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Bunin N, Aplenc R, Iannone R, et al. Unrelated donor bone marrow transplantation for children with severe aplastic anemia: minimal GVHD and durable engraftment with partial T cell depletion. Bone Marrow Transplant.2005;35 :369– 373
The choices expectant parents make today go beyond finding out the gender of their baby. They span beyond deciding whether to find out if their child, still in the womb, may potentially have a genetic disorder. Today, many parents must decide whether to store their baby’s umbilical cord blood so it will be available to heal their child if at any point in the child’s lifetime he or she becomes sick.
One of the first things I learned is that the couples in my childbirth class were not unique. In fact, research indicates that most pregnant women are underinformed about the issue of cord blood banking (Fox et al., 2007). While reviewing the literature on cord blood banking, I also found that the information available for nurses and childbirth educators often comes from private cord blood banks or their employees (Cord Blood Registry, 2009; Wolf, 1998, 1999), thus introducing the chance of bias.
Cord blood banking means preserving the newborn stem cells found in the blood of the umbilical cord and the placenta. After a baby is born, and even after delayed cord clamping, there is blood remaining in the umbilical cord and placenta that holds valuable newborn stem cells. Parents have a choice between donating cord blood to a public bank for free, or paying to store it for their family in a private bank. Cord blood banking includes the whole process from collection through storage of newborn stem cells for future medical purposes.
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.
Wall DA, Carter SL, Kernan NA, et al. Busulfan/melphalan/antithymocyte globulin followed by unrelated donor cord blood transplantation for treatment of infant leukemia and leukemia in young children: the Cord Blood Transplantation study (COBLT) experience. Biol Blood Marrow Transplant.2005;11 :637– 646
Initially, cord blood stem cell transplantation using allogeneic umbilical cord blood was performed in relatively small children, because the cell dose per weight of recipient was shown to be important.19,20 However, older children, adolescents, and adults have benefited from unrelated allogeneic umbilical cord blood transplantation.34,55–61 Because of the relationship between cell dose per recipient weight and transplant outcome, the number of cord blood cells needed for marrow reconstitution in older children or young adults is much larger than that needed when cord blood is used for transplantation in small children. Cord blood transplants using multiple cryopreserved units from separate donors have been performed successfully in adults, and the approach is currently under investigation as a strategy to increase the dose of cells for transplantation in a single recipient.62 Cord blood is collected in observance of good obstetric and pediatric practice.45
Current applications for newborn stem cells include treatments for certain cancers and blood, metabolic and immune disorders. Additionally, newborn stem cell preservation has a great potential to benefit the newborn’s immediate family members with stem cell samples preserved in their most pristine state.
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.
With umbilical cord blood harvesting, the harvested cord blood does not come from the newborn baby itself; instead, the cord blood is harvested from the blood that remains in the umbilical cord after birth. Umbilical cord blood is never harvested from either mother or child, but only from the unused blood in the umbilical cord, which would otherwise be discarded waste. The harvesting procedure takes only a few minutes and there is zero danger to either the parent or the baby.
If you want the blood stored, after the birth, the doctor clamps the umbilical cord in two places, about 10 inches apart, and cuts the cord, separating mother from baby. Then she inserts a needle and collects at least 40 milliliters of blood from the cord. The blood is sealed in a bag and sent to a lab or cord blood bank for testing and storage. The process only takes a few minutes and is painless for mother and baby.
After injections with their own umbilical cord blood, 63 children with cerebral palsy improved on motor skills, on average. And a clinical trial to see whether cord blood transplants improve symptoms of children with autism spectrum disorder should wrap up in the summer of 2018, says pediatric researcher and clinician Joanne Kurtzberg of Duke University, who helped establish a not-for-profit umbilical cord bank in North Carolina. (A small but optimistic pilot study has already been completed.)
Families that are predisposed to certain diseases, that are ethnically mixed, that are adopting a newborn child, or that have a family member who may need a stem cell transplant should take special care to understand the value the cells may provide and their storage options.
One of the key things you’ll want the cord blood bank’s representative to explain to you is how the cord blood bank collects and stores cord blood. Collection and storage methods may differ across cord blood banking companies, and you’ll want to be sure that the cord blood bank complies with all federal standards.2
Donating your baby’s cord blood to a public bank is always free. The limitations of the public banking network in the United States are: they only collect donations at large birthing hospitals in ethnically diverse communities, the mother must pass a health screening, they prefer registration by 34 weeks of pregnancy, and they only save the largest cord blood collections. The potential reward of public donation is that your baby could Be The Match to save a life!
