Obstetrician Role in Increasing Patient's Access to Cord Blood
Each year, more than 12,000 patients in the U.S. are diagnosed with life-threatening diseases such as leukemia, sickle cell anemia, and certain genetic diseases, and their best or only hope of a cure is a blood stem cell transplant. Umbilical cord blood, which is typically discarded, is rich with blood-forming cells that can give these patients a potential cure by serving as donor cells to rescue the blood forming system in a blood or bone marrow transplant.
Currently, the Be The Match Registry® provides access to nearly 185,000 cord blood units and 10.5 million potential adult donors, as well as additional potential donors and cord blood units on international registries. In 2012, The NMDP facilitated nearly 1,200 umbilical cord blood transplants, and has facilitated more than 7,000 total umbilical cord blood transplants since 2000, when the organization first began using cord blood as a cell source.
Because a cord blood unit does not need to match as closely as marrow or peripheral blood stem cells, cord blood transplants are a good option for patients with uncommon tissue types who do not have a closely matched adult donor. In 2012, 39 percent of all minority recipients received cord blood transplants. This is important to people with racially and ethnically diverse backgrounds that tend to have a more difficult time finding a matched donor. Because it’s stored and readily available, cord blood is particularly useful for patients with an urgent need for a transplant.
Obstetricians are uniquely positioned to educate their patients on the importance of cord blood donation, evaluate prospective donors, as well as collect high quality cord blood units.
Currently, obstetricians lack awareness of the importance of discussing cord blood donation with prospective patients, thus impeding women from donating their baby's cord blood to a public bank. In addition, a large percentage of cord blood units that are collected, do not qualify for banking. Cord blood banks have reported challenges related to obstetrician cord blood collections. According to the Parent’s Guide to Cord Blood, between 50 – 75% of donations are discarded. The primary reason is that the collection volume is too small.
As efforts to increase the national inventory of publicly available cord blood units moves forward, it is imperative that obstetricians have a better understanding in the role of helping parents decide to donate, as well as training in the proper collection procedures and processes.
While research indicates that obstetricians are generally familiar with the utility of donated cord blood in transplantation, they could benefit from additional information regarding how cord blood is used in transplantation. Data from a 2011 Transfusion publication indicated that while 80% of affiliated obstetricians feel confident discussing cord blood options with their patients, less than half (49%) indicated that they have insufficient knowledge of cord blood donation to effectively answer patients’ questions about donation.
Hours of Participation for Allied Health Care Professionals
The Medical College of Wisconsin designates this activity for up to 1 hours of participation for continuing education for allied health professionals.
- Family Practitioners
At the conclusion of this activity, I will be able to:
- Identify the utility of cord blood units in the field of unrelated donor hematopoietic stem cell transplantation.
- Describe the role of the obstetrician in educating and evaluating appropriate patients for umbilical cord blood donation.
- Cite best practices for in-utero collection of umbilical cord blood to maximize the quality and volume of a cord blood collection
- 1.00 AMA PRA Category 1 Credit(s)™AMA PRA Category 1 Credit(s)™
- 1.00 Hours of ParticipationHours of Participation credit.