Hematopoietic stem cell transplantation (HSCT) is common practice today for life threatening
malignant and non-malignant diseases of the blood and immune systems. Umbilical cord blood
(UCB) is rich in hematopoietic stem cells (HSCs) and is an attractive alternative to harvesting HSCs
from bone marrow or when mobilized into peripheral blood. One of the most appealing attributes
of UCB is that it can be banked for future use and hence provides an off-the-shelf solution for
patients in urgent need of a transplantation. This has led to the establishment of publicly funded
and private UCB banks, as seen by the rapid growth of the UCB industry in the early part of this
century. However, from about 2010, the release of UCB units for treatment purposes plateaued
and started to decrease year-on-year from 2013 to 2016. Our interest has been to investigate the
factors contributing to these changes. Key drivers influencing the UCB industry include the emergence
of haploidentical HSCT and the increasing use of UCB units for regenerative medicine purposes.
Further influencing this dynamic is the high cost associated with UCB transplantation, the
economic impact of sustaining public bank operations and an active private UCB banking sector.
We foresee that these factors will continue in a tug-of-war fashion to shape and finally determine
the fate of the UCB industry.