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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.
Families with a history of diseases can store cord blood in a bank. These families can access it should a person get sick with an immune system or blood disease, like leukemia or sickle-cell anemia, later in life.
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.
Cord blood banking takes blood from the umbilical cord at the time of birth, and donates it to a public blood bank, or stores it in a private one. Since this blood is so rich in stem cells, which have the potential to become any human cell, it could someday be used as a treatment for the child or their family members.
Publicly banking your baby’s cord blood is a wonderful gift. Unfortunately, however, your chance of donating your baby’s cord blood is very low due to the regional and financial constraints of public cord blood banks. It is estimated that cord blood from less than 3% of all U.S. births can be collected and stored by the public banks. We support any efforts to increase the resources available for public banking.
Cord blood specimens for non-clinical scientific research studies are also available through the Cord Blood Transplantation (COBLT) Study, funded by the National Heart Lung and Blood Institute (NHLBI)
Over 95% of newborns’ cord blood stem cells fall into this category. It is unfortunate that public banking is not readably available and private banking is so expensive. Some industry leaders believe that as the industry grows, banking or donating cord blood will be as common as it is uncommon today.
After a baby is born, the umbilical cord and placenta are no longer needed and are usually discarded. However, the blood remaining in the umbilical cord and placenta is rich with blood-forming cells. (These cells are not embryonic stem cells.) By collecting and freezing this blood, the healthy blood-forming cells can be stored and may later be used by a patient who needs them.
Both public and family cord blood banks must register with the US Food and Drug Administration (FDA), and since Oct. 2011 public banks also need to apply for an FDA license. All cord blood banks are required by federal law to test the blood of the mother for infectious diseases. At public banks the screening is usually more extensive, similar to the tests performed when you donate blood. The typical expense to a public bank is $150 per unit.
The second couple listened intently to the conversation, interjecting that they hadn’t considered cord blood banking, and they looked toward me. They started asking the other couple, and me, many questions about cord blood banking. What is the cost? How is it done? What are the uses of cord blood? Is it only used to treat the baby later in life? Will cord blood treat myasthenia gravis? And finally, is it worth the time, effort, and money to invest in cord blood banking?
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
Insurance assisted payments: Some cord blood companies work with insurance companies that can help parents pay for cord blood processing and storage, particularly if one child in the family has an illness and might be able to benefit from cord blood use.
The use of cord blood is determined by the treating physician and is influenced by many factors, including the patient’s medical condition, the characteristics of the sample, and whether the cord blood should come from the patient or an appropriately matched donor. Cord blood has established uses in transplant medicine; however, its use in regenerative medicine is still being researched. There is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.
Options for Umbilical Cord Blood Banking and Donation—As expectant parents, learn how umbilical cord blood can help others through public donation, family (private) cord blood banking, or directed donation for a biological sibling.
Cade Hildreth is the Founder of BioInformant.com, the world’s largest publisher of stem cell industry news. Cade is a media expert on stem cells, recently interviewed by the Wall Street Journal, Los Angeles Business Journal, Xconomy, and Vogue Magazine.
Direct-donation umbilical cord blood banks function as an amalgamation of public and private banks. Direct-donation banks collect cord blood without charging fees. In addition, they accept autogenous donations and reserve them only for the family, especially for a family whose infant has a sibling with a disorder that may be treated with umbilical cord blood stem cells (Moise, 2005).
§ CBR Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue and long-term storage of umbilical cord-derived stem cells. CBR Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
In recent years, umbilical cord blood has been used successfully to treat a variety of pediatric genetic, hematologic and oncologic disorders. This advance has resulted in both not-for-profit and for-profit cord blood banking programs. The AAP’s statement is intended to help guide physicians in answering parents’ questions about cord blood banking.
In a number of genetic, hematologic, immunologic, metabolic, and oncologic disorders, reconstitution of bone marrow (transplantation) can be a potentially life-saving procedure.1–16 Allogeneic (related or unrelated) or autologous (self) bone marrow or peripheral blood stem cells are the usual sources of hematopoietic progenitor cells to achieve this goal. If autologous stem cells are not available or cannot be used, the best option for successful reconstitution therapy is to secure stem cells from an HLA-matched sibling.1,3,11 Close matching confers a higher probability of successful engraftment and minimizes the risk of potentially fatal graft-versus-host disease. Unfortunately, there is only a 25% chance for identifying a full HLA match in a sibling donor.17,18
Parents often complain about cord blood banking costs. This is not an industry where costs can be cut by running a turn-key operation. Each cord blood unit must be individually tested and processed by trained technicians working in a medical laboratory.
