Deciding ‘Quality' Surrounding Umbilical Cord Blood Treatments in Japan and the UK

Stem cell treatments, such as those derived from umbilical cord blood, are relatively novel in the UK and Japan compared to other countries, such as Spain and America. Hence, the policy and practices surrounding the treatments are still emerging (Brown et al, 2011), and as a result creating uncertainty in the decision-making of haematologists and oncologists in the UK and Japan. In particular, when do they deem an umbilical cord blood treatment suitable for a patient, and how do they choose between umbilical cord blood banks when more than one unit is available for a patient? In essence, how do they ‘know’ what constitutes a ‘quality’ cord blood sample?

These are important insights to be gained when the cost of a single cord blood sample can reach between £16,000 to £25,000. Factors such as where the cord blood treatments are carried out and by whom have been considered as influential by policy makers in determining the success of treatments. How such a move to establish ‘clinical expertise’ around cord blood treatments would impact upon perceptions of ‘quality’ cord blood in the two countries is significant as it challenges the notion that the success of cord blood treatments is determined by the inherent properties of the cord blood unit. Furthermore, a connection between cord blood collection and banking practices and the perceived ‘transplant quality’ of a cord blood unit for stem cell treatments is also emerging from recent policy discussions, due to the proposed ‘best practice tariff’ to reimburse hospitals for securing ‘high quality collections’.

Emerging findings from a three year project, funded by the Great Britain Sasakawa Foundation, to explore through qualitative interviews how those working in Japanese and UK transplant centres perceive ‘quality’ in cord blood in a global context, and what factors influence their perceptions, will be presented.