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Maschan AA, Trakhtman PE, Balashov DN, et al. Fludarabine, low-dose busulfan and antithymocyte globulin as conditioning for Fanconi anemia patients receiving bone marrow transplantation from HLA-compatible related donors. Bone Marrow Transplant.2004;34 :305– 307
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There are several advantages of using umbilical cord blood stem cells over bone marrow stem cells for transplants (see Table 2). The first advantage is that umbilical cord blood is relatively easy to collect and process. Once considered a substance to be thrown away after a birth, now the cord blood can be easily saved. After it is saved and sent to a storage facility, the cord blood is quickly available for use within days to weeks after processing. In contrast, bone marrow stem cells can take much longer to find a match, collect the sample, and process. The process for bone marrow transplantation can take from weeks to months. The collection process for cord blood is not painful to either mother or child and can be done either prior to or after the delivery of the placenta (Gonzalez-Ryan, VanSyckle, Coyne, & Glover, 2000; Percer, 2009). Bone marrow transplants, on the other hand, require the donor to be hospitalized, anesthetized, and experience postcollection pain and discomfort. Thus, compared to cord blood, bone marrow collection and transplantation of stem cells are more costly (Drew, 2005; Moise, 2005).
Some financial aid is available for families that opt for private cord blood banking. If you have a sick child who could benefit from umbilical cord blood, some cord blood banks offer programs in which the bank will cover free cord blood processing and storage if the baby has a biological sibling with certain diseases. Certain insurance companies may pitch in if that sibling needs to be treated with the cord blood in the near future, Dr. Verter says.
Hard numbers are tricky to pin down, but between that first transplant in 1988 and 2015, an estimated 35,000 umbilical cord blood transplants had been performed globally. That number includes people treated for leukemia and other types of cancer, blood disorders and immune diseases. And the utility of umbilical cord cells may stretch well beyond the disorders that the cells are currently being used for. “If you read the literature, it’s pretty exciting,” says pediatrician and immunologist William Shearer of Baylor College of Medicine and Texas Children’s Hospital.
This web page was researched by Frances Verter, PhD, Alexey Bersenev, MD PhD, and Pedro Silva Couto, MSc ©2016-2018. Sources of information about established therapies were publications in the medical literature found via PubMed and Google Scholar. Sources of clinical trials were searches of ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), Japan University hospital Medical Information Network Clinical Trial Registry (UMIN-CTR), Japan Medical Association Clinical Trial Registry (JMA-CTR), Clinical Research Information Service from South Korea (CRiS), EU Clinical Trials Register (EudraCT), World Health Organization International Clinical Trials Registry Platform (ICTRP), Netherlands Trial Register (NTR), Australian New Zealand Clinical Trial Registry (ANZCTR), Clinical Trials Registry-India (CTRI), German Clinical Trials Register (DRKS), and Iranian Registry of Clinical Trials (IRCT).
Most of the diseases for which HSCT is a standard treatment are disorders of blood cell lineage. The proliferation by which blood cells are formed from stem cells is illustrated in the side graphic (click on the image to expand it); you can also read about specific cell types in the immune system in more detail. In the United States, most health insurance providers will pay for a stem cell transplant if it is a “standard therapy” for the patient’s diagnosis.
Properly preserved cord blood is long-lasting. Cord blood is stored in a nitrogen freezer (the same technology used to freeze donated sperm), so it can last for a long time. “The scientist who first developed cord blood preservation methods in 1990 has confirmed that some of the first specimens he stored 23 plus years ago are just as potent as fresh cord blood,” says Mary Halet, Director, Central Region at Be The Match, which is operated by the National Bone Marrow Foundation.
Cord blood has been shown to contain pluripotent stem cells that have the potential to differentiate into nonhematopoietic tissue, such as cardiac, neurologic, pancreatic, and skin tissue, in vitro.53,54 Extensive laboratory research is taking place to explore the potential therapeutic benefit of cord blood under these circumstances. The results of this research will be necessary to formulate future recommendations regarding autologous cord blood banking.
Several of these groundbreaking trials only use cord blood stem cells processed by Cord Blood Registry as a way of ensuring consistent quality. That means, saving with Cord Blood Registry gives families access to more uses and treatments.
However, this does not mean more is better. Cord blood banks we reviewed are similar in terms of the quality of services they provided. Affordable services are still available, especially with the different discount options offered by many of the top cord blood banks reviewed.
Ballen KK, Kurtzberg J, Lane TA, et al. Racial diversity with high nucleated cell counts and CD34 counts achieved in a national network of cord blood banks. Biol Blood Marrow Transplant.2004;10 :269– 275
Migliaccio AR, Adamson JW, Stevens CE, Dobrila NL, Carrier CM, Rubinstein P. Cell dose and speed of engraftment in placental/umbilical cord blood transplantation: graft progenitor cell content is a better predictor than nucleated cell quantity. Blood.2000;96 :2717– 2722
If you do decide to bank your baby’s cord blood, there’s one more thing to keep in mind: It’s best not to make it a last-minute decision. You should coordinate with the bank before your baby is born so nothing is left to chance.
The American College of Obstetricians and Gynecologists (ACOG, 2008) recommends giving pregnant women information about umbilical cord blood banking that is free from bias. According to ACOG, the chance of a child or family member needing a stem cell transplant is about 1 in 2,700. Therefore, ACOG recommends the collection and banking of cord blood only when an immediate family member has a known diagnosis for which stem cells are currently being used for treatment, and not for potential future uses.
