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Autologous cord blood transplantation. A procedure with potential beyond bone marrow replacement?

Bone Marrow Transplantation volume 26, page 1129 (2000)Cite this article

Ferreira and collaborators1 recently reported the first successful use of autologous cord blood transplantation as part of cancer therapy. Their report proves a principle. At the same time it raises many more questions than it provides answers. In their article they brought up the issue of cost-benefit for ‘insurance storage’ of cord blood for protection of the donors and the ethical questions this would entail.

As stated by Ferreira, there are presently no data that can or cannot justify ‘insurance storage’. In view of existing pressures for commercialization, we find it paramount that such a study be undertaken. Besides cost-benefit assessments and ethical issues it should address questions relating to technical issues of collection on a broad basis and storage over long periods of time, logistic issues, legal issues of proprietary rights and competition between allo- and autologous banking. Cost-benefit estimates should include traditional indications for autologous hemopoietic stem cell transplants, as well as the possibility of using cord blood for adoptive therapy of infections, autoimmune diseases2 or for gene therapy.3 In addition, cord blood hemopoietic stem cells might benefit late in life to counter the normal age-related decline in cellular immune capacity. Animal experiments at least indicate such a possibility.4 Lastly, cord blood harbors stem cells for other organs or tissues besides the hemopoietic system.

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Authors and Affiliations

  1. Department of Virus and Cancer, Danish Cancer Society, Aarhus, Denmark

    P Ebbeson

  2. Department Internal Medicine, Kantonsspital Basel, Div. Hematology, Basel, Switzerland

    A Gratwohl

  3. Division of Transplantation Sciences, University of Bristol, Bristol, UK

    J Hows

  4. Department of Ethics, Philosophy and History of Medicine, University of Nijmegen, Faculty of Medical Sciences, Nijmegen, The Netherlands

    H ten Have

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  1. P Ebbeson
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  2. A Gratwohl
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Ebbeson, P., Gratwohl, A., Hows, J. et al. Autologous cord blood transplantation. A procedure with potential beyond bone marrow replacement?. Bone Marrow Transplant 26, 1129 (2000). https://doi.org/10.1038/sj.bmt.1702652

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