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Health: Cord Blood

Volume 697: debated on Monday 7 January 2008

asked Her Majesty's Government:

What percentage of the 8,000 cord blood transplants which have taken been place worldwide have been performed in the United Kingdom.[HL832]

This information is not held centrally. However, the NHS Cord Blood Bank estimates that around 150 transplants using material from cord blood have been undertaken in the United Kingdom.

asked Her Majesty's Government:

How many blood disorders have been successfully treated in the United Kingdom using cord blood. [HL833]

The department does not hold this information. Cord blood units are used to treat the same diseases as those treated by bone marrow transplant; that is to say, acute leukaemia, immunodeficiencies and metabolic defects.

asked Her Majesty's Government:

In respect of women donating cord blood, (a) how many NHS hospitals allow this procedure; (b) how many of these are outside London; (c) how many NHS hospitals there are in total in the United Kingdom; (d) what public funds have been allocated to develop these services; and (e) how long it will be before there is a national network of hospitals able to collect blood. [HL834]

Currently the NHS Cord Blood Bank collects cord blood stem cells from four collection sites—Barnet General, Northwick Park, Luton and Dunstable and Watford General hospitals. Luton and Dunstable and Watford General are not covered by London NHS trusts. Department funding for the NHS Cord Blood Bank from 2006-09 is approximately £10 million.

The aim of the NHS Cord Blood Bank is to redress the imbalance of minority groups that are represented on bone marrow registries by focusing collection at hospitals with high ethnic diversity and high delivery rates. As a consequence, approximately 40 per cent of donations in the NHS Cord Blood Bank derive from ethnic minority mothers, contrasting with approximately 3 to 4 per cent ethnic minority bone marrow donors present in the British Bone Marrow Registry, hence increasing the potential matches for patients from diverse ethnic groups.

All the cord blood units stored in the NHS Cord Blood Bank are available to NHS patients across the country. For these reasons, it is not considered necessary to collect cord blood from all hospitals.

The development of these services is kept under regular review and the Government will continue to support this work in the best way possible.

asked Her Majesty's Government:

What would be the justification or rationale for the creation of saviour siblings, as provided for in the Human Fertilisation and Embryology Bill, if there existed in the United Kingdom a coherent and effective cord blood service. [HL835]

The NHS Cord Blood Bank has been set up to complement bone marrow registries. In most cases, if a patient requires a stem cell transplant, cord blood is used only if an appropriate matched bone marrow donor cannot be found. Only 25 to 35 per cent of patients have a matched sibling. The chances of obtaining matched stem cells from an unrelated donor vary, depending on the ethnic origin of the patient. Therefore, matching is greatly improved when the donor and recipient have the same ethnic and racial background.

Since the majority of the 10 million unrelated donors available in registries worldwide at present are of white caucasoid ethnic background, most patients from this racial group have more than a 90 per cent chance of finding a matched, unrelated donor. However, this figure falls substantially for patients from ethnic minorities, who have only a 30 to 40 per cent chance of finding a good match.

The aim of the NHS Cord Blood Bank is to redress the imbalance of minority groups that are represented on bone marrow registries by focusing collection at hospitals with high ethnic diversity and high delivery rates. As a consequence, approximately 40 per cent of donations in the NHS Cord Blood Bank derive from ethnic minority mothers, contrasting with approximately 3 to 4 per cent ethnic minority bone marrow donors presently in the British Bone Marrow Registry, hence increasing the potential matches for patients from diverse ethnic groups.

The Human Fertilisation and Embryology Authority (HFEA) currently licenses, on a case-by-case basis, the screening of embryos where the intention is that the resulting baby's umbilical cord blood stem cells, or bone marrow stem cells, will be used to treat an existing sibling who has a life-threatening or serious illness.

The Human Fertilisation and Embryology Bill clarifies the scope of the HFEA to make such decisions by introducing five purposes for which embryos can be tested under a treatment licence. One of the purposes is for tissue typing (the creation of a “saviour sibling”). In practice tissue typing is only ever considered when all other options are exhausted; in other words, when there are no matched donors on the registry or within the family.

This may be the case when someone has a particularly rare tissue type. Even if there were a greater supply of cord blood available for treatment, it would still be possible that no match would be found. Therefore, it may still be necessary to use embryo testing to find an embryo that would result in a child with matched tissue whose cord blood cells could be used to treat a sick older sibling.