Q&A with Dr. Heidi Elmoazzen
One thousand Canadians need a stem cell donation on any given day, according to Canadian Blood Services (CBS). About 250 usually can find a match in their own family. The other 750 must look elsewhere. For years, CBS has operated its OneMatch Stem Cell and Marrow Network to find and match volunteer donors to patients. Last year, CBS added to the much needed supply of donor stems cells by officially launching its Cord Blood Bank where new mothers can donate umbilical cord blood — a plentiful source of stem cells that are more easily matched than adult stem cells. The bank is supported by nine provinces and the three territories (Québec has its own cord blood bank and registry). Five collection sites now operate in four cities. Dr. Heidi Elmoazzen is the Director of the Cord Blood Bank.
Q: The official launch was last year, but how long has the national public cord blood bank been operating?
A: We started collecting in Ottawa in 2013, then rolled out to Brampton in 2014. We started collections in Edmonton and Vancouver in 2015. We did the official launch in June of 2015 to say, “We’re open.”
Q: Canada was the last G7 country to establish a public cord blood bank. Why were we so late to the party?
A: Part of it is just the way funding is structured. We needed agreement from the provinces and territories. But there are actually advantages of us coming late to the party. We’ve been able to learn from other cord blood banks and we’re fortunate to now be in a position where we’ve set up one of the best in the world in terms of quality of inventory.
Q: What stage are you at now?
A: Our biggest goal is building up an inventory that’s reflective of the unique population we have here in Canada. We have a lot of ethnic groups that you don’t find in other parts of the world, including our Aboriginal — First Nations, Métis and Inuit — populations. We have a lot of mixed race patients here. It’s building up that inventory that reflects that unique population. And we’re really going for quality units — large units with lots of stem cells in them so there are enough stem cells for a transplant. As you can appreciate, we need an inventory of a certain size before we see uptake. We’re in that phase now. We currently have 1,145 units listed and available to Canadian and international transplant centres. We’ve had inquiries, but nothing has been shipped out yet. So that’s our next big milestone. I’m expecting we will probably see that soon.
Q: So, for example, a Canadian patient with a blood-based cancer who is looking for a stem cell transplant, they would look at what your bank has available and look internationally as well?
A: It goes through our OneMatch Stem Cell and Marrow Network, where we search all the adult donors and cord blood units in Canada as well as internationally. We have access to over 27 million adult donors around the world. In Canada there are 345,000 adult donors. And then you have 684,000 publicly banked (cord blood) units, with our own units in there as well.
Q: Are most people aware that the public bank is there and there’s an option to donate cord blood?
A: There are always opportunities to increase awareness. We really try to make moms who are delivering at one of our designated collection hospitals aware. We have conversations with all of the physicians who have delivering rights at those hospitals. We try to do outreach so that moms do know this is available to them.
Q: What’s their reaction been?
A: It has been great. It’s a very easy sell to mothers because they know the alternative is the cord blood will be discarded as medical waste. We don’t get push-back.
Q: The collection service is only available in four centres. What happens if you don’t happen to live in Ottawa, Brampton, Edmonton and Vancouver?
A: Unfortunately, then you can’t participate in the public bank. But it’s important to realize these units are available to anyone in Canada and around the world who needs them. We selectively chose the cities we are in and what hospitals we partner with. We wanted large urban centres with a large ethnic diversity. We wanted hospitals that had at least 4,000 births (per year) with a minimum 20% ethnic diversity. We’re trying to build a bank that reflects the ethnic diversity in Canada.
Q: Will there be more collection centres opening?
A: We’re always looking at whether we need to do that. At this time there are no plans to open any more sites.
Q: The total price tag for the bank is $48 million, with $12.5 million raised in a fundraising campaign and the rest coming from the provinces and territories. Why did one-quarter of the funds come from fundraising?
A: It was to show the governments that we had skin in the game and that Canadian Blood Services was committed to this.
Q: Does this save money? If a Canadian gets a stem cell transplant from here in Canada, does that save money compared to going to Europe to have the stem cells harvested and shipped over here?
A: Absolutely. It costs about $40,000 when we use either an adult donor or a cord blood unit from overseas. It’s a huge cost savings to the health care system, especially when you’re talking about adults because they’re using two cord blood units per transplant. The fact that these are available through our transplant centres at no cost represents a huge savings.
Q: Can the cord blood also be used for research?
A: Yes; we have a cord blood for research program. Moms who donate in Ottawa can indicate on their permission to collect form that in the event that their baby’s cord blood is not bankable it can go to research. We make those research units available to scientists across Canada. We have shipped out hundreds of units for research purposes. There’s been a big uptake because it’s such a valuable resource.
(For more information on the Cord Blood Bank, click here.)