Cord blood is the blood that remains in the umbilical cord after the delivery of a newborn. It is a rich source of stem cells and immune system cells. During cord blood banking, these cells are isolated and cryopreserved for future use. The cells are collected from the two arteries and the vein which run along the length of the umbilical cord. The Wharton’s jelly is a gelatinous tissue that composes the umbilical cord, which also contains valuable therapeutic cells such as MSCs.
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. To date, 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.
During the past 35+ 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 to reduce the risk of infection and cost. At present, there are more than 430+ cord blood banks worldwide. Approximately half of them operate laboratory facilities, while the others contract with third-party partners to facilitate their processing and storage activities. As of 2024, there are over 800,000 units stored in public cord blood banks and nearly seven million units are stored within private banks worldwide.
Although cord blood storage emerged as a commercial service in the early 1990s, cord tissue storage didn’t emerge as a commercial service until 2008, when a Taiwanese company, HealthBanks Biotech Company Ltd., began offering the service making it the first company worldwide to do so. HealthBaby, a Hong Kong based company subsequently launched the service in 2009. Hong Kong-based Cryolife, added the service in 2009 as well. Within the United States, Cord Blood Registry (CBR) was the first private company to begin offering cord tissue storage in July of 2010. Today, nearly all U.S. cord blood banks and approximately one-third of global cord blood banks offer cord tissue storage.
For placental banking, LifebankUSA initiated the service in the U.S. when it launched placental blood storage in 2006 and placental tissue storage in 2011. In September 2017, Americord Registry became the second U.S. cord blood bank to provide offering placental tissue banking. Internationally, a few dozen cord blood banks offer placental blood and tissue storage services. Some cord blood banks have also diversified into the storage of other types of stem cell derivatives, such as dental pulp stem cells. For example, DentCell is a dental pulp stem cell bank controlled by Cryoholdco, the largest cord blood banking consolidator in the Latin America. A small number of cord blood banks have also expanded into adipose-derived stem cell storage.
On April 17, 2023, the U.S. FDA also approved the world’s first expanded cord blood cell therapy (Omisirge). This was a landmark moment because numerous companies have been pursuing this goal for years. Omisirge is being developed by Gamida Cell as an allogeneic cord blood cell therapy to speed up the recovery of white blood cells in cancer patients. The approval is for a single intravenous dose of stem cells from a donor’s expanded umbilical cord blood cells that are processed and cultured with nicotinamide (a form of vitamin B3).
For both therapeutic and financial reasons, the cord blood industry has been witnessing record levels of merger and acquisition (M&A) activity in recent years. Market consolidation has been particularly pronounced within Europe, Latin America, and the United States. Today, 80% of the global cord blood market is controlled by the world’s 10 largest cord blood banking operators. Large market competitors include:
- Global Cord Blood Corporation (GCBC)
- Cord Blood Registry (owned by CooperSurgical)
- Cryo-Cell International
- Cordlife Group
- VCANBIO Cell & Gene Engineering Corporation
- Lifecell International
In this aggressive M&A environment, a growing number of cord blood banks have been venturing into new types of stem cell storage, as well as adding fertility and assisted reproductive services, newborn and maternal genetic testing, and intriguingly, venturing into cell therapy applications. Cord blood, cord tissue, placental blood and tissue, and amniotic fluid have demonstrated intriguing therapeutic promise, causing storage services for these biomaterials to proliferate.
While the private market has been consolidating to favor larger market competitors, the public (nonprofit) cord blood banks have been experiencing financial difficulties, particularly within the U.S. where many public cord blood banks are barely breaking 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.
Today in 2024, cord blood and other perinatal tissues have the potential to be an important source of cells for use in a growing range of applications, ranging from use in hematopoietic stem cell transplantation (HSCT) to regenerative medicine applications, research applications, and beyond.