LITTLE ROCK — The Cord Blood Bank of Arkansas has collected only two units of umbilical-cord blood for use in an international donor network in its first year of operation, falling short of operators’ expectations.
Doctors throughout the state have collected public donations of the blood from 125 new mothers, said Dr. Michele Fox, the bank’s medical director. But only 37 of those samples yielded enough blood to be usable. And of those, 35 had to be discarded because they did not have enough cells, she said.
“The good news is that we have an increasing number of moms who want to donate for us,” Fox said. “We’ve gone from one or two a month to one or two a week. But there’s a difference between donating and actually getting into the bank.”
Organizers of the fledgling bank, believed to be the first statewide cord-blood storage facility in the country, must now work to educate the state’s doctors about how to more effectively fill collection bags, she said.
Previously discarded as medical waste, cord blood is now seen as a precious resource rich with stem cells or “seed cells,” which can be used to regenerate healthy blood cells and fill the needs of patients who need bone marrow transplants. And the stem cells derived from cord blood - different from embryonic stem cells that have stirred ethical contention - may lead to further medical breakthroughs in the future.
Doctors can quickly and painlessly collect the blood after a woman gives birth, drawing it from the umbilical cord and placenta, which makes donating it more attractive to women who are informed about its benefits, Fox said.
Gov. Mike Beebe in 2007 signed into law the creation of a commission to oversee the state’s umbilical-cord blood bank at the University of Arkansas for Medical Sciences in Little Rock.
An anonymous foundation awarded the bank a $250,000 grant, matched through private contributions, and the legislation provided about $180,000 in one-time funding.
When the bank reaches 100 usable public blood donors, it will be connected to the National Marrow Donor Program, allowing blood collected from Arkansans to be used in patients around the world.
Public donations are anonymously stored and available for any patient to use. Patients can also bank privately, paying an annual fee to store their own cord blood for use by their child or family members.
But the American Congress of Obstetricians and Gynecologists does not advise doctors to recommend private banking for most patients because there is a low likelihood that a child will use that blood within his lifetime.
“Some experts estimate this likelihood at one in 2,700, while others argue the rate is even lower,” the organization’s position paper said. “Physicians should also disclose to their patients that it is unknown how long cord blood can successfully be stored.”
The Cord Blood Bank of Arkansas has banked 32 private cord-blood samples, Fox said, charging $1,399 for the collection and the first year of storage, and an annual fee for each year it holds the sample after that.
The money from private banking helps cover the cost of storing public donations.
It takes 80 milliliters to fill a donor bag, which is about a third of a cup of cord blood.
Obstetricians at UAMS are developing educational materials and an instructional video to train the state’s doctors on how to more effectively fill donation bags, Fox said. The bank currently relies on a slide show posted on its website.
“We are trying to determine what the problem is,” Fox said. “We will end up with an educational tool we can share with other institutions.”
Because there is limited research on cord-blood banking, it is difficult to determine a national benchmark for how many viable donations Arkansas doctors should be collecting, she said.
The Arkansas bank is unique because it allows doctors throughout the state to collect donations. Most other public cord-blood banks draw donations only from individual hospitals, which are frequently part of medical schools.
David Harris, chief science officer of the University of Arizona’s cord-blood bank, said only about 40 percent of cord-blood donations collected have enough volume and enough cells to meet criteria set by the U.S. Food and Drug Administration.
“It’s not unusual for a public bank to not be able to use half of the material that it collects,” he said.
The Arizona bank, in operation since 1992, collects about 500,000 samples a year, Harris said.
Several factors can create samples with low cell volume, including low birth-weight babies and delay in collecting the cord blood, he said.
Harris said he wouldn’t be surprised to learn that a cord blood bank relying on doctors from multiple hospitals, such as Arkansas’, was struggling to collect viable donations. Problems with collection tend to be higher with inexperienced doctors, he said.
“If you’re at a place that delivers 100 babies a year, you’re not going to have the same experience as a couple that delivers a couple thousand,” Harris said.
Of the 8 million publicly banked cord-blood samples in the United States, 85 percent are from white donors, he said. Because of this, public banking efforts should be focused on areas with large minority group populations, who have been less likely to donate, Harris said.
Arkansas may have more success making a targeted effort to seek black donors from Little Rock and Hispanic donors from Northwest Arkansas, he said.
“That’s really where the unmet need is,” Harris said.
Arkansas, Pages 9 on 05/29/2012