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This follows the announcement by Richard Branson of plans to store stem cells from the umbilical cord blood of new-born babies to aid medical research.
Nicholas Fisk, Professor of Obstetrics and Foetal Medicine, Imperial College London and Queen Charlotte’s Hospital London, said:
“The Virgin launch is characterised by much more honesty than we have been used to. They have acknowledged that the chances of using the blood stem cells for your own child are practically nil. They have also acknowledged that the use in stem cell and regenerative medicine is currently only a possibility, but may in the future happen.
“The main use would be in public blood banks from which people could obtain a sample for cord blood transplant. It cleverly mixes both public and private storage by splitting the sample into 20% private and 80% public storage. Although 20% is not much, in 99% of cases the public sample will not have been used and therefore continues to be available for the child. And conversely the 80% for public usage will reduce the success rate of transplant slightly because 100% would be optimum, but that is the cost of a compromise to achieve this public private split. Scientists welcome the public component of this and also the offer to contribute 50% of profits to fund translational research.
“There remain considerable logistic barriers to collection both in terms of safety in complicated pregnancies, and in the relatively low staffing levels for safety available in the NHS. The way to do this would be for the company to provide additional staff or trained collectors.
“There are a plethora of companies offering cord blood storage with differing forms and collection requirements. As a result, currently only 20% of NHS hospitals will agree to collect cord blood. The Branson proposal will go someway to alleviating clinical and scientific scepticism about private cord blood banking. However, streamlining collection procedures will remain a major barrier to the uptake of this initiative.”
Leroy Edozien, Consultant Obstetrician and Gynaecologist, St Mary’s Hospital, Manchester, said:
“Workforce constraints constitute a major threat to patient safety in UK maternity units. Midwives and obstetricians are working at full stretch and any intervention which places additional burden on them will increase the opportunities for human error and patient safety incidents. It appears that Sir Richard Branson’s proposal will impose such a burden. It must be emphasised that cord blood collection entails more than merely passing a needle through a placental vessel. There are issues relating to consent, screening the donor for infection, precautions to avoid contamination, safety measures to avoid mislabeling and mix-up of samples, and a number of other considerations.
“A more altruistic approach will be to promote public rather than commercial cord blood banking. This will allow more equitable access to cord blood units. Also this type of collection is done by staff trained for and dedicated to cord blood collection, not staff who are involved in the clinical care of the woman.”
Prof Robin Lovell-Badge, Head of Developmental Genetics, MRC National Institute for Medical Research, said:
“We should welcome Sir Richard Branson’s investment and commitment to stem cell research and therapy, and his proposals which should make a very favourable change in the cost-benefit ratio with respect to cord blood stem cell banking. However, it should still be recognised that the clinical use of these particular stem cells has only been demonstrated for a set of (thankfully) rare disorders affecting the blood system, and while it is hoped they may have uses in a broader range of problems, such as degenerative diseases, it is possible that other stem cell types, such as embryonic stem cells, may provide better therapies in the future. So, while this venture is certainly worthwhile, the bank may not necessarily contain useful ‘deposits’ in the future. It is critical that Sir Richard maintains a dialogue with a wide range of scientists and clinicians to ensure the value of his own financial investments in this area.”
Dr Chris Mason, Group Leader, Stem Cell & Regenerative Medicine Bioprocessing Unit, Advanced Centre for Biochemical Engineering, UCL, said:
“This is win-win situation; it’s good for patients and good for helping to keep the UK at the forefront of stem cell research.”
Dr Marita Pohlschmidt, Director Of Research, Muscular Dystrophy Campaign, said:
“Families affected by muscle disease are always anxious not to miss an opportunity to do the best for their children, but there is currently no evidence to recommend private cord blood banking for these genetic conditions. We support the RCOG’s cautious approach to storing umbilical cord blood for non-blood-related diseases.
“We do, however, welcome Virgin’s plan to make the bank accessible to researchers worldwide. We hope this will help scientists understand more about whether and how stem cells could be used to develop treatments for a range of muscle conditions.”
Dr Jacky Boivin, School of Psychology, Cardiff University, said:
“The possibility of a sick child is traumatic for any parent, especially at the highly emotive time surrounding birth.Pregnant women and their families should be given information about the pros and cons of cord blood storage very early in the pregnancy so that their decision-making is not unduly influenced by these emotions.”
A spokesperson for the RCOG (Royal College of Obstetricians and Gynaecology), said:
“This initiative sets out some novel concepts which accord with the RCOG guidelines Umbilical Cord Blood Banking (Opinion Paper 2) published in June 2006. We are pleased with the honesty of the Health Bank statement that the likely need of a child in a low risk family for its own cord blood as a personally assured alternative to bone marrow transplantation for serious haematological conditions is remote. This reinforces our recommendation that there is little evidence to recommend private cord blood banking for this purpose. However, the intention to develop a substantial bank of cord blood available internationally to cord blood registers is to be applauded. The RCOG has supported strongly the need for an increase in public banks and international accessibility which the Virgin Health Bank sets as one of its priorities.
“Our prime concern remains the process of collection of the cord blood and the health of mother and baby. It is imperative that the collection should not in any way compromise the attention of the carers to the delivery, and ideally the sample should be collected by a trained third party once the placenta has been delivered. This will also reduce the likelihood of bacterial contamination of the sample which would render it useless for storage. Further dialogue with the profession and involved Maternity Units is essential.
“Professor Peter Braude, chair of the RCOG Scientific Advisory Committee, said, ‘Regenerative medicine holds great promise for future management of many diseases, and cord blood stem cells might fulfil that promise if they can be expanded and grown successfully in large numbers. So far this has not been the case, but it may change in the future. This proposal provides a long term insurance lottery that may or may not prove to be successful. However in the wake of the personal storage of a teaspoonful of stem cells for the child itself, is the possibility of a significant increase in the availability of larger cord blood samples for all through a form of public banking.”
Dr Kieran Breen, Director of Research and Development at the Parkinson’s Disease Society, said:
“Stem cell research is an important area of study for people with a range of conditions, including Parkinson’s. Because stem cells are so versatile they could possibly be used to repair and renew cells in the body and brain, and therefore, potentially lead to a cure for conditions such as Parkinson’s.
“The Parkinson’s Disease Society firmly supports stem cell research, provided it is carried out within the UK’s strict ethical and regulatory framework.
“However, the research potential of umbilical-cord derived stem cells is still at an early stage and it is not possible to predict if it could provide any benefit to people with Parkinson’s.
“The decision for a person to store stem cells from their umbilical cord would be a personal choice, which the Parkinson’s Disease Society cannot advise on.”
A Department of Health (DH) spokesperson, said:
“We support the RCOG view that private cord blood collection is not recommended for treating children from low risk families. The NHS Cord Blood Bank already collects sufficient cord blood to treat children who may need it for treatment.
“We welcome the Virgin Health Bank’s plans to increase the availability of cord blood for research and treating patients. This will build on the £100m that we are investing in all forms of stem cell research over the next two years. Parents wishing to bank their baby’s cord blood should still discuss this carefully with their midwife and delivery team in advance.”