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FROM THE AMERICAN ACADEMY OF PEDIATRICS: Section on Hematology/Oncology and Section on Allergy/Immunology Cord Blood Banking for Potential Future Transplantation Pediatrics 2007; 119: 165-170 [Abstract] [Full text] [PDF]

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Cord Blood Banking for Potential Future Transplantation

Robert A. Dracker   (9 January 2007)

Cord Blood Banking for Potential Future Transplantation 9 January 2007
Robert A. Dracker, Doctor FAAP Send letter to journal: Re: Cord Blood Banking for Potential Future Transplantation rdracker{at}hotmail.com Robert A. Dracker	Robert A. Dracker MD, MHA, FAAP Summerwood Pediatrics 4811 Buckley Road Liverpool, NY 13088 Tel (315) 457-9966 Fax (315) 457-9854 January 9, 2007 Jerold Lucey, M.D. University of Vermont College of Medicine D201 Given Building 89 Beaumont Avenue Burlington, VT 05405-0068 Dear Editor: It is widely known that umbilical cord blood contains a large proportion of pluripotent hematopoietic stem and progenitor cells with proven clinical utility in treating over 40 diseases in over 8,000 transplantations. Through continued research, truly pluripotentent stem cells found in cord blood may increase the therapeutic value beyond blood and immune-based diseases. Since the ability to collect and preserve unique stem cells from cord blood is a one-time opportunity, missing this important option may prevent future patients from benefiting from related medical therapies. Such an important choice should only be made by informed parents, not physicians. Physicians have a duty to inform their patients regarding health care options. The Institute of Medicine Report (IOM) issued recommendations that cord blood donors must be provided clear, balanced information about their options for preserving cord blood stem cells. Inherent in these recommendations is the duty of physicians to uphold the underlining principles of informed choice which all parents deserve for their children. The opinions represented in the recently updated policy statement titled Cord Blood Banking for Potential Future Transplantation appear to contradict these recommendations. The opinions rendered provide a biased view and not necessarily the opinions of many practitioners or thought leaders in this emerging area. The lack of acknowledgement that most units preserved privately are used by the family (not necessarily by the child whose unit was stored) is clearly misleading. The overall incidence of diseases amendable to transplantation in family members is obviously many times greater than the incidence of a transplantable disease in the child whose cord blood was preserved. Data suggest that 45% of birthing mothers have had no previous children, while 35%, 14%, and 5% have had one, two, or three previous live births. Half of the birthing families have more than one child, and half may have another child in the future; therefore, these siblings must be considered during the families’ educational process. Efforts supporting the development of public banks are critical but should not be pursued to the exclusion of family banking which is a family’s prerogative. I believe the policy may have the potential to interfere with families having access to the highest quality medical option at the time of need. I believe that only through the availability and collaboration of both private and public endeavors can the most efficient and effective options remain available for all of our patients. Sincerely, Robert A. Dracker MD, MHA, FAAP APPENDIX B FINANCIAL DISCLOSURE Over the past 10 years I have held various roles such as ViaCord Medical Director / Tissue Bank Director / Laboratory Director with ViaCord, a Division of ViaCell, Inc. I have never held any stock or equity position in the parent corporation. Robert Dracker MD, MHA, FAAP Conflict of Interest: None declared