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CBR works with Quick International, a private courier service with 30 years of experience as the market leader in the transport of cord blood, tissue, organs, and the U.S. blood inventory. CBR offers our clients a unique “Track My Kit” system to provide progress updates as the kit containing the cord blood travels to our lab. If it gets lost or damaged while in transit with Quick International, you are covered by a $2,500 warranty.
Extracting stem cells from bone marrow requires surgery under anesthesia; extracting them from the blood requires taking a drug to stimulate their production. And in order to work, these stem cell donations need to come from a person who carries a similar pattern of proteins on the outsides of his or her cells, a molecular calling card known as HLA type. Stem cells found in cord blood don’t need to be as closely matched to work. Because these cells are so flexible, there’s more wiggle room between donor and recipient. That’s particularly good news for people of certain ethnic minorities who often have trouble finding matched stem cell transplant donors.
A typical cord blood collection only contains enough stem cells to transplant a large child or small adult. This website has a page explaining the optimum transplant dose. At one time it was believed that cell dose limitations restricted the use of cord blood transplants to children. In recent years growing numbers of adults are also receiving cord blood transplants, either by growing the cells in a lab prior to transplant or by transplanting more than one cord blood unit at a time. More information about these trials is available on the web page about Research on Cord Blood Transplants.
Tracey Dones of Hicksville, N.Y., paid to bank her son Anthony’s cord blood. But four months after he was born, Anthony was diagnosed with osteopetrosis, a rare disease that causes the body to produce excess bone, leads to blindness, and can be fatal if left untreated.
Umbilical cord blood stem cells are different from other kinds of cells in a couple of different ways. The first is that umbilical cord blood stem cells are unspecialized cells, which have the ability to renew themselves by cell division, even after significant time has elapsed since they were frozen. The second reason is that in certain situations, and under exacting conditions, the umbilical cord stem cells can become tissue- or organ-specific cells, allowing regeneration of those tissues.
Private banking is an alternative option if you can afford the associated costs and if the family’s history suggests a higher probability of need. Families that are predisposed to certain diseases, that are ethnically mixed, or that include a family member who may need a stem cell transplant should take special care to understand the value the cells may provide.
1. As today’s children grow up and some of them develop cancer as adults, autologous (self) cord blood transplants will become more commonly used. Pediatric cancers and adult cancers are completely different diseases at the cellular level (to learn more about cancer visit the website of the National Cancer Institute). While pediatric cancer patients rarely receive autologous transplants, among adult cancer patients the autologous transplants are more common than transplants from donors.
A history of releasing cord blood units for therapy. “This shows they’re not just selling contracts to parents — there are doctors who are actually accepting units of cord blood that have been stored there for therapy,” says Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists.
Ballen K., Broxmeyer H. E., McCullough J., Piaciabello W., Rebulla P., Verfaillie C. M., & Wagner J. E. (2001). Current status of cord blood banking and transplantation in the United States and Europe. Biology of Blood and Marrow Transplantation, 7(12), 635–645 [PubMed]
Harvesting and banking cord blood is a fairly simple procedure that can be performed during vaginal or cesarian deliveries without interrupting the birth process. The doctor or nurse will collect the cord blood after the umbilical cord has been clamped. The collection of cord blood is not painful, intrusive or risky to the mother or baby.
Banking a baby’s blood and stem cells in a cord blood bank is a type of insurance. Ideally, you would not need to access your baby’s stem cells in order to address a medical concern. However, using a cord blood bank can provide peace of mind in knowing that you have a valuable resource if you need it.
ViaCord’s Sibling Connection Program, a dedicated transplant program for siblings, was designed to help families in need of a stem cell transplant. This program provides ViaCord’s cord blood banking services at no cost to expecting parents. A family with a child with an established diagnosis of a disease that is currently treatable with sibling cord blood may be eligible.
“Processing” refers to separating the important components of the whole cord blood before cryopreservation. There are many methods used to process cord blood that can achieve the same goal: storing the important cells for potential future use. However, it’s important to point out some differences between methods:
Karanes C, Confer D, Walker T, Askren A, Keller C. Unrelated donor stem cell transplantation: the role of the National Marrow Donor Program. Oncology (Williston Park).2003;17 :1036– 1068, 1043–104, 1164–1167
Public umbilical cord blood banks accept altruistic donations of cord blood and do not charge donation fees. Donated units are also processed, antigen typed, and frozen, ready for use. Unlike private banks, public banks do not reserve the units for the family that donated them; rather, units are available to the general public. In fact, a family that donates the blood would be no more likely to be a recipient of the blood than anyone else in the general population. Public cord blood banks function much like venous blood banks. The blood is released on an “as-needed” basis, and a processing fee may be charged to recoup some of the cost of storage (Moise, 2005; Percer, 2009).
