To the Editor.
—The discussion of fairness by Dr Sugarman and colleagues1 in collecting and distributing umbilical cord blood (UCB) for transplantation can be considered at best wishful thinking in the current climate of limited access to new therapies. Before a national UCB bank is created, reciprocity, a basic tenet of fairness, should be addressed. Evaluating the safety and efficacy of drugs in populations that for financial or other reasons would not have access to such drugs violates a principle of fairness.Similarly, the collection of UCB from infants whose families could not afford the cost of having their children treated with UCB transplants is inherently inequitable. With current trends in transplant management,2,3 it seems likely that access to unrelated UCB transplants will be limited to an affluent minority. In creating a national registry of HLA-typed cord blood donations, consideration should be given to providing donor families
Howe CWS. Umbilical Cord Blood for Transplantation. JAMA. 1996;275(12):910. doi:10.1001/jama.1996.03530360020025