Bone marrow transplantation can successfully treat patients with advanced malignancies, bone marrow failure syndromes, congenital immunodeficiency syndromes, hemoglobinopathies and inborn errors of metabolism. However the majority of patients in need of this therapy lack a matched related family member to serve as the donor. The National Marrow Donor Program was established 17 years ago to provide a registry of volunteer adult unrelated donors for patients in need of a hematopoietic stem cell transplant. The NMDP lists >5,000,000 donors and has facilitated >20,000 unrelated transplants to date. Despite this success, approximately 30% of Caucasian and 80% of African American patients are unable to find a suitably matched living volunteer adult donor.
Over the past 11 years, studies have demonstrated that partially HLA mismatched, banked unrelated donor umbilical cord blood could substitute for bone marrow as an allogeneic hematopoietic cell source for transplantation. This resource may help increase access to transplantation therapy for the majority of patients lacking a fully HLA matched volunteer adult donor. This has created a need to increase the inventory of banked unrelated donor cord blood units nationwide. To date, existing banks have operated independently without a central registry to list and manage donors. In addition, overall banking practices had not been standardized leading to confusion about product quality and content. Finally, increased diversity and larger units are needed to best meet the needs of patients looking for an allogeneic donor.
The NMDP has created a network of 13 cord blood banks, with a registered inventory of > 30,000 banked cord blood units, that are working together to establish and follow common quality standards. In addition, the network of banks lists their inventory in a single registry in order to facilitate and increase the efficiency of patient and transplant center access. Additional objectives of the network include the establishment of an ongoing inter-bank proficiency program; an educational program to train transplant center search coordinators on cord blood unit selection and to train transplant center laboratory staff on cord blood thawing and testing; a collections subcommittee to evaluate collection activities, donor selection criteria, donor testing; and an informatics program for intra and interbank cord blood unit information, HLA typing, searching and post transplant followup clinical data collection and analysis (CORDLink® and TRANSLink®).
All member banks have agreed upon criteria for quality standards for future cord blood units collected through the members of the network. Specific details of donor education, recruitment, selection; cord blood collection, processing, cryopreservation and banking; information technology for cord blood data, inventory and search management; thawing and post transplant clinical data acquisition and analysis have been established.
This NMDP Cord Blood Banking Network represents the first cooperative effort of multiple unrelated donor cord blood banks to agree to common practices and quality standards on a National basis. Of utmost importance is the additional fact that these units will be listed on a single, search registry ensuring access to all NMDP Transplant Centers.