Cord blood stem cells for hematopoietic stem cell transplantation in the UK: how big should the bank be?

• Published in: Haematologica (Roma) 2009-04, Vol.94 (4), p.536-541
• Main Authors: Querol, Sergio, Mufti, Ghulam J, Marsh, Steven G.E, Pagliuca, Antonio, Little, Ann-Margaret, Shaw, Bronwen E, Jeffery, Robert, Garcia, Joan, Goldman, John M, Madrigal, J. Alejandro
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Banks - standards; Cord Blood Stem Cell Transplantation; Fetal Blood - cytology; Hematologic and hematopoietic diseases; Hematopoietic Stem Cells; Histocompatibility; Humans; Medical sciences; Original; Tissue Donors - supply & distribution; United Kingdom
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2008.002741

1 Anthony Nolan Research Institute, Royal Free Hospital, London, UK 2 Department of Haematology, UCL Cancer Institute, Royal Free Campus, London, UK 3 Department of Haematology, Kings College Hospital and Kings College, London, UK 4 Royal Marsden Hospital, Sutton, Surrey, UK 5 Programa de Sang de Cordó, Banc de Sang i Teixits, Barcelona, Spain Correspondence: J. Alejandro Madrigal, Anthony Nolan Research Institute, Royal Free Hospital, Pond Street, London NW3 2QG, UK. E-mail: a.madrigal{at}medsch.ucl.ac.uk Background: A stored cord blood donation may be a valuable source of hemopoietic stem cells for allogeneic transplantation when a matched sibling donor is not available. We carried out a study to define the optimal size of a national cord blood bank for the UK. Design and Methods: We calculated the actual numbers of possible donors and the chance of finding at least one donor for 2,000 unselected and for 722 non-North Western European patients for whom searches had been initiated as a function of three levels of HLA matching (4, 5 and 6 out of 6 alleles by HLA-A, -B low and -DRB1 high resolution HLA typing) according to various donor bank sizes. Results: With a bank size of 50,000, 80% of patients will have at least one donor unit available at the 5 out of 6 HLA allele match level (median 9 donors per patient), and 98% will have at least one donor at the 4 out of 6 allele match level (median 261). Doubling the size of the bank yields at least one donor for only an additional 6% of patients at the 5 of 6 allele match level. Moreover, for non-North Western European patients a 50,000 unit bank provides a donor for 50% at the 5 allele match level, and for 96% at the 4 allele match level. Conclusions: A bank containing 50,000 units is optimal for the UK and larger banks would only marginally increase the chance of finding suitable units. Key words: cord blood, banking, stem cell transplantation. Related Article Cord blood transplantation: state of the art Eliane Gluckman, Vanderson Rocha Haematologica 2009 94: 451-454. [Full Text] [PDF]