These are diseases for which transplants of blood-forming stem cells (Hematopoietic Stem Cell Transplants, HSCT) are a standard treatment. For some diseases they are the only therapy, and in other diseases they are only employed when front-line therapies have failed or the disease is very aggressive. The lists below include ALL therapies that use blood-forming stem cells, without distinction as to whether the stem cells were extracted from bone marrow, peripheral blood, or cord blood.
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.
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.
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.
Families with a history of diseases can greatly benefit from cord blood banking, as an insurance policy against possible future diseases. However, cord blood banking is expensive, can’t be used to treat everything, and your child may not even need it—at private cord blood banks, most is eventually discarded. Lastly, you should be aware that if the child develops certain genetic diseases, the cord blood will have the same genetic flaws.
LifebankUSA is the only cord blood banking company to have pioneered the advanced technology to collect additional placental stem cells for today’s treatments, and unique placental stem cells for future medical advancements. We discovered unique stem cells that remained trapped in the blood vessels of the placenta, so we created an innovative retrieval method to collect those cells.
Bielorai B, Trakhtenbrot L, Amariglio N, et al. Multilineage hematopoietic engraftment after allogeneic peripheral blood stem cell transplantation without conditioning in SCID patients. Bone Marrow Transplant.2004;34 :317– 320
‡ Payment Plan Disclosures for in-house CBR 6-Month Plan (interest free) – No credit check required. The 6-month plan requires a $10/month administrative fee. The plans may be prepaid in full at any time.
*Fee schedule subject to change without notice. If a client has received a kit and discontinues services prior to collection, there is no cancelation fee if the kit is returned unused within two weeks from cancelation notice; otherwise, a $150 kit replacement fee will be assessed. †Additional courier service fee applies for Alaska, Hawai’i and Puerto Rico. ††Applies to one-year plan and promotional plan only. After the first year, an annual storage fee will apply. Cryo-Cell guarantees to match any written offer for product determined to be similar at Cryo-Cell’s sole discretion. ** Promotional Plan cannot be combined with any other promotional offers, coupons or financing.
Because there are no scientific data at the present time to support autologous cord blood banking and given the difficulty of making an accurate estimate of the need for autologous transplantation and the ready availability of allogeneic transplantation, private storage of cord blood as “biological insurance” should be discouraged. Cord blood banks should comply with national accreditation standards developed by the Foundation for the Accreditation of Cellular Therapy (FACT), the US Food and Drug Administration (FDA), the Federal Trade Commission, and similar state agencies. At a minimum, physicians involved in procurement of cord blood should be aware of cord blood collection, processing, and storage procedures as shown in Table 2.
Prior to freezing the cells, samples are taken for quality testing. Banks measure the number of cells that are positive for the CD34 marker, a protein that is used to estimate the number of blood-forming stem cells present. Typical cost, $150 to $200 per unit. They also measure the number of nucleated cells, another measure of stem cells, both before and after processing to determine the cell recovery rate. Typical expense, $35 per unit. A portion of the sample is submitted to check that there is no bacterial or fungal contamination. Typical expense, $75 per unit. Public banks will also check the ability of the sample to grow new cells by taking a culture called the CFU assay. Typical expense, $200 to $250 per unit.
When you’re pregnant, especially for the first time, you have to make a lot of decisions. Will coffee remain a part of your life? Where are you going to give birth? What are you going to name the baby? What values will you teach him? Do you really need a baby spa bathtub?
Regulatory agencies (eg, FDA, Federal Trade Commission, and state equivalents of these federal agencies) are encouraged to have an active role in providing oversight of the cord blood program. All cord blood–banking programs should comply with FACT or equivalent accreditation standards.
* Disclaimer: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used. Cord tissue stem cells are not approved for use in treatment, but research is ongoing.
There is little doubt that scientists believe umbilical cord blood stem cells hold promise for the future. Cord blood stem cells are already used to treat blood disorders such as aplastic anemia, and research is underway to determine if they can treat other more common conditions like type 1 diabetes. But many experts question whether many companies’s marketing materials confuse or even mislead parents about the usefulness of private banking.
