Stem Cells in Haematopoietic Stem Cell Transplants (HSCT)

Stem cells are primarily used in transplant medicine to regenerate a patient’s blood and immune system after the patient has been treated with chemotherapy and/or radiation to destroy the cancer cells. These stem cells used in HSCT, can be obtained through bone marrow, peripheral blood donation or cord blood, after a baby’s birth.

While chemotherapy and radiation destroy the cancer cells in a patient, they also destroy the precious stem cells. Therefore, an infusion of stem cells or a stem cell transplant is performed after the chemotherapy and/or radiation treatment. The infused stem cells then migrate to the patient’s bone marrow where they multiply and regenerate all the blood cells necessary to create a new blood and immune system for the patient.

Cord Blood Transplants

Stem cells from cord blood are unique and can overcome some of the limitation of adult stem cells from bone marrow. As naïve or new born cell, it can easily adapt to alternative environment compared to stem cell from an adult.

Over 35,000 cord blood transplants have been performed around the world to treat a number of diseases including blood cancers like leukaemia and lymphoma. Many of these transplant patients received unrelated cord blood that was generously donated to a public cord blood bank¹.

Transplants Facilitated

SCBB, Singapore’s only public cord blood bank, has facilitated 321* allogeneic cord blood transplants for haematological conditions for both adults and children in Singapore and across the world.

Cord blood units from SCBB are listed on international donor database like Bone Marrow Donors Worldwide (BMDW), and National Marrow Donor Program (NMDP), accessible by Transplant Centres worldwide.

Cord blood is a precious resource that can offer recipients a new lease of life when a suitable match is found. Many patients depend on a public cord blood bank like SCBB for their live-saving cord blood unit(s) to survive.

* As of 15 May 2025

SCBB has facilitated transplants for the following conditions:

Blood disorders	Malignancies	Metabolic disorders
Aplastic Anaemia Congenital Dyserythropoietic Anaemia (CDA) Fanconi Anaemia Myelodysplastic Syndrome (MDS) Neutropenia Systemic Mastocytosis Thalassemia Major	Leukaemia (ALL, AML, ANLL, ANKL, aBLL, CLL, CML) Lymphomas (Hodgkin & Non-Hodgkin, NK/T-cell, SPTCL) Myelofibrosis with Myeloid Metaplasia Granulocytic Sarcoma Multiple myeloma	Hunter Syndrome Leukodystrophy
Immunodeficiencies	Autoimmune Diseases	Other Inherited Disorders
Chronic Granulomatous Disease (CGD) Haemophagocytic Lymphohistiocytosis (HLH) Hyper-IgM (HIGM) syndrome Severe Combined Immuno-Deficiency (SCID) Omenn's Syndrome Wiskott Aldrich Syndrome	Lupus Erythematosus	Adrenoleukodystrophy (ALD) Osteopetrosis

Patients who are diagnosed with a blood-related condition should consult their Haematologist and Transplant Physician. Treatment depends on the patient’s disease and many other factors. Please note that not all patients will benefit from a cord blood transplant.

Blood Cancers in Singapore

According to the Singapore Cancer Registry Report 2022, Lymphoma and Leukaemia are amongst the top 10 leading cause of cancer death in Singapore. Every year, 40% - 60% of patients in Singapore who need a HCST to survive are unable to find a suitable stem cell match from bone marrow donors and other public cord blood banks.

These patients need not succumb to their disease if efforts to boost SCBB’s cord blood inventory continues to gain support.

Ethnicity Matters

Ethnicity is a critical factor in finding a suitable stem cell match. For Singaporeans and Asians, finding these matches remains a challenge as the majority of Stem Cell Registries are of Caucasian ancestry. With more than 70% of patients unable to find a match within their families, many rely on adult stem cell registries and public cord blood banks like SCBB for hope. Mirroring Singapore's ethnic profile, SCBB increases the prospect of a life-saving match for these patients, with a public cord blood inventory of Chinese, Malay, Indian and Pan-Asian origins.

Data has shown a higher incident of blood cancer among Malay and Indian Communities in Singapore¹. Public donation from these communities is thus even more urgent to ensure that a stable inventory of high quality cord blood units is always available.

Developments using Cord Blood

Cord blood continues to play an important role in blood-forming stem cell transplantation. Over the years, there have also been a number of developments in biomedical research and clinical trials with the role of regenerative medicine² emerging in recent years. There have been clinical trials on the use of one’s own cord blood for cerebral palsy, hypoxic-ischemic encephalopathy etc., with increasing interest in new therapies for non-homologues (non-homologous) use of cord blood³. While clinical trials are underway, trial outcomes and efficacy of treatment (e.g. improved function in cerebral palsy patients) are difficult to measure compared to haematological conditions⁴⁵.

In response to requests from parents, family cord blood banking offers the opportunity to families to participate in future clinical trials in partnership with SCBB.

¹ Watt SM, Hua P. Chapter 6: Umbilical Cord Blood Hematopoietic Stem and Progenitor Cell Expansion for Therapeutic Use. In: Watt SM, Hua P. Umbilical Cord Blood Banking for Clinical Application and Regenerative Medicine. Open Access, InTech: Chapters published under CC by 3.0 license; 11 January 2017

²O’Connor MAC, Samuel G, Jordens CFC and Kerridge IH. Umbilical cord blood banking: Beyond the public-private divide. (2012) 19 Journal of Law and Medicine 512

³ Roura S, Pujal JM, Galvez-Monton C and Bayes-Genis A (2015) The role and potential of umbilical cord blood in an era of new therapies: a review. Stem Cell Research & Therapy 2015, 6:123

⁴ Sun J, Allison J, McLaughlin C et al. Differences in quality between privately and publicly banked umbilical cord blood units: A pilot study of autologous cord blood infusion in children with acquired neurologic disorders. Transfusion 2010;50:1980-1987.

⁵ Ballen K. Umbilical Cord Blood Transplantation: Challenges and Future Directions. Stem Cell Translational Medicine 2017;6:1312-1315