Activity Description
Blood stem cells allow for hematopoietic reconstitution in patients with blood disorders. Bone marrow from siblings or otherwise histocompatible donors has been the traditional source of these cells. However, even with the development of the National Bone Marrow Donor Registry, many patients lack a suitable donor--minorities are especially affected.
Umbilical cord blood has been found to have a high concentration of blood stem cells, and as such, offers a potential source of treatment for patients who lack a matching marrow donor.
Legislation calling for the establishment of a National Cord Blood Bank Network was introduced in both the house and the Senate and the Appropriations Act for the Department of Health and Human Services provided ten million dollars for the establishment of a new national cord blood stem cell bank program within the Health Resources and Services Administration (HRSA).
The Institute of Medicine (IOM) was asked to provide HRSA with an assessment of the status of the existing cord blood programs and inventories and to make recommendations to enhance the structure, function, and utility of this resource.
Specifically, the committee considered the following:
- The role of Cord Blood in hematopoietic progenitor cell (HPC) transplantation in context with other sources of HPC.
- What is the current status of blood banks already in existence?
- What is the optimal structure for the cord blood program?
- What is the current use and utility of cord blood for stem cell transplants?
- How best to advance use of cord blood units (CBU) for HPC transplantation (i.e. setting storage standards, collection procedures, information sharing, distribution, and outcome measures)
- How best to make CBUs available for research, what consent procedures should be followed in order to obtain informed consent for both research and transplantation use.
- Should the cord blood program set practice guidelines for all banks or just the public banks? (e.g. what kind of haplotyping would need to be done before blood goes into the cord blood bank, how are the databases advertised)
In establishing the committee, IOM drew upon known experts in fields including medicine, bioethics, statistics, clinical outcomes, medical database development, obstetrics, cord blood banking, stem cell biology, clinical research design, blood and marrow banking operations, and HLA typing for transplantation.
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