Frequently Asked Questions
About Cord Blood and Haematopoietic (Blood) Stem Cells
SCBB adheres to international public cord blood banking guidelines for Unrelated Haematopoietic Stem Cell Transplants (HSCT). As an affiliate member bank of the National Marrow Donor Program (NMDP) in the US, the SCBB follows FDA guidelines and stringent public cord blood banking criteria, thus, not all donated umbilical cord blood can be stored at the SCBB. In order to meet international requirement for a life-saving cord blood transplant, all collected CBUs will be evaluated for volume of blood, cell count, cell viability, and infectious disease amongst other panel of testing requirements. These will ensure only samples of the highest quality are banked and made available to patients in need of cord blood stem cells for cord blood transplant procedures. Suitable samples will then be prepared for storage at -180° Celsius, in cryogenic tanks, until they are required for HSCT. When CBUs do not meet the banking requirements, it may be assigned for approved research. In cases where the maternal donor has indicated that she does not want the cord blood unit for research, it will be discarded according to normal hospital protocols.
Options for Storing Umbilical Cord Blood
Umbilical cord blood can be donated to the public cord blood bank or stored at a private cord blood bank.
SCBB offers Community Cord Blood Banking, a comprehensive and holistic approach to cord blood banking. It comprises public cord blood donation and family cord blood banking services (with the option of potential donation in future). While SCBB remains committed to our mission of saving lives with a focus on public cord blood banking, family cord blood banking is a service for parents who choose to store for their family.
Public Cord Blood Donation
Umbilical cord blood is rich in life-saving stem cells, as described above. Rather than discard it after delivery, which is done frequently, you can donate it to give someone a chance at a cure.
Donating cord blood to a centralised public cord blood bank such as the SCBB increases the number of cord blood units available to all potential stem cell transplant patients. This therefore increases the chances of finding a match for the patient.
Donation is even more urgent when data shows that ethnicity plays an important role in finding a stem cell match. The donation of umbilical cord blood units that matches the ethnicity of the population is critical in helping to save lives of needy patients.
Since the first unrelated umbilical cord blood transplant in 1993, over 30,000 cord blood transplants have been performed around the world. These patients received unrelated cord blood units that were generously donated to a public cord blood bank.
Ten delivering hospitals, both restructured and private, in Singapore are participating in our cord blood donation programme.
These are the restructured hospitals:
- KK Women’s and Children’s Hospital (KKH)
- National University Hospital (NUH)
- Singapore General Hospital (SGH)
The private hospitals include:
- Gleneagles Hospital (GEH)
- Mount Alvernia Hospital (MAH)
- Mount Elizabeth Novena Hospital (MNH)
- Mount Elizabeth Orchard Hospital (MEH)
- Raffles Hospital (RH)
- Parkway East Hospital (PEH) formerly known as East Shore Hospital
- Thomson Medical Centre (TMC)
The following are the procedures and processes which need to be undertaken to ensure that cord blood collected meets stringent quality standards for transplants.
Pre-screening evaluation of eligibility
A pre-screening evaluation of donation eligibility can be conducted on our
website or via telephone interview. questions to ensure that the mother and infant donor meets scbb’s established criteria for donation, including the birth parents and family medical history, will be asked. this will help to ascertain donor suitability before proceeding to the next stage of donation.>
The next stage involves taking informed consent from the mother. SCBB’s donor coordinators will arrange for a counselling session for the mother to understand the implications and process of donation. The mother would need to complete and sign the Volunteer and Informed Consent Form and the Maternal Risk Questionnaire.
Affirmation of consent
The mother, who signed the informed consent in the previous stage, would need to reaffirm her consent for the collection of the umbilical cord blood, when she has been admitted and awaiting delivery in the delivery suite.
Collection of maternal sample
The next stage involves the collection of blood sample from the mother before delivery takes place. Approximately 30mls, about three soupspoons, will be collected and used for evaluation of infectious diseases. This procedure is necessary to ensure that all cord blood units collected are free of all infectious diseases and safe for transplant.