If you intend donating umbilical cord blood for preservation and later use, you should let your doctor know by your 34th week so that they can help make any arrangements with a cord blood bank. Once you and your doctor have decided on which cord blood bank to use, you will often be sent informational reading materials from the cord blood bank for further education regarding the process of cord blood harvesting.
Umbilical cord blood can save lives. Cord blood is rich in stem cells that can morph into all sorts of blood cells, which can be used to treat diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. There are a few ways for transplant patients to get blood cells (umbilical and placenta, bone marrow, peripheral/circulation), but cord blood is easier to match with patients, and because it is gathered during birth from the umbilical cord, it’s a painless procedure.
After all is said and done, the cost to collect, test, process and store a donated cord blood collection at a public bank is estimated to be $1,200 to $1,500 dollars for each unit banked. That does not include the expense for the regulatory and quality systems needed to maintain licensure, or the cost of collecting units that are discarded because they don’t meet standards.
Many public banking proponents believe that the greater good to society is to donate your baby’s cord blood stem cells to a public bank for use by someone who may need it, since the likelihood of your baby needing it is very small.
Barker JN, Davies SM, DeFor T, Ramsay NK, Weisdorf DJ, Wagner JE. Survival after transplantation of unrelated donor umbilical cord blood is comparable to that of human leukocyte antigen-matched unrelated donor bone marrow: results of a matched-pair analysis. Blood.2001;97 :2957– 2961
Make no mistake, cord banks are businesses to the core. And just like any other business, there’s always the possibility of a cord bank failing. Which is why we suggest begining your search by checking the company’s experience, the number cord blood units stored, and how many of these cord blood units have been used for transplants.
Of particular interest are the flexible hematopoietic stem cells important in that initial transplant. In certain cases, transplanting these cells might be able to reboot a person’s body and get rid of a disease-related defect. Cord blood transplants are similar to bone marrow transplants. A person with leukemia, for instance, might have his own cancerous blood cells wiped out with chemotherapy and radiation. Healthy, non-cancerous stem cells from a donor can then repopulate the blood.
The blood within your newborn baby’s umbilical cord contains young stem cells that can renew themselves and become specialized. These cord blood stem cells have been proven in treatment to help children replace damaged blood cells with healthy ones and strengthen their immune systems. Cord blood banking is the process of collecting and storing these stem cells for potential medical use.
Barker JN, Weisdorf DJ, DeFor TE, Blazar BR, Miller JS, Wagner JE. Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning. Blood.2003;102 :1915– 1919
Eapen M, Horowitz MM, Klein JP, et al. Higher mortality after allogeneic peripheral-blood transplantation compared with bone marrow in children and adolescents: the Histocompatibility and Alternate Stem Cell Source Working Committee of the International Bone Marrow Transplant Registry. J Clin Oncol.2004;22 :4872– 4780
There are many “what if” situations that we all consider in our life. One of the most serious is “What if a child or other family member was to become seriously ill?” Cord Blood Banking clinics have been growing exponentially in response to this common fear. But should you ever find yourself in this dilemma, what are the pros and cons of using cord blood cells versus other stem cell-related treatments? This article will take a comparative look at some of the key benefits and difficulties as well as the financial costs of cord blood banking.
Priority shipping: Cord blood companies that use priority shipping services have families ship them cord blood in a heavily insulated box, which arrives at the cord bank at a certain time, but does not guarantee that the blood remains at a certain temperature.
Umbilical cord blood was once thought of as a waste product of the birthing experience, but now it is valued for its content of stem cells. Today, more than 20 years after the first successful umbilical cord blood stem cell transplant, more families are seeking information about whether or not to invest in saving their newborn’s umbilical cord blood. Saving the cord blood in public banks is a worthy undertaking for any family. It is recommended that expectant families only consider cord blood banking in private banks when they have a relative with a known disorder that is already treatable by stem cell transplants. Moreover, expectant families should not rely on commercial cord blood banks as their sole source of information about cord blood banking.
After harvesting, the umbilical cord blood is taken to a cord blood bank where it will be tested to make sure that it is clear of disease and other contaminants. Before being frozen, a cryopreservant is added to the cord blood so that the stem cells are able to be frozen without damaging them, after which they are stored in a liquid nitrogen Cord Blood storage tank at –196 Celsius.
4. Parkinson’s disease. Stem cells may also help those who suffer from Parkinson’s, a neurodegenerative disorder that can cause tremors, stiffness, and other movement and speech problems. Studies show that embryonic stem cells can give rise to the dopamine-making neurons that Parkinson’s patients lack. When transplanted into rodents with a Parkinson’s-like disorder, those replacement brain cells improved the animals’ motor function.
Kasamon YL, Jones RJ, Piantadosi S, et al. High-dose therapy and blood or marrow transplantation for non-Hodgkin lymphoma with central nervous system involvement. Biol Blood Marrow Transplant.2005;11 :93– 100
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.
StemCyte™ has extensive experience providing cord blood units for transplants in children and adults with life-threatening diseases. Other private cord blood banks may have provided family-related cord blood for transplants, but only StemCyte™’s cord blood units have been used to 2000 plus transplants to date.
Some parents-to-be are sold on the advertising that banking their child’s cord blood could potentially treat an array of diseases the child, or his siblings, could encounter in their lives. Other parents-to-be may find all the promises too good to be true.