title: Impact of selection of cord blood units from the United States and swiss registries on the cost of banking operations.
abstract: BACKGROUND
  Over the last 2 decades, cord blood (CB) has become an important source of blood stem cells. Clinical experience has shown that CB is a viable source for blood stem cells in the field of unrelated hematopoietic blood stem cell transplantation.
  
  
  METHODS
  Studies of CB units (CBUs) stored and ordered from the US (National Marrow Donor Program (NMDP) and Swiss (Swiss Blood Stem Cells (SBSQ)) CB registries were conducted to assess whether these CBUs met the needs of transplantation patients, as evidenced by units being selected for transplantation. These data were compared to international banking and selection data (Bone Marrow Donors Worldwide (BMDW), World Marrow Donor Association (WMDA)). Further analysis was conducted on whether current CB banking practices were economically viable given the units being selected from the registries for transplant. It should be mentioned that our analysis focused on usage, deliberately omitting any information about clinical outcomes of CB transplantation.
  
  
  RESULTS
  A disproportionate number of units with high total nucleated cell (TNC) counts are selected, compared to the distribution of units by TNC available. Therefore, the decision to use a low threshold for banking purposes cannot be supported by economic analysis and may limit the economic viability of future public CB banking.
  
  
  CONCLUSIONS
  We suggest significantly raising the TNC level used to determine a bankable unit. A level of 125 × 10(7) TNCs, maybe even 150 × 10(7) TNCs, might be a viable banking threshold. This would improve the return on inventory investments while meeting transplantation needs based on current selection criteria.
authors: Transfusion SRC Switzerland, Bern, Switzerland.
authors: Thomas
authors: T
authors: Bart
authors: Michael
authors: M
authors: Boo
authors: Snejana
authors: S
authors: Balabanova
authors: Yvonne
authors: Y
authors: Fischer
authors: Grazia
authors: G
authors: Nicoloso
authors: Lydia
authors: L
authors: Foeken
authors: Machteld
authors: M
authors: Oudshoorn
authors: Jakob
authors: J
authors: Passweg
authors: Andre
authors: A
authors: Tichelli
authors: Vincent
authors: V
authors: Kindler
authors: Joanne
authors: J
authors: Kurtzberg
authors: Thomas
authors: T
authors: Price
authors: Donna
authors: D
authors: Regan
authors: Elizabeth J
authors: EJ
authors: Shpall
authors: Rudolf
authors: R
authors: Schwabe
keywords: Blood products; CD34+ cells; Collection efficiency; Cord blood; Cost-benefit analysis; Cost-effectiveness analysis; Cryopreservation; Health economics; Hematopoietic cell transplantation; Hematopoietic stem cells
references: Clinicoecon Outcomes Res. 2010;2:141-7
references: 21935324
references: Transfusion. 2000 Jan;40(1):122-4; author reply 124-5
references: 10644825
references: Br J Haematol. 2007 Apr;137(1):20-35
references: 17359369
references: Klin Padiatr. 1999 Jul-Aug;211(4):224-32
references: 10472555
references: Blood. 2001 May 15;97(10):2957-61
references: 11342417
references: Blood. 2002 Sep 1;100(5):1611-8
references: 12176879
references: Cytotherapy. 2005;7(3):219-27
references: 16081348
references: Biol Blood Marrow Transplant. 2005 Feb;11(2):149-60
references: 15682076
references: Transfus Med Hemother. 2010 Apr;37(2):90-97
references: 20737051
references: Hematology. 2012 Apr;17 Suppl 1:S185-8
references: 22507816
references: Pediatr Blood Cancer. 2010 Jan;54(1):138-43
references: 19693941
references: Best Pract Res Clin Haematol. 2010 Jun;23(2):223-9
references: 20837334
references: Vox Sang. 2001 May;80(4):236-43
references: 11455961
references: Proc Natl Acad Sci U S A. 1995 Oct 24;92(22):10119-22
references: 7479737
references: N Engl J Med. 1957 Sep 12;257(11):491-6
references: 13464965
references: Transfusion. 2005 Jun;45(6):842-55
references: 15934981