than those of countries of a similar size, such as France. Greater attention and resources are paid to this issue in other countries such as Spain, Italy, Germany and the US. At present, UCB can be used only to treat a fairly narrow set of illnesses, but scientists believe that with more research and investment it could be used to treat a much wider range.

A key difficulty with cord blood transplants is the problem of engraftment where the body rejects the transplants, particularly in adolescents and adults. Until recently, UK transplanters have tended to opt for other established treatments because the reported results of UCB usage have not been as promising. Indeed, I received concerning news recently of a health commissioner asking for a business case to be made for a prospective cord.

However, recent overseas advances in the use of UCB and the launch last month of the first UK clinical trials of cord blood have greatly encouraged clinicians. At the instigation and under the management of Dr Rachael Hough of University College London hospital, two clinical trials are running across the UK. The aim is to establish the safety and efficacy of using unrelated UCB to bridge the engraftment problem, and to establish conditioning protocols. For example, it may be that by increasing the amount of cord blood stem cells - given the unique mobility involved - unrelated cord blood can provide safer and more effective life-saving treatments.

The scientific development and application of UCB in other countries has reached a point where it would be neglectful for the UK not to embrace to the full this exciting option. It is becoming clear that having a large range of cord blood donations available for patients to find compatible transplants would save both lives and money.

At my recent debate in the House of Commons on UCB I was delighted that the Government responded to the debate in a very positive and constructive way. The Health Minister Gillian Merron MP confirmed that £10 million has been set aside to increase the number of cords collected to 20,000. She has also agreed to provide regular information about the numbers of cords collected, stored and used for transplantation and research. Finally, she announced the establishment of an expert strategic forum which will operate as a high-level taskforce to advise ministers on the best options going forward and to pave the way for a comprehensive national strategy.

At last there seems to be real progress being made to make more use of the life saving resource of UCB.

 

SOURCES & REFERENCES
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