How many lives could CB potentially save?
According to van Rood and Oudshoorn (2008), between 2000 and 2006, 151 000 patients qualified for an HLA unrelated donor transplant but, of these, only 64 720 actually received a transplant. [link]
Overall, 38% of patients for whom a search was started were actually transplanted. 28% of patients waited 6 months before failing the search procedure, 33% of patients were not transplanted despite a donor being found within 4 months, and finally, unrelated transplants were performed 2 months later than sibling transplants for the same indications. [link]
…timely CB access could benefit about one third of the patients requesting an unrelated donor. [link]
Public CB effectiveness
At a registry size of 10 million [bone marrow] donors, approximately 7 million additional donors are needed to increase the chance of matching by only 1%. [link]
…over 400,000 cord blood units donated and stored worldwide for unrelated use. Approximately, 14,000 unrelated cord blood transplants have been performed to date… [link]
… you can only donate your child’s cord blood if the baby is delivered in a hospital associated with a collection program. There are less than 200 collection centers in the US, mostly at large hospitals which deliver thousands of babies per year. [link]
The study showed that 50,000 donors would be required to provide at least one donor for 98% of the patients with at least a 4 out of 6 HLA match, to 80% with a 5 out of 6 match, and to 34% with a 6 out of 6 match. [link]
…estimate on the clinically useful size of a public CB bank to provide a suitable match for the UK population of 61 million people – 50 000 CB units. [link]
A non-biased bank of 50 000 would have around 15% of minority ethnic groups (about 7500 donors) and give a 36% chance of match for this group, and 80% for the whole population. If we bias collection towards the minority groups (i.e. doubling their representation to 30% of the inventory) the predicted figures are 74% for the whole population but 52% for the non-predominant ethnic groups. [link]
…the inventory should reach 150 000 donors to offer an 80% chance to the minority groups using the whole population… [link]
Private CB effectiveness
… about 900,000 cord blood units have been stored privately for personal use, with about 100 autologous transplants performed. [link]
Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. [link]
Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained.
if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. [link]
None of the 93 US and Canadian physicians surveyed recommended private cord blood banking if there were no ill siblings and parents were of Northern European descent. [link]
There is no data on long-term viability of cord blood cells after 10-15 years. [link]
An analysis of 52 transplantation cases from cord blood units stored in private cord blood banks in the period 1994 to 2004 showed that of these 46 cases were actually allogeneic transplantation to siblings. Allogeneic transplantation is clearly the most common use of privately stored cord blood units. [link]
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