Background: The discovery that blood from the placenta contains hematopoetic stem cells (HSC's) promises an exciting new generation of treatment options for children with certain genetic conditions. Most significantly, this blood provides an attractive alternative to bone marrow as a resource for HSC transplantation (TP). Cord blood (CB) offers several advantages over bone marrow. 1. CB can be drawn without endangering newborn or mother. 2. Though CB volume is limited, HSC's are more concentrated than in marrow, highly proliferate, and give rise to engraftment at a cell dose 1/10 of that for marrow. 3. Decreased incidence and severity of graft-vs-host disease (GVHD) and rejection. 4. A complete HLA match is not necessary. 5. Low incidence of CMV. Since 1988, over 1.000 CB TPs have been used to treat patients with malignant and nonmalignant diseases. The success rate has been remarkable, with approximately a 90% engraftment rate and a 40% probability of disease-free survival.Children's Hospital Oakland (CHO) has developed a Related Cord Blood Program (RCBP). This is the first and only NIH-supported family donor cord blood bank. The program provides services free of charge to families who have a child with a transplant-treatable condition and are expecting another child. Of special interest to genetic counselors (GC's). mothers carrying a fetus known through prenatal diagnosis to have a transplant-treatable condition are also eligible for this free service.CHO's RCBP aims to serve a small but critical population. We enroll about 5 new cases a week; 175 families have collected and stored CB with us. Over half are affected by genetic conditions such sickle cell disease and thalassemia. According to the California State Department of Health Genetics Disease Branch (CSDH/GDB) over 1,000 babies are diagnosed yearly with transplant-treatable genetic conditions. The majority of these families are referred to prenatal diagnostic centers (PDC's) for genetic counseling. Our goal is to reach those families who may benefit from our services.Hypothesis: Hundreds of families currently affected by genetic conditions potentially treatable with HSC are not banking CB due to a lack of information. The most effective way of communicating this information to this unserved patient population is through education of PDC GC's. GC's are a trusted source of advice and information; families often look to them for treatment options. From the RCBP's point of view, GC's are highly informed and empathetic individuals, ideally suited for identifying and communicating with families who could benefit from CB banking. In addition, Califorina has one of the best organized networks of PDC's in the country. This infastructure will aid in the systematic education of GC's and the integration of CB banking education into genetic counseling.Methods: 1. Contact directors of California PDC's to assess interest in and understanding of CB collection. Each director will identify a genetic counselor interested in CB to act as a point person. 2. Send out resource packets for PDC staff (patient leaflet, GC/PCD leaflet, video, articles.) 3. Ask point person to distribute information and schedule a meeting where a member of our staff will come and speak to PDC staff. 4. Invite point persons to an educational and planning conference for California GC's from across the state, sponsored by CHO and CSDH. 5. Set up an e-mail network of GC's.Conclusions: Our preliminary data show that the PDC chiefs are eager to learn more about the RCBP. We are confident that our strategy will help integrate information about these services into the PDC setting, and that an increasing number of families affected by genetic conditions will benefit from cord blood banking as a result of our efforts.