cord blood cells | cord blood vs peripheral blood

Family Cord, located in Los Angeles, has a high-quality lab, a top rating from the Better Business Bureau, and accreditation from AABB; it’s also been in business since 1997. Family Cord is one of the few banks that will also cover the cost of cord blood banking for the first year (there’s an annual fee after the first year) in cases where a baby has a sick sibling or another family member who could benefit from the cord blood.
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.
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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.
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.
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.
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
Learning about cord blood banking shouldn’t have to be confusing – or boring. Watch one of our stem cell experts who also happens to be a former RN and Labor & Delivery nurse, talk cord blood banking 101. She answers the questions every parent has about banking cord blood and ViaCord.
“This is a medical service that has to be done when your baby’s cells arrive and you certainly want them to be handled by good equipment and good technicians,” 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. “It’s just not going to be cheap.” Although the American Academy of Pediatrics (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 reduce costs.
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.
“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:
The Cord Blood Registry (CBR) is unique, because it is currently the world’s largest cord blood bank, with over a half-million cord blood and cord tissue units stored to date. This is substantially more than its nearest competitor, ViaCord, which has 350,000 units stored. It was recently acquired by pharmaceutical giant, AMAG Pharmaceuticals, for $700 million in June 2015.
Since the first unrelated cord blood–banking program was started at the New York Blood Center in 1991,40 a number of public cord blood–banking programs have been established throughout the world to collect, type, screen for infection, and cryogenically store cord blood for potential transplantation to unrelated and related recipients.41–49 Some of these programs had been funded by the National Heart, Lung, and Blood Institute (National Institutes of Health), the National Marrow Donor Program, the American Red Cross, or academic programs based in not-for-profit organizations. One cord blood program initiated by the National Institutes of Health exists solely for sibling donor collection for families who are likely to consider cord blood transplantation because a first-degree relative has been diagnosed with a disease that is treatable with allogeneic transplantation. In this bank, families own the cord blood, and it is shipped to a designated transplant center in the event a medical decision to proceed with cord blood transplantation is made.50
There are no health risks related to cord blood collection. Cord blood is retrieved from the umbilical cord after it has been cut, thus preventing any pain, discomfort, or harm. This process is completely safe.
Cord blood can’t be used to treat everything. If your child is born with a genetic condition such as muscular dystrophy or spina bifida, then the stem cells would have that condition, says Dr. Kurtzberg. But if the cord blood donor is healthy and there is a sibling or another immediate family member who has a genetic condition, the cord blood could be a good match for them.
Some ethical concerns over umbilical cord blood banking warrant mention. As previously stated, the AAP (2007) acknowledges that claims in advertisements for private cord blood banks are not accurate. In fact, some of the statements made by private cord blood banks are outright misleading (Fox et al., 2007), which raises questions about how informed consent for cord blood collection is obtained. Legally, the cord blood belongs to the child, but the consent of the mother alone is usually obtained for collection, and the consent of the father is rarely considered (Ballen, 2006). Because the cord blood now has a “value,” the person who obtains consent and that same person’s professional connection to the private cord blood bank may come into question (Pinch, 2001).
Finally, there is a significant lack of regulation for umbilical cord blood banking. The lack of quality control, in turn, affects the quality of the specimen available for transplant. Some cord blood banks have submitted to voluntary accreditation, but the process of accreditation varies from bank to bank, whether public or private (McGuckin & Forraz, 2008; Moise, 2005).
When you consider that public banks can only expect to ship 1-2% of their inventory for transplant, you can quickly understand why most public banks are struggling to make ends meet. That struggle means that fewer collection programs are staffed, and there are fewer opportunities for parents to donate to the public good. We said earlier that public banks only keep cord blood donations over a minimum of 900 million cells, but today most public banks have raised that threshold to 1.5 billion cells. The reason is that the largest units are the ones most likely to be used for transplants that bring income to the bank. Family cord blood banks do not need to impose volume thresholds because they have a profit margin on every unit banked.
To save money, public banks will not even process a cord blood donation unless they know in advance that they are going to keep it. When the collection first arrives at the lab, it is passed through a cell counting machine. Only collections that have at least 900 million nucleated cells are kept. As a result, over 60%-80% of cord blood donations are discarded. The public bank must absorb the expense of the collection kit and delivery charges for discarded blood; typically $100 per unit.
In order to preserve more types and quantity of umbilical cord stem cells and to maximize possible future health options, Cryo-Cell’s umbilical cord tissue service provides expectant families with the opportunity to cryogenically store their newborn’s umbilical cord tissue cells contained within substantially intact cord tissue. Should umbilical cord tissue cells be considered for potential utilization in a future therapeutic application, further laboratory processing may be necessary. Regarding umbilical cord tissue, all private blood banks’ activities for New York State residents are limited to collection, processing, and long-term storage of umbilical cord tissue stem cells. The possession of a New York State license for such collection, processing and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
I had some information about the very basics of umbilical cord blood banking, but I did not have the answers to most of the second couple’s questions. The first couple had some of the answers, but based on the limited knowledge I had, I felt that the information that the first couple shared was simply the information that the cord blood bank had supplied. I suspected that the cord blood bank had only shared information that was in its best interest to gain another customer. Therefore, my suspicions put me on a path to learn more about umbilical cord blood and, thus, cord blood banking and cord blood transplants.
To begin a discussion of umbilical cord blood banking, it must first be understood that the component from the blood that is salvaged is the stem cells. Stem cells are unspecialized cells that are the basis of all tissue and organ cells of the body. There are three main sources of stem cells in humans: embryonic stem cells, adult stem cells, and umbilical cord stem cells. Embryonic stem cells are generally used in research but not in clinical practice. Adult stem cells are found in various locations in the human body, but they are most commonly found in bone marrow (McGuckin & Forraz, 2008). Over the years, transplants of bone marrow stem cells have been used clinically to treat disease processes in which stem cells are beneficial. Umbilical cord blood stem cells were historically considered a waste product of the birthing process but are now known to have up to 10 times more stem cells than adult bone marrow (Gunning, 2007).
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.
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Cairo MS, Wagner EL, Fraser J, et al. Characterization of banked umbilical cord blood hematopoietic progenitor cells and lymphocyte subsets and correlation with ethnicity, birth weight, sex, and type of delivery: a Cord Blood Transplantation (COBLT) Study report. Transfusion.2005;45 :856– 866
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Dennis Michael Todd, PhD, joined Community Blood Services as its President and CEO in 2000. Community Blood Services operates the NJ Cord Blood Bank and The HLA Registry bone marrow donor center, both of which are affiliated with the National Marrow Donor Program (NMDP). In 2012, the blood center expects to distribute over 85,000 units of red cells and 20,000 platelets to hospitals and medical centers throughout northern NJ and Orange County, NY. Dr. Todd is presently a member of the NMDP Executive Committee and Chairman of the Finance Committee. He is a member of the International Society for Cellular Therapy (ISCT), the International Society for Stem Cell Research (ISSCR), the AABB, the American Association of Bioanalysts, and the New Jersey Society of Blood Bank Professionals.
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.

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