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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
Many expectant parents would love the opportunity to bank their baby’s cord blood and cord tissue, but with an initial fee of $1600–$1800 for a quality service and an annual fee of $150–$175, the cost of banking cord blood may seem out of reach. At Cryo-Cell, we are committed to offering a high standard of service at the best price possible, with absolutely no unexpected fees or hidden surcharges. To help keep cord blood banking in everyone’s budget, we offer in-house financing options that begin for as little as $199 down and $128 per month. In addition, we regularly offer specials and have a number of discounts for current clients, referrals, multiple birthes and medical professionals. We will even meet the price of any reputable competitor through our best-price guarantee.
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?
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.
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
Professionals affiliated with institutions or organizations that promote for-profit placental blood stem cell banking should make annual financial-disclosure and potential-conflicts-of-interest statements to an appropriate institutional review committee that possesses oversight authority.
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.
It depends on who you ask. Although commercial cord blood banks often bill their services as “biological insurance” against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
Private cord blood banks usually charge an enrolment and collection fee ranging from about $775 to $2,150, plus annual storage fees ranging from about $85 to $150. Some banks include the first year’s storage as part of your initial payment and lower your annual payment if you put down more money initially.
The baby’s cord blood will be processed and stored in a laboratory facility, often referred to as a blood bank. The cord blood should be processed and stored in a facility that is accredited by the American Association of Blood Banks (AABB) for the purpose of handling stem cells.
Bunin N, Aplenc R, Leahey A, et al. Outcomes of transplantation with partial T-cell depletion of matched or mismatched unrelated or partially matched related donor bone marrow in children and adolescents with leukemias. Bone Marrow Transplant.2005;35 :151– 158
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
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.
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.
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
AABB accredited: Some cord blood companies have received extra accreditation from the AABB, or the American Association of Blood Banks, which means they meet a certain standard of service and accuracy of work.
Given the difficulty in estimating the need for using one’s own cord blood cells for transplantation, private storage of cord blood as “biological insurance” is unwise. However, banking should be considered if there is a family member with a current or potential need to undergo a stem cell transplantation.
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.
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.
The “cell recovery rate” is often used to compare processing methods. Expressed as a percentage, the cell recovery rate tells you how many cells are retrieved from the original cord blood collection, once plasma has been removed and red blood cells have been reduced or removed. It is expected that some cells will be lost during processing, and most processing methods have published cell recovery rates between 80%—99%
Smith F, Kurtzberg J, Karson E, et al. Umbilical cord blood collection, storage and transplantation: issues and recommendations for expectant parents and patients. Cancer Res Ther Control.1999;10 :217– 226
Researchers continue to investigate new applications of stem cells. Ballen (2006) reported on studies examining the use of stem cells for treating autoimmune diseases, such as lupus, systemic sclerosis, and multiple sclerosis. Gunning (2007) reported on stem cell research for regenerative uses for heart attacks, stroke, spinal cord injury, diabetes, liver injury, and even traumatic brain injury. However, Gunning also noted that these regenerative uses for stem cells are purely in the research stage and, so far, no tangible evidence supports any clinical uses beyond the diseases that are currently being treated.
2. Diabetes. For the many Americans with type 1 diabetes, whose insulin-making pancreatic cells have been killed off by their immune system, stem cells may be the answer. Last year, scientists reported that they had coaxed human embryonic stem cells into becoming insulin-producing, blood sugar-regulating cells in diabetic mice. The aim: to someday do the same for people.
An alternative to a related donor involves seeking unrelated HLA-matched adult allogeneic donors outside of the family.2,6,11 There are more than 7 million potential unrelated volunteer adult donors registered in the National Marrow Donor Program registry.17 Although the number of patients who receive unrelated adult allogeneic donor stem cell transplants continues to increase each year, many patients are unable to find a fully matched donor, which diminishes access to transplantation therapy. Nonwhite patients have a lower chance of identifying a fully matched unrelated adult donor because of genetic heterogeneity and lack of nonwhite donors. Over the past decade, unrelated-donor, banked umbilical cord blood has been shown to contain sufficient numbers of stem cells for successful transplantation between unrelated, partially HLA-mismatched individuals.19–23 With advances in the clinical practice of cord blood transplantation, most patients unable to find a fully matched adult donor can identify a partially matched cord blood donor.
A few years ago, cord blood was simply discarded as medical waste after a birth. However, in the past few years, doctors have recognized that the stem cells have unique qualities which can be used in the treatment of certain cancers. The most common medical use is for transplantation in many situations where bone marrow is considered. In the future, it is possible that scientists will discover more diseases that can be cured with cord blood.
When all the processing and testing is complete, the cord blood stem cells are frozen in cryogenic nitrogen freezers at -196° C until they are requested for patient therapy. Public banks are required to complete the entire laboratory processing and freeze the cord blood stem cells within 48 hours of collection. This is to insure the highest level of stem cell viability. The accreditation agencies allow family banks a window of 72 hours.
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
Cord blood transplantation has been shown to be curative in patients with a variety of serious diseases. Physicians should be familiar with the rationale for cord blood banking and with the types of cord blood–banking programs available. Physicians consulted by prospective parents about cord blood banking can provide the following information:
There are several cord blood banks that are accredited by the American Association of Blood Banks. Most offer information on cord blood banking and provide private cord blood banking services. With a little research, you should be able to locate a credible cord blood bank online.
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.
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.
The policy also points out that if cord clamping is done too soon after birth, the infant may be deprived of a placental blood transfusion, resulting in lower blood volume and increased risk for anemia later in life.
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]
Cord blood has been used for 20 years to treat more than 80 serious diseases.34 Successful treatments have paved the way for further research and today, FDA-regulated clinical trials are exploring the use of a child’s own stem cells for conditions that currently have no cure.
Another important disadvantage that is not well understood by the general public is the limited use of an infant’s own umbilical cord blood stem cells later in life, called an autologous transplant. Commercial cord blood banks often advertise the banking of the infant’s cord blood as “biologic insurance.” However, the chance that a child would be able to use his or her own cord blood is extremely small: from a 1:400 to a 1:200,000 chance over the child’s lifetime (Sullivan, 2008). In fact, there are certain instances in which the use of one’s own umbilical cord blood is contraindicated, as in cases when the defect is of a genetic origin. For example, autologous cord blood stem cells cannot be used to treat malignant cancers such as leukemia because the genetic mutations for the cancer already exist on the DNA of the cord blood. Using one’s own stem cells would be, in effect, “contaminating” oneself with the same disease process (Percer, 2009).