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Our 53rd Year

Umbilical Cord BloodBy Reed Abelson

Congress’s main medical advisory group called for a new federal program to oversee and promote the use of umbilical cord blood, a natural byproduct of healthy childbirths, for medical treatment.

Collected with the donor mother’s permission, stem cells from umbilical cords represent a promising therapy for the thousands of people with leukemia, lymphoma and other diseases who cannot currently undergo bone-marrow transplants because they cannot find the right match. About 600 cord-blood transplants were performed in this country last year.

But broader use of the technique has been impeded by a limited supply of donor blood and doctors’ difficulties in finding compatible blood types among the 50,000 or so units now scattered among about 20 cord-blood banks around the country.

“This emerging field of therapy needs a coordinated center,” said Kristine M. Gebbie, an associate professor of nursing at Columbia University, who was the chairwoman of the committee that examined the issue for the Congressional advisory group, the Institute of Medicine.

While some banks allow parents to store the blood privately for their own families’ use, experts see the need for a much larger public supply of cord-blood units. Congress allocated $10 million last year toward this cord-blood effort, and another $10 million should follow this year.

In its report recommending how the effort takes place, the institute concluded that at least 100,000 more units were needed, especially to help provide matches for ethnic and racial minorities. Because the collection and preparation of the blood is so expensive, about $1,100 per unit, many of the banks do not have enough money for

the effort. The institute also concluded that much more needed to be done to track the results of the transplants so doctors and patients would have better information about how to proceed.

Because a turf war and dueling visions between the two major players in the field have delayed the spending of the federal money already approved, Congress asked the institute to study the matter last year. It would be up to the federal Health Resources and Services Administration to act upon those recommendations. Calls to the agency yesterday were not returned.

One of the field’s competing players is the National Marrow Donor Program, a nonprofit group in Minneapolis that oversees the main registry of blood and marrow donors, which wants to expand its authority. Its rival, the New York Blood Center, a nonprofit blood bank, wants the government to finance the blood banks directly.

The Institute decided that neither group’s proposed approach was exactly the right one.