Report proposes structure for national network of cord blood stem ...( ter the committee concluded. HRSA off...)

ter, the committee concluded. HRSA officials should use a competitive process to solicit proposals and identify an organization to take on this function. NMDP and other organizations would have an opportunity to present plans for ensuring that all the necessary elements are in place to link participating transplant centers and cord blood banks; establish standards for cord blood storage and matching; and make sure that data on the results of transplants are available for decision-making and quality assurance. Although the new center would coordinate these various activities, it need not assume all of these functions itself, the report says.

The majority of funding available for the national cord blood bank program should be targeted to expanding the inventories of participating banks. Based on the current estimate that 50,000 useable units of cord blood are now available through public banks and the NMDP, the committee projects a need for at least 100,000 more high-quality units. The larger the inventory, the greater the likelihood that a patient will be matched to a suitable unit and receive an optimal dose of cells, although the costs of collecting and storing cord blood also must be considered. The point at which the costs of banking cord blood exceed the benefits for the patient population is 200,000 units, according to an economic analysis conducted for the study.

Cord blood banks should strive to provide units with a high-enough concentration of stem cells to make up for imperfect matches between donor and recipient -- a frequent occurrence, the report notes. The more closely surface markers on donated cells match those on a patient's own cells, the less likely that the patient's body will reject the transplant. In many cases, a mismatch of one or two degrees is the best that can be found in public banks. Patients for whom an ideal match cannot be located should receive units that contain at least 2.5 x 107 cells per kilogram of body
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Contact: Christine Stencel or Chris Dobbins
news@nas.edu
202-334-2138
The National Academies
14-Apr-2005

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