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Constituting a public umbilical cord blood bank in South Africa

Bone Marrow Transplantation volume 50, pages 615–616 (2015)Cite this article

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The South African population is known as ‘the rainbow nation’ which is appropriate for a country with a cultural diversity that is illustrated by its 11 official languages, mostly indigenous to South Africa. This diversity translates into an extensive genetic diversity in the populations residing in the country. As the South African Bone Marrow Registry (SABMR) is constituted of potential donors who are predominantly Caucasian, it is not a representative of the demographics of the country, in which nearly 80% of inhabitants are of Black African origin. The HLA complex that comprises the most polymorphic genes in humans, has a pivotal role in determining the successful outcome of hematopoietic SCT (HSCT).1 The high degree of diversity and the small number of Black African individuals registered with the SABMR decreases the likelihood of finding HLA-compatible donors for these individuals.2 Table 1 indicates the number of matched-unrelated HSCTs performed on South African patients as reported by the SABMR since its inception in 1991.3

Table 1 Matched-unrelated HSCTs reported by the SABMR
Full size table

A regional public cord blood bank is therefore likely to provide individuals of African origin, both locally and abroad, with a higher probability of obtaining an HLA-compatible donor. In addition, umbilical cord blood-derived hematopoietic stem cell (HSCs) require a minimum 4/6 HLA-match between donors and recipients at three HLA loci, namely HLA-A, -B (antigen-level) and -DRB1 (allele-level),4 which is less than is required for bone marrow-derived HSCs for transplantation. Our objective is to determine the basis on which a public cord blood bank would need to be constituted to accommodate the diversity of local and regional populations. The diversity of the South African population can be considered at three levels: racial groups, ethnic/linguistic groups and HLA diversity.

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Acknowledgements

This research and the publication thereof is the result of funding provided by the South African Medical Research Council of in terms of the MRC’s Flagships Awards Project SAMRC-RFA-UFSP-01-2013/STEM CELLS, the Institute for Cellular and Molecular Medicine of the University of Pretoria, and the National Research Foundation of South Africa.

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  1. Department of Immunology, Faculty of Health Sciences and Institute for Cellular and Molecular Medicine (ICMM), University of Pretoria, Pretoria, South Africa

    J Mellet, M Alessandrini, H C Steel & M S Pepper

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  1. J Mellet
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  2. M Alessandrini
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  3. H C Steel
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  4. M S Pepper
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Correspondence to M S Pepper.

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Mellet, J., Alessandrini, M., Steel, H. et al. Constituting a public umbilical cord blood bank in South Africa. Bone Marrow Transplant 50, 615–616 (2015). https://doi.org/10.1038/bmt.2014.329

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