Have proved their worth and now deserve a firmer foundation

Allogeneic stem cell transplantation has revolutionised the outcome for a wide range of malignant and non-malignant haematological conditions.1 Of the sources of stem cells, umbilical cord blood, obtained from the placenta directly after delivery, is enriched in stem cells and has a higher proliferative capacity than cells obtained from bone marrow and peripheral blood. 2 3 Like any blood product, however, stem cells from cord blood need an infrastructure for collecting, banking, and matching the donations.

Several cord blood banks and registries have been formed internationally (four of them in the United Kingdom) which collect the cord blood products and perform cryopreservation, tissue typing, and viral assessment. These products can then be accessed after a search of the internet linked databases and the cryopreserved product transported to the transplant centre for use.

Marrow engraftment can occur quite quickly after infusion of cord blood, although it may be delayed in some instances—this depends largely on the cell dose in the sample and the size of the recipient. In the largest series, reported by Rubinstein et al, 562 …