A Portrait of Cord Blood Units Distributed for Transplantation from Canadian Blood Services’ Cord Blood Bank: First Analysis

Abstract

Background: The Canadian Blood Services Cord Blood Bank (CBS CBB) was created to improve access to stem cell products for transplantation for patients across ethnic groups. An analysis of distributed units is needed to assess the effectiveness of the bank to meet the needs of patients from different ethnic groups. Methods: A descriptive analysis was performed on all cord blood units distributed from the CBS’ CBB as of 30 June 2022. Results: Distribution of the first 60 units based on CBS’ CBB inventory has been linear over time. A similar proportion of cord blood unit (CBU) recipients were pediatric or adult. More than half of the cord blood units (56.7%) were distributed to recipients outside of Canada, and CBUs were used to treat a broad range of hematologic and immune disorders. 43.3% of distributed CBUs were of non-Caucasian ethnicity and 18% were from donors self-reporting as multi-ethnic. The mean total nucleated cell counts and total CD34+ cell counts were 1.9 ± 0.1 × 109 cells and 5.3 ± 0.5 × 106 CD34+ cells, respectively. CD34+ cells per kg (recipient weight) varied significantly between pediatric (age 0–4), adolescent (age 5–17) and adult recipients (age 18 and older) (3.1 ± 0.5, 1.4 ± 0.5 and 0.9 ± 0.07 × 105 CD34+ cells/kg, respectively). HLA matching was 6/6 (15%), 5/6 (47%) or 4/6 (38%). Conclusions: The CBS’ CBB has facilitated the utilization of banked units for patients across a broad range of ages, geographic distribution, ethnicity, and diseases. Distributed units were well matched for HLA alleles and contained robust cell counts, reflecting a high-quality inventory with significant utility.

Optimizing Access to Unrelated Donors in Canada: Re-Examining the Importance of Donor Factors on Outcomes Following Hematopoietic Cell Transplantation

“…To supplement the CBS SCR, the CBS' CBB was established to improve access for patients of diverse ancestry. Initial analysis of the CBS CBB's usage demonstrated that 18% of distributed cord blood units were of multi-ethnic background [48]. However, 54% of distributed cord blood units were from donors self-reporting as white, which underscores the ongoing need to collect units from this group to meet patient needs and avoid an overall reduction in total matches.…”

Modeling unrelated blood stem cell donor recruitment using simulated registrant cohorts: Assessment of human leukocyte antigen matching across ethnicity groups

“…Moreover, increasing numbers of registrants and patients self-report associations with more than one ethnic group, or multi-ethnicity. In recent analyses of the cord blood bank inventory at Canadian Blood Services, 18,19 we identified many combinations of ethnic groups within the multi-ethnicity category, including some who identified with Caucasian and another ethnicity as the most common subgroup. An analysis of multi-ethnic simulated recruits would be worthwhile, particularly in a country such as Canada with an evolving and growing population of people who may self-identify as multi-ethnic.…”