Anak S, Saribeyoglu ET, Bilgen H, et al. Allogeneic versus autologous versus peripheral stem cell transplantation in CR1 pediatric AML patients: a single center experience. Pediatr Blood Cancer.2005;44 :654– 659
Chandy M, Balasubramanian P, Ramachandran SV, et al. Randomized trial of two different conditioning regimens for bone marrow transplantation in thalassemia: the role of busulfan pharmacokinetics in determining outcome. Bone Marrow Transplant.2005;36 :839– 845
Specializing in health and medicine, Sandra Gordon has written extensively about cord blood banking for national and regional parenting magazines. She also has written about baby products, including breast pumps, for national and regional parenting magazines, blogs and books. Her work has appeared in hundreds of publications, including Parents, Prevention, Woman’s Day and Self. Gordon also appears on TV as a baby safety and money-saving expert. She is also the author of 10 books and the founder of babyproductsmom.com, a site dedicated to helping new parents gear up safely and within their budget.
Public cord blood banking is free, but you give up your rights to the cord blood stem cells at the time of donation. Just like donating to a blood bank, this means your donation would be owned by the public cord blood bank and not by you. Your donated cord blood stem cells can be used for medical research or could possibly save a life through a transplant. Public cord blood banks release your child’s stem cells when a good match from a registry is identified.1
24/7 opperation of services, including holidays, is a must. As we all know, giving birth can happen at any time of day, which is why core blood banks should be at the ready for whenever your little one make his or her grand debut. Select a cord blood bank that utilizes industry approved standards for shipping. Temperature fluctuations speeds up cell death which affects the number of viable cells that reaches the laboratory for storage. Cord blood banks which use commercial shipping services, such as FedEx, use heavily insulated boxes to protect specimens. While others use medical couriers who specialize in delivering medical specimens, for added protection of your cord blood or tissue specimens.
Choosing a bank (specifically a private bank) for her daughter’s cord blood made perfect sense to Julie Lehrman, a mom based in Chicago. “We wanted the extra assurance that we were doing everything we could to keep Lexi healthy,” Lehrman says. “I was older when Lexi was born, and there’s a lot we didn’t know about my mom’s health history, so we felt that we were making a smart decision.” Fortunately, Lexi was born healthy, and neither she nor anyone else in the family has needed the cord blood since it was stored seven years ago. But Lehrman has no regrets; she still feels the family made a wise investment. “Lexi or her brother or even one of us could still need that blood in the future, so I’m thankful that we have it.” But banking your child’s cord blood may not be the right decision for you. Read on to see if you should opt for private cord blood banking.
Entz-Werle N, Suciu S, van der Werff Ten Bosch J, et al. Results of 58872 and 58921 trials in acute myeloblastic leukemia and relative value of chemotherapy vs allogeneic bone marrow transplantation in first complete remission: the EORTC Children Leukemia Group report. Leukemia.2005;19 :2072– 2081
Frances Verter, PhD, founded the Parent’s Guide to Cord Blood in 1998 and has been a Scientific Advisor to Community Blood Services since 2007. In 2011 the NMDP presented her with their Lifeline Award in recognition of her efforts to improve public education about cord blood donation.
For the 12- and 24-month payment plans, down payment is due at enrollment. In-house financing cannot be combined with other offers or discounts. *Please add $50 to the down payment for medical courier service if you’re located in Alaska, Hawai’i or Puerto Rico. **Actual monthly payment will be slightly lower than what is being shown. For the length of the term, the annual storage fee is included in the monthly payment. Upon the child’s birthday that ends the term and every birthday after that, an annual storage fee will be due. These fees are currently $150 for cord blood and $150 for cord tissue and are subject to change.
Anyway, the excitement over the embryonic cells comes from their remarkable ability, as biological blank slates, to become virtually any of the body’s cell types. Many observers believe the president’s move will accelerate the hunt for cures for some of our most vexing diseases. However, the benefits are largely hypothetical, given the infancy of the field, and are offset by some real obstacles: The risks of embryonic stem cells, as well as cells programmed to become like them, including the possibility they will actually cause cancers in people who receive them. Nonetheless, here’s a look at 10 health problems that stem cells might someday cure or at least help treat.
An additional cost that is borne only by public banks is the “HLA typing” that is used to match donors and patients for transplants. This is an expensive test, running about $75 to $125 per unit. Family banks always defer this test until it is known whether a family member might use the cord blood for therapy.
Myers LA, Hershfield MS, Neale WT, Escolar M, Kurtzberg J. Purine nucleoside phosphorylase deficiency (PNP-def) presenting with lymphopenia and developmental delay: successful correction with umbilical cord blood transplantation. J Pediatr.2004;145 :710– 712