Singapore's public cord blood bank faces donor shortage despite rise in awareness

CNA

2 days ago

SINGAPORE: When Esmond Cheng was just three months old, he was diagnosed with a rare genetic disorder that severely compromised his immune system and left him highly susceptible to infections.
While his only chance of survival was a stem cell transplant, no one in his family was a match. A donor in Hong Kong was willing to donate, but it fell through after the infant developed recurrent fevers and infections lasting more than a year.
His parents then turned to Singapore's sole public cord blood bank for help on their doctor's advice.
Within a month, the boy found a matching unit – thanks to a donor.
Today, the 12-year-old is doing well, his father Edmund Cheng told CNA.
'At times, it was very, very sad for us but luckily, he had the persistence to push on which all the other doctors were so amazed (by),' the older man said.
'He's a very strong boy and we're also very glad that cord blood really saved his life.'
Since the Singapore Cord Blood Bank (SCBB) – located within the KK Women's and Children's Hospital – was set up two decades ago, it has collected about 75,000 units from donors.
But the bank is grappling with a shortage of donors to build a diversified inventory, despite increasing awareness in recent years of the benefits of cord blood.
It also comes as the use of cord blood has grown not just in clinical treatments, but also in advanced medical research.
Cord blood contains a rich source of blood stem cells that have strong regenerative properties. These stem cells have been proven to be useful in the treatment of many blood disorders and cancers, including severe combined immunodeficiency – the disease that Esmond suffers from.
PARENTS MORE ENGAGED
SCBB's medical director Aloysius Ho told CNA that parents are now more informed and ask more detailed questions on the conditions of cord blood storage, quality control and contingency measures.
The Baby Bonus scheme has made family banking more accessible, providing Singaporean parents with a practical financing option, said Associate Professor Ho.
He added that private storage levels with the bank rose by nearly 50 per cent after an incident in 2023 with private player Cordlife, which was found to have mishandled cord blood units. More than 2,000 clients were affected.
Donation levels also increased by 14 per cent following the incident, but that has not been enough, noted Assoc Prof Ho.
"We, despite having 15,000 units in our inventory, often find ourselves having to actually import cord blood from other global cord blood banks, because we're not able to find a suitable match within SCBB. So, we do need to increase the pool of donors,' he said.
'We know that we have a fairly unique population mix in Singapore, and we would like to try and encourage potential parents, especially from the ethnic minorities, to sign up as public donors because of the unique gene pool in that population.'
He explained that people are more likely to find a suitable match within their own ethnic group due to genetic similarities, so a wider donor pool ensures better chances of finding a match for patients of all backgrounds.
Assoc Prof Ho pointed out that misconceptions remain about public cord blood banking, such as that it is not always successful.
Nevertheless, he acknowledged this is 'probably partially true' as only about 20 to 25 per cent of donated units end up being banked for use for transplants.
The remaining units do not meet the standard of quality. But with the donors' consent, they can be used for other purposes like research studies, added Assoc Prof Ho, who is also a senior consultant at the SingHealth Duke-NUS Transplant Centre.
NEED GROWING MORE URGENT
According to doctors, the need for cord blood is now more urgent than ever.
With smaller family sizes and more people starting families later in life, fewer patients can rely on relatives for a close genetic match.
Cord blood is also increasingly used in medical research to regenerate cells and even slow down ageing.
Cord blood is especially attractive as they mutate less compared to adult blood stem cells, and can help fight leukaemia cells 'quite well' due to their adaptability, said Professor William Hwang, chief executive of the National Cancer Centre Singapore and a senior consultant at Singapore General Hospital's haematology department.
'In the past, we needed to have a fully matched brother or sister or an unrelated donor who is fully matched with the patient in order to do the (cord blood) transplant,' he noted.
'But now, we can do the transplant even though there is only half match with the patient … because technology has developed such that we can do two forms of manipulation of the cells."
To encourage more families to donate, SCBB said it is working to raise awareness through outreach and education initiatives. These include engaging mothers in public hospitals, active social media outreach and community events.
Esmond's family is also encouraging others to donate cord blood to save lives like his.
'For those newly married or just had a kid, it's good to keep their cord blood. You won't know if you will be needing it or if other people need it. It's good to have that so that it can help other people in another way,' added Mr Cheng.