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Marcon AR, Murdoch B, Caulfield T. Peddling promise? An analysis of private umbilical cord blood banking company websites in Canada. Cell Tissue Bank 2021; 22:609-622. [PMID: 33890172 PMCID: PMC8558271 DOI: 10.1007/s10561-021-09919-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/27/2021] [Indexed: 11/13/2022]
Abstract
Private umbilical cord blood banking is growing around the world. A family's decision to bank cord blood publicly or privately can be influenced by numerous sources including healthcare practitioners, personal networks, the popular press, social media and marketing discourse from private entities. Issues have been raised concerning how private banks market their services, particularly with regards to the likelihood of use and for what purposes cord blood can be used. The objective of this study was to analyze the marketing on the seven company websites offering private cord blood storage in Canada. We performed a mix of content and general qualitative analysis on the seven websites. Our analysis shows substantial hype around cord blood uses, amplifying the promise of speculative uses and distorting the likelihood of use. Findings show that this promotional messaging often deploys communication strategies which draw on testimonials and emotionally-charged narratives. Questions should be asked about whether the promissory aspects of these websites constitute breaches of Canadian law or regulation. Careful monitoring of the private cord blood space is important for ensuring that the Canadian public is adequately and accurately informed of the services being offered.
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Affiliation(s)
| | - Blake Murdoch
- Faculty of Law, Health Law Institute, University of Alberta, Edmonton, Canada
| | - Timothy Caulfield
- Faculty of Law, Health Law Institute, University of Alberta, Edmonton, Canada
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Murdoch B, Marcon AR, Caulfield T. The law and problematic marketing by private umbilical cord blood banks. BMC Med Ethics 2020; 21:52. [PMID: 32611408 PMCID: PMC7329494 DOI: 10.1186/s12910-020-00494-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/23/2020] [Indexed: 01/04/2023] Open
Abstract
Background Private umbilical cord blood banking is a for-profit industry in which parents pay to store blood for potential future use. Governments have noted the tendency for private banks to oversell the potential for cord blood use, especially in relation to speculative cell therapies not yet supported by clinical evidence. We assessed the regulatory landscape governing private cord bank marketing in Canada. Main body Because the problematic marketing of private cord blood banking for future use often relates to speculative future cell therapies that do not exist and are not being advertised for current clinical use, most private blood bank marketing seems to fall outside Health Canada’s regulatory scope. However, this problematic marketing is regulated by the Competition Bureau pursuant to the Competition Act. While representations relating to future hypothetical treatments may not always be subject to the legal requirement for claim substantiation, the law also prohibits individuals and companies from knowingly or recklessly making representations that are “false or misleading in a material respect.” A representation is materially false or misleading when it could “influence a consumer’s behavior or purchasing decisions,” and consumers are likely to be considered to be “credulous and inexperienced” for the purposes of assessing an advertisement’s general impression. Because all of the potential benefit of the banking is derived from the potential future use of the biological material for health interventions directed toward the customers and their relatives, and because we know the best available medical evidence indicates a very low probability of utility in this context, we can say with confidence that some private cord blood banking claims are materially misleading. Moreover, to the extent that medical professionals are involved in private bank interactions with customers or hold ownership stakes in private banks, they are subject to professional codes, standards of practice, and potentially fiduciary obligations that further prohibit misleading marketing. Conclusions Private cord blood bank marketing that advertises hypothetical future treatments can be misleading and may influence consumer behaviour. This marketing may breach existing advertising law. Regulatory bodies should enforce the law in order to help prevent public health and personal financial harm.
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Affiliation(s)
- Blake Murdoch
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, T6G 2H5, Canada
| | - Alessandro R Marcon
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, T6G 2H5, Canada
| | - Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, T6G 2H5, Canada.
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Isasi R, Mastronardi C, Golder M, Allan D, Walker M, Halpenny M, Yang L, Elmoazzen H, Chargé S. Assessing opportunities and challenges for establishing a national program to distribute cord blood for research. Transfusion 2018; 58:1726-1731. [PMID: 29607499 DOI: 10.1111/trf.14602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research is needed to enhance cord blood (CB) transplantation outcomes and to develop new clinical applications. Based on quality criteria for transplantation, CB collected by public CB banks (CBBs) is often unsuitable for banking, but may still be valuable for research. Canadian researchers have described a need for a centralized program providing ethically sourced CB for research projects. To meet this need, Canadian Blood Services (CBS), in partnership with The Ottawa Hospital, launched the Cord Blood for Research Program (CBRP) in 2014. STUDY DESIGN AND METHODS The CBRP developed processes for donor research consent and research project approval with oversight from CBS's CBB and appropriate research ethics boards. The CBRP distributes deidentified CB products to research projects across Canada. RESULTS Since its inception, the CBRP has distributed more than 525 CB units to researchers, supporting 11 research projects. Of the mothers who donate their baby's CB, 77% have chosen to consent to its use for research if it is not bankable. The number of CB units currently available for research via the CBRP exceeds the requests from researchers. CONCLUSION The CBRP reliably distributes quality CB products that do not qualify for banking to investigators across Canada in an ethical, legal, and transparent manner. This provides an opportunity for the public to directly support research, helps meet the need expressed by Canada's research community, and maximizes the donor's gift. More research is needed to clarify the factors influencing donor and researcher participation in the CBRP.
