Pennsylvania has state legislation around cord blood education that follows the Institute of Medicine guidelines and mandates/encourages physicians to educate expectant parents about ALL forms of cord blood banking. The Pennsylvania bill was enacted 3 April 2008 and became effective 2 June 2008.
- How is education from the Parent's Guide to Cord Blood unique?
- We are the only organization in the United States providing cord blood education materials that offer balanced information about both donation and family storage, and are approved by an Advisory Panel of leading Scientists and Medical Doctors.
- Are related donors better for transplants?
The overall answer is yes, but this is a complex topic.
The two important measures of patient outcome are: long-term survival, and the impact on quality of life from graft-versus-host disease (GvHD). Sibling donors tend to trigger less GvHD. Also, sibling donors are available faster than searching for an unrelated donor, and patients have better survival when they go to transplant faster after diagnosis.
The exact comparison of outcome between sibling or unrelated donor varies with the patient diagnosis. The NMDP website has a page on this, with numerous references. For many cancers the outcomes are comparable, although sibling donors have a slight edge. The largest study was by Weisdorf et al. 2002, for over 2900 patients with CML leukemia. When correcting for all other factors, the survival with sibling donor vs unrelated donor was 68% vs. 61%. Sibling donors show a significant improvement for pediatric cord blood transplants of hereditary disorders. The European Blood and Marrow Transplantation Group (EBMT) reported 3 year survival rates of 95% from a sibling donor vs. 61% from an unrelated donor.
Weisdorf, D.J. et al. Blood 2002; 99:1971-1977.
Bizzetto, R. et al. (EBMT) Haematologica 2011; 96(01):134-141
- Processing: How is cord blood processed before storage?
The three main components of cord blood, like any blood collection, can be separated by weight: the heaviest layer is the red blood cells (RBC), the lightest is the plasma (a clear white liquid), and in the middle is a pinkish layer called the "buffy coat" which contains the white blood cells (WBC), including stem cells. When banks process the cord blood, the final separated component that goes into storage is the buffy coat, even though only about 1% of the cells are actually stem cells. There is no procedure to separate out the stem cells alone.
The vast majority of blood processing methods rely on the different density of the three main blood components. They can be separated by sedimentation, or by centrifuge, or by a combination of the two techniques. The procedure can be performed manually by trained technicians or by automated machine.