Lewis ID, Almeida-Porada G, Du J, et al. Umbilical cord blood cells capable of engrafting in primary, secondary, and tertiary xenogeneic hosts are preserved after ex vivo culture in a noncontact system. Blood.2001;97 :3441– 3449
All cord blood banks in the US are required to register with Food and Drug Administration. To ensure safety, cord blood banks must comply with FDA regulations, including current good tissue practice regulations, donor screening and testing for infectious diseases, including HIV I & II (the virus that causes AIDS), Hepatitis B & C, which can cause liver disease, Cytomegalovirus (CMV) a virus that can lead to pneumonia, Human T-cell Lymphotropic Virus (HTLV) 1 & 2, which can suppress the immune system, West Nile Virus, Zika Virus, Treponema pallidum (the bacterium that can cause syphilis) and Variant Creutzfeldt-Jakob Disease (vCJD), a rare virus that can cause brain disease. Since 2011, the FDA has required public cord blood banks to obtain a license under a Biologics License Application.
FACT accredited: Cord blood companies that are FACT accredited have been evaluated by the Foundation for the Accreditation of Cellular Therapy, and they’re found to have met the foundation’s standards of operation.
CBR’s lab stores over 700,000 cord blood and cord tissue stem cell units. As a result of our size, we are able to continuously invest in clinical trials, product innovation, and our lab and storage facility. We own our state-of-the-art facility. And, we continually invest in quality and security. This means our families will always have access to their stem cells.
Lamaze International (2010) does not have a policy specific to umbilical cord blood banking; however, the organization has a specific policy that prohibits advertising of private cord blood banks in any Lamaze media vehicle. This policy was most recently updated and revised in July 2010. In addition, in their book, The Official Lamaze Guide: Giving Birth With Confidence, Lothian and DeVries (2010) reinforce the AAP’s position that expectant families are vulnerable to the marketing strategies of private cord blood banks. The authors go on to say that expectant parents should know that banking umbilical cord blood does not guarantee a cure. Likewise, there is no guarantee that a private umbilical cord blood bank will be able to adequately preserve the cord blood until a time when it is needed. One potential reason for being unable to preserve the cord blood is that the private cord blood bank could go out of business.
The stem cells obtained from umbilical cord blood are also less likely than bone marrow stem cells to be rejected in transplants. Considered to be immunologically immature, umbilical cord blood stem cells produce significantly fewer natural killer cells, creating a substantial decrease in rejection. Consequently, cord blood stem cells require less rigorous antigen tissue matching for transplants than bone marrow stem cells (Sullivan, 2008). Research indicates that a mismatch of up to two antigen sites still provides successful clinical outcomes (Ballen, 2006; Fox et al., 2007). In fact, researchers report that the rate of rejection for cord blood stem cell transplants is half the rate of rejection for bone marrow transplants (Ballen et al., 2001). When compared directly in cases of mismatched antigens, there was clearly less rejection in transplants involving cord blood stem cells than bone marrow stem cells (Moise, 2005).
Although cord blood is currently considered discarded human material, it should only be collected for banking with an institutional review board–approved protocol and with signed informed consent from a parent.42,43 Pertinent donor information communicated to the cord blood bank should be kept confidential by the cord blood bank and used only to report important medical information obtained during the cord blood collection, processing, and screening process that is relevant to the safety of the donor and family. If cord blood was collected from a newborn who subsequently developed a genetic, immunologic, or malignant neoplastic disorder, parents should notify the cord blood bank so that the unit is not used for transplantation. All cord blood units banked for potential use should be tested for infectious diseases, similar to those tested in a blood bank, and for hereditary hematologic diseases. The informed consent must contain information pertaining to what tests are to be performed on the cord blood and how the parents will be informed if test results are abnormal. Pediatricians should be aware that legal cases relating to the duty of a physician to warn parents about the risks of inheriting a genetic disease are new and untested. Pediatricians should remain vigilant, because future cases may define who has a legal duty to notify parents about genetic abnormalities identified during cord blood testing. Informed consent should be obtained before the onset of active labor and before cord blood collection.
You need to plan ahead if you decide to store cord blood. Banks need to be notified four to six weeks before your due date if you’re interested in donating blood. Once you do decide on a public bank, those affiliated with the Be the Match registry (bethematch.org/cord) will cover the costs of collecting, processing, and storing cord blood units.