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Affiliation(s)
- Rosario Isasi
- Department of Human Genetics and Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, Florida
| | - Cherie Mastronardi
- Centre for Innovation, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mia Golder
- Centre for Innovation, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - David Allan
- Blood and Marrow Transplantation, Department of Medicine (Hematology), The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Cord Blood Bank and Stem Cell Manufacturing, Canadian Blood Services, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mark Walker
- Blood and Marrow Transplantation, Department of Medicine (Hematology), The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mike Halpenny
- Cord Blood Bank and Stem Cell Manufacturing, Canadian Blood Services, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Lin Yang
- Cord Blood Bank and Stem Cell Manufacturing, Canadian Blood Services, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Heidi Elmoazzen
- Cord Blood Bank and Stem Cell Manufacturing, Canadian Blood Services, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sophie Chargé
- Centre for Innovation, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Shearer WT, Lubin BH, Cairo MS, Notarangelo LD. Cord Blood Banking for Potential Future Transplantation. Pediatrics 2017; 140:peds.2017-2695. [PMID: 29084832 PMCID: PMC6091883 DOI: 10.1542/peds.2017-2695] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This policy statement is intended to provide information to guide pediatricians, obstetricians, and other medical specialists and health care providers in responding to parents' questions about cord blood donation and banking as well as the types (public versus private) and quality of cord blood banks. Cord blood is an excellent source of stem cells for hematopoietic stem cell transplantation in children with some fatal diseases. Cord blood transplantation offers another method of definitive therapy for infants, children, and adults with certain hematologic malignancies, hemoglobinopathies, severe forms of T-lymphocyte and other immunodeficiencies, and metabolic diseases. The development of universal screening for severe immunodeficiency assay in a growing number of states is likely to increase the number of cord blood transplants. Both public and private cord blood banks worldwide hold hundreds of thousands of cord blood units designated for the treatment of fatal or debilitating illnesses. The procurement, characterization, and cryopreservation of cord blood is free for families who choose public banking. However, the family cost for private banking is significant and not covered by insurance, and the unit may never be used. Quality-assessment reviews by several national and international accrediting bodies show private cord blood banks to be underused for treatment, less regulated for quality control, and more expensive for the family than public cord blood banks. There is an unquestionable need to study the use of cord blood banking to make new and important alternative means of reconstituting the hematopoietic blood system in patients with malignancies and blood disorders and possibly regenerating tissue systems in the future. Recommendations regarding appropriate ethical and operational standards (including informed consent policies, financial disclosures, and conflict-of-interest policies) are provided for physicians, institutions, and organizations that operate or have a relationship with cord blood banking programs. The information on all aspects of cord blood banking gathered in this policy statement will facilitate parental choice for public or private cord blood banking.
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Affiliation(s)
- William T. Shearer
- Department of Pediatrics and Pathology and Immunology, College of Medicine, Baylor University and Section of Immunology, Allergy, and Rheumatology, Texas Children’s Hospital, Houston, Texas;,address correspondence to William T. Shearer, MD, PhD, FAAP. E-mail:
| | - Bertram H. Lubin
- Children’s Health, University of California, San Francisco and Benioff Children’s Hospital, San Francisco, California
| | - Mitchell S. Cairo
- Department of Pediatrics, Medicine, Pathology, Microbiology and Immunology, and Cell Biology and Anatomy, Maria Fareri Children’s Hospital and New York Medical College, Valhalla, New York; and
| | - Luigi D. Notarangelo
- Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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Developing Educational Resources to Advance Umbilical Cord Blood Banking and Research: A Canadian Perspective. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 37:443-450. [DOI: 10.1016/s1701-2163(15)30260-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Yao Y, Song Q, Chu Y, Gong H, Li N, Hu Q, Xu X. Infusion of allogeneic umbilical cord blood hematopoietic stem cells in patients with chemotherapy-related myelosuppression. Exp Ther Med 2014; 8:1946-1950. [PMID: 25371761 PMCID: PMC4218683 DOI: 10.3892/etm.2014.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/29/2014] [Indexed: 11/05/2022] Open
Abstract
Chemotherapy-induced myelosuppression is one of the main problems in the treatment of cancer. In the present study, the effects of allogeneic umbilical cord blood hematopoietic stem cell (UCB-HSC) infusion were investigated on the treatment of chemotherapy-related myelosuppression. In total, 65 patients (male, 42; female, 23) diagnosed with chemotherapy-related myelosuppression were included in the study. The majority of the patients were classified with stage II myelosupression at enrolment, and an average concentration of 7.07×109/l UCB-HSCs were transfused through the peripheral vein. The minimum values of the white blood cell (WBC) count, hemoglobin (Hb) level, platelet (PLT) count and Karnofsky performance status (KPS) scores were recorded prior to and between days 7 and 14 following UCB-HSC infusion. When assessing the overall data, the results revealed that the mean WBC and PLT counts increased significantly following UCB-HSC infusion. However, the subgroup analyses based on gender and KPS score revealed that UCB-HSC infusion was more successful in male patients and those with a higher KPS score. Spearman's correlation analysis revealed a linear correlation between the number of transfused UCB-HSCs and the changes in the WBC and PLT counts following treatment. In conclusion, the results indicated that peripheral vein infusion of non-human leukocyte antigen matched UCB-HSCs can markedly improve chemotherapy-related myelosuppression in a safe and effective manner.
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Affiliation(s)
- Yi Yao
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Qibin Song
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yuxin Chu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Hongyun Gong
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Na Li
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Qinyong Hu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xiaotao Xu
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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