Cord Blood Storage

Time for a national policy

Case presentation- Baba Inusa

Policy proposal- Jo Howard

The Laboratory Role -Jon Smythe

 Cord Blood storage
Family1

2nd Child diagnosed HbSS at Birth

1st Acute Chest syndrome
At 6 developed abnormal TCD now
transfused
Interested PGD but unavailable
3rd preg-Prenatal- non sickle
Requested to have cord blood storage
 Cord Blood storage
Family2
2 children with HbSS, 3rd HbAS

1st Child with multiple complications, initially

transfused

2nd Child with abnormal TCDs-declines transfusion

as 1st developed ab on tx

Family tissue typing-haplotype mismatch for both

SCD

Family not eligible for funded PGD

 Cord Blood storage
Family2- 1st Child
Severe anaemia @16 days, Pneumococcal sepsis at 4,
with multi-organ disorders (+Cardiomyopathy),

morixella Osteomyelitis at 6,

Rosai-Dorfman Disease at 7

Abnormal antibodies- Lower steady state Hb-5.5-6.5

@8

TRJet velocity- >4m/sec@10

Rosai-Dorfman Disease: A previously unreported association with
Sickle Cell Disease
Stebbing, van der Walt, Ramadan and Inusa. . BMC Clinical Pathology 2007, 7:3 doi:10.1186/1472-6890-7-3
 Rosai-Dorfman Disease:
A previously unreported association with
Sickle Cell Disease
 Both Families
Family1- referred to GP SIDCUP and
Haematologists
GP presented to PCT/ Haematologist
uncertain about indication
Mother contacted other parents
Options- Move to ‘correct’ postcode/
private arrangement
 Family 2
Referred to Obstetrician and GP
(Lewisham)
Outcomes
PCT-declines as the case is not supported
by GSTFT policy
Obstetrician-who takes lead-Paeds or
Haematology
GSTFT panel to review policy- NEXT!!