Can routine commercial cord blood banking be scientifically and ethically justified?

Umbilical cord blood - the blood that remains in the placenta after birth - can be collected and stored frozen for years. It is sometimes used as an alternative to bone marrow for treating diseases such as cancer and immune disorders - the cord blood is given to siblings or unrelated recipients. Many women altruistically choose to donate cord blood for unrelated recipients to public banks. However, private banks are now open that offer expectant parents the option to pay a fee for the chance to store cord blood for possible future use by that same child (known as an autologous transplant). Is such private banking scientifically and ethically justifiable? A debate in this month's PLoS Medicine looks at both sides of the commercial cord blood controversy.

Nicholas M. Fisk, Professor of Obstetrics and Fetal Medicine, and Irene A. G. Roberts, Professor of Paediatric Haematology, both at Imperial College London, United Kingdom, criticize the practice of private cord blood banking. They say that umbilical cord blood collection for possible autologous transplantation is logistically difficult and that it is very unlikely that the blood will ever be used: "The probability of needing an autologous transplant is less than one in 20,000, although commercial providers quote figures at least an order of magnitude higher." Fisk and Roberts also say that private cord blood banks target parents at a vulnerable time. "Such banks have been said to raise hopes of utopia and to use the promise of 'helping children' to disguise a mercantile project."

But Roger Markwald, Distinguished University Professor and Chair, and Vladimir Mironov, Associate Professor, both at the Department of Cell Biology and Anatomy at the Medical University of South Carolina, USA, argue that although the chance of a donor benefiting may presently be low, "at the pace that stem cell research is moving, perhaps there will be new uses for umbilical cord blood cells in the

Contact: Paul Ocampo
Public Library of Science

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