The main disadvantage of cord blood transplants is that they take at least a week longer to “engraft”, which means repopulate the patient’s blood supply so that cell counts reach minimum acceptable levels. The longer engraftment time is a risk because it leaves the patient vulnerable to a fatal infection for a longer time.
The primary benefit to cord blood banking is that it provides a type of medical insurance. This insurance is not from a financial perspective, but rather takes the form of having the necessary medical building blocks available should they be needed in the event of certain illnesses and diseases. Those medical building blocks are the stem cells found in umbilical cord blood.
Targeted efforts should be made to recruit underserved minorities (black, Hispanic, American Indian/Alaska Native individuals) in public cord blood–banking programs to extend to them potential treatments afforded other segments of society.
Refer-a-friend program: The New England Cord Blood Bank gives families $100 for each friend they refer to the company, so customers have further incentive to choose the company for storage and processing.
We chose the site of our lab for one reason in particular: safety. As one of the safest cities in the US, Tucson ensures our families’ samples will be protected from natural disaster. Natural disasters, such as hurricanes, tornadoes, and earthquakes, could interrupt consistent long-term storage of stem cells.
Private cord blood banking is recommended for families with a history of certain diseases. Specifically, these are families with diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. Why? The type of stem cells in cord blood can form all kinds of blood cells that can help treat these diseases.
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.
Your baby’s cord blood could be a valuable resource for another family. From foundations to non-profit blood banks and medical facilities, there are numerous locations that will collect, process, and use the stem cells from your baby’s cord blood to treat other people.
Cord tissue is rich in another type of stem cell. Although there are no current uses, researchers are excited about the benefits cord tissue stem cells may offer in potential future users, such as regenerative medicine. By storing both, you’ll have potential access to more possibilities
After the baby is delivered, according to the procedures of cord blood banking, the umbilical cord is initially clamped and then cut out in the natural and usual manner. Here, the procedure for clamping and cutting remains the same for vaginal deliveries and c-section deliveries. However, while convening the procedure, make sure to get it done under the supervision of a competent and efficient professional.
A well-established history. Public banks are affiliated with nonprofit research institutions or hospitals, so they have a better chance of being managed more soundly. For families without a history of diseases treated by cord blood, such as leukemia and sickle cell anemia, the American Academy of Pediatrics (AAP) recommends that cord blood be donated to public banks. Although the AAP states cord blood has been used to treat certain diseases successfully, there isn’t strong evidence to support cord blood banking. If a family does choose to bank cord blood, the AAP recommends public cord blood banking (instead of private) to cut down on expenditures. Private cord blood banks are affiliated with business corporations, so, like any business, they may go under, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston.
Because of their ability to regenerate, umbilical cord stem cells may provide the answers to conditions such as various forms of heart disease and diabetes. Medical researchers studying umbilical cord blood stem cells have recorded several positive observations in animal studies, including instances where cord blood stem cells have improved vascular functions in injured tissue, as well as blood flow and improved overall heart function.
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.
Your baby’s newborn stem cells are transported to our banking facilities by our medical courier partner, and you can receive tracking updates. Each sample is processed and stored with great care at our laboratory in Tucson, Arizona. CBR’s Quality Standard means we test every cord blood sample for specific quality metrics.
CorCell has almost 20 years of experience banking cord blood, cord tissue and DNA. The company is one of the first licensed private cord blood programs in the United States and has its own AABB-accredited laboratory.
With President Obama’s lifting of the ban on federal funding for embryonic stem cell research, scientists had necessary funding for developing medical treatments, in which case with a new Trump’s administration it might be different now.
Laughlin MJ, Rizzieri DA, Smith CA, et al. Hematologic engraftment and reconstitution of immune function post unrelated placental cord blood transplant in an adult with acute lymphocytic leukemia. Leuk Res.1998;22 :215– 219
To explain why cord blood banking is so expensive in the United States, we wrote an article with the CEO of a public cord blood bank that lists the steps in cord blood banking and itemizes the cost of each one.
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.
Cord blood is the fastest growing source of stem cells in pediatric transplants, and ongoing research indicates that we’ve only just begun to harness the healing power of these amazing cells.3, 15 By collaborating with some of the country’s leading hospitals and research centers, ViaCord is helping to advance critical research in cord blood stem cell therapy and to unlock the promise of cord tissue stem cells.
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.
The stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling. Cord blood stem cells have similar ability to treat disease as bone marrow but with significantly less rejection.
Cord blood therapies have gotten more successful, and they also hold the promise of future innovative medical procedures for conditions like cerebral palsy and autism. Currently, cord blood 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. It’s an even more valuable resource for ethnic minorities, who statistically have a harder time finding stem cell matches in the registry of adult bone marrow donors.