The first transplant using cord blood-derived hematopoietic stem cells was performed in October 1988. Since that year, remarkable achievements have been made in terms of research into umbilical cord blood-derived hematopoietic and progenitor cells. More than 40,000 UCB transplants (UCBTs) have been performed across different geographies of the world, in both children and adults, to treat diseases that include hematologic, metabolic, immunologic, neoplastic, and neurologic disorders.
Moreover, cord blood banking has been strengthened to the point that approximately 800,000 units are now stored in public banks and more than 8,100,000 units are stored within private banks worldwide. During the past 30 years, research in the umbilical cord blood field has made tremendous progress in the area of HSCT. Today, major efforts are focusing on increasing the rate of engraftment, in order to reduce the risk of infection and cost.
Umbilical cord tissue storage has also grown tremendously over the past 15 years since it was first introduced in Asia in 2008. While the number of cord tissue units in storage is less widely know, BioInformant estimates this figures to be over 2,050,000 worldwide, with the majority of these units stored within the U.S. market where cord tissue storage is widely accessible.
Cord blood banking services involve the collection of cord blood and cryogenically freezing the stem cells, as well as other immune system cells, so that they can be preserved for medical uses in future. Interviews with cord blood industry experts indicate that the nonprofit public cord blood banks are experiencing financial difficulties, both in the U.S. and other countries. Most public cord blood banks find it difficult to break even. Public cord blood banks spend from $1 million to $6 million for processing, testing, storing, and licensing technologies required for their operations. At the same time, revenue from the sales of cord blood units is relatively low and the loss is mostly compensated by government subsidies for registered units, as well as donations and grants.
Annually, a medium-sized public cord blood bank collects approximately 8,500 cord blood units, but ultimately stores only 5% to 40% of this collection. In a given year, a public cord blood bank will release only 0.1% to 3% of its stored units. In order to remain viable, some public cord blood banks have embraced hybrid banking models. Others have improved their financial position by offering processing and testing services to the private banks.
Initially, government subsidies and grants encouraged too many public cord blood banks to be formed. However, some of them have now shut down collection sites and others have closed altogether, transferring their inventory to other nearby public cord blood banks. In contrast, private cord blood banks always receive a fee for their cord blood or tissue banking services, and therefore, do not face these problems. However, in the case of public cord blood banks, the societal value outweigh the loss, and consequently, they are supported by the government so that transplant recipients can benefit.
Currently, cord blood is being marketed for two uses: as a transplantation treatment for diseases including leukemia and sickle cell disease and as a potential source of cells for regenerative medicine to repair tissues damaged by everything from heart disease to cerebral palsy. Although the number of cord blood transplantations performed per year has been decreasing since 2012, the number of cord blood units released for regenerative medicine clinical trials has been increasing. Thus, the cord blood banking service market is predicted to witness moderate growth from 2022 to 2030.