Collection of umbilical cord blood
The next stage involves the collection of the umbilical cord blood; which is done after the delivery has been completed and when the delivering doctor has ensured the well-being and safety of both mother and baby. The collected units will then be transported to SCBB for processing.
Community Cord Blood Banking
What Happens after Donation
About the SCBB
A public cord blood bank such as the SCBB will help to increase the number of cord blood units available for unrelated blood stem cell transplant patients; hence increasing treatment options.
While there are cord blood banks in the region, they are only for domestic use and most do not have the multi-racial ethnic profile that is present in Singapore. Thus, it would be difficult for a Singaporean to find a match in these banks. Each year, about 60% of patients in Singapore are not able to find a suitable stem cell match from bone marrow donors and other public cord blood banks. Likewise, about 65 to 80 per cent of Asians worldwide are also unable to find a suitable match.
Access to Units stored at SCBB
Public cord blood banks, such as the SCBB, do not reserve any cord blood units for the specific family’s usage. However, if the family requires the unit and it is still available in the bank, we will work with your Transplant Physician on the release of the unit, if it has been found to be suitable. If the cord blood unit has already been released for transplantation, we will also work with your Transplant Physician on finding another suitable unit.
However, statistics show that the donor’s own unit may not be the best sample for transplantation. Most Transplant Physicians may not feel that the patient’s own cord blood unit is the best choice. This is because it may already carry the genetic abnormality that led to the blood or immune system failure or cancer in the first place.
We do not reserve any cord blood unit for the child or a specific family’s usage. If the donated cord blood unit meets the criteria for banking, and is still in SCBB at that time, the unit would be made available for the patient who would benefit most from it; this could be the donor or another recipient. Research has shown that there is an extremely low probability that the donor should ever need or benefit from his/her own cord blood unit. Transplant Physicians may not feel that the patient’s own cord blood unit is the best choice as it may already carry the genetic abnormality that led to the blood disorder or immune system failure. The donated cord blood unit, would have to be removed from the public cord blood inventory, as it would have at that point, failed the medical history, and would not be suitable for public use.
The CBU will only be released based on the following:-
- CBU met SCBB’s stringent banking criteria, and was banked
- CBU available in SCBB at the time of request
- CBU is to be used and/or released to the donor upon advice of the Transplant Physician.
If the three criteria above are met, the CBU will be released to the donor, through the Transplant Centre, upon advice of the Transplant Physician provided he/she feels that it is the unit most beneficial to the donor.
For donors, regardless of whether their donated cord blood unit is available or not, SCBB will work with the Transplant Centre to find a suitable match from its public inventory, without any charge.
For non-donor patients, the cost of a unit ranges between S$6,800 and S$28,500 for the first unit (based on cell dosage required) and flat rate of S$3,500 for the second unit (if needed) for the same patient. This cost recovery practice allows SCBB to sustain its operations so that it can continue to save lives. Patients with financial difficulties have been able to seek support with the help of their hospital's Medical Social Worker.
Cord Blood and Transplant
Stem cell Registry (Donor Registry) is a listing of potential bone marrow donors and donated umbilical cord blood units. Doctors can search the registry to find a match for their patients who need a transplant but don’t have a matched donor in their family.
When you donate cord blood, it’s listed on the registry and stored at a public cord blood bank. Cord blood is especially useful when:
- There is no adult donor who is a close match for a patient. Patient outcomes are improved when the cells for transplant closely match the patient. However, studies show that cord blood does not need to match as closely as bone marrow or peripheral blood for a successful transplant.
- A patient needs a transplant quickly. Sometimes a patient can’t wait several weeks or months for a donor to be contacted and the marrow donation to be collected. Cord blood units are stored in a public cord blood bank and ready to use.
- A patient's ethnic background is important in predicting the likelihood of finding a match.
Studies show that when donated cells closely match a patient, their chances of transplant success improve. Patients are more likely to match someone of the same ethnic background.
Increasing the diversity of cord blood units on the registry makes it possible for more patients to receive a transplant. In 2016, 29% of umbilical cord blood transplants were for transplant patients of color.