Chapter 7, Problem 1QC

Summary Introduction

To review:

The decision of the federal government to allocate $79 million (about 40 cents per adult) for a public cord blood collection and storage network is wise or not.

Introduction:

After the birth of the baby, the mother’s body expels the umbilical cord and the placenta from her body, which is then cut out by a health professional. After birth and loss of physical connection with the mother, the baby starts surviving on its own. These discarded portions contain some amount of cord blood (about 50 milliliters), which along with the other blood components is rich in immature stem cells. These stem cells have the capability to divide and produce immature blood cells, which can further form platelets, RBCs (red blood cells), and WBCs (white blood cells).

There are many people who get diagnosed with a type of stem cell cancer that is acute leukemia in the bone marrow. The person diagnosed with this needs to be treated with the help of chemotherapy and radiations for killing the cells of cancer, this is then followed by bone marrow transplantation.

Explanation of Solution

The decision taken by the federal government, who allocated $79 million (about 40 cents per adult) for a public cord blood collection and storage network, is a very good decision. This is because there are many people who are diagnosed with acute leukemia and need to have a bone marrow transplant to get fully cured of this cancer.

Three antigens HLA-B, (human leukocyte antigen-B), HLA-A, and HLA-DR, each having two forms, are involved in a good bone marrow transplantation between the recipient (patient) and the donor. An ideal match for the patient would be having all the same six forms matching to the donor, that is, a 6/6 match. Thus, this seems to be highly difficult and only about 10% of the patients are able to find out their compatible donors.

Due to this reason, the cord blood has become so important because the stem cells in the cord blood are immature, so the transplant of cord blood would lead to fewer transfusion reactions. Transfusion reactions are the ones where the patient's immune system rejects the blood of the donor. Thus, less or even no transfusion reaction would enable a match of 5/6 or 4/6 to be sufficient for transplantation of the bone marrow between the donor and the patient.

Further, keeping all this in mind having a public cord blood collection would be really beneficial as here, people can be able to find their perfect donor from a large pool of cord blood collection. However, if this public cord blood collection is not present, then the patient might have to struggle a lot for a compatible donor or can even end up getting no compatible donor at all.

Conclusion

Therefore, a child born to a healthy family may or may not need its cord blood, but if this child's cord blood is donated into a public cord collection, then anyone going through problems like leukemia can easily access it. Hence, the decision of the federal government for a public cord blood collection was a very good decision.