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One of the factors that influence engraftment time is cell dose (Gunning, 2007). Cell dose is directly related to the volume of umbilical cord blood collected. Cell dose refers to the amount of useful stem cells in the sample of blood. Because of the limited volume of cells collected from cord blood, the amount of stem cells in cord blood is approximately 10% less than the amount obtained from bone marrow (Moise, 2005). A single unit of umbilical cord blood usually contains 50 to 200 ml of blood (Gonzalez-Ryan et al., 2000). If an amount of cord blood is less than this minimum volume, the unit is discarded as being unsatisfactory because the cell dose of the sample would not be high enough. Collecting an insufficient volume of cord blood occurs in about 50% or more cases of cord blood collection (Drew, 2005). In general, fewer stem cells are needed for cord blood transplantation, and usually a volume of 50 to 100 ml of cord blood will provide enough of a cell dose for a child or small adult. However, should the recipient need additional stem cells, it is impossible to obtain more stem cells from the infant because the cord blood volume is a limited amount (Percer, 2009).
New England Cord Blood Bank was founded in 1971 and is one of the pioneers in processing and cryopreservation of human cells and tissue. The company is continuing to expand its research and development center.
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.
Rocha V, Wagner JE Jr, Sobocinski KA, et al. Graft-versus-host disease in children who have received a cord-blood or bone marrow transplant from an HLA-identical sibling. Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources. N Engl J Med.2000;342 :1846– 1854
For families that choose to bank cord blood, the American Academy of Pediatrics (AAP) recommends public cord blood banking. Estimates vary, but the chances of a child having a stem cell transplant, with either bone marrow or cord blood, are 1 in 217 over a lifetime. 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 decide on cord blood banking, the AAP recommends public cord blood banking (instead of private) to cut down on costs. If you donate cord blood and your child eventually needs it, you can get it back as long as it hasn’t been discarded or used.
Cord blood, which is harvested from the umbilical cord right after a baby is born, is marketed as a treatment for diseases such as leukemia and sickle cell disease, and as a potential source of cells for regenerative medicine – a cutting-edge field of medicine studying how to repair tissues damaged by everything from heart disease to cerebral palsy.
The main purpose of a cord blood company is to store umbilical cord blood for families in case they need to access it for future use. Cord blood from a baby is stored because it has the potential to help treat blood or immune system diseases. There are both private and public cord blood companies, sometimes referred to as cord blood banks.
“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:
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.
Families should seriously pursue public banking, donation for research, or private banking instead of discarding their baby’s umbilical cord blood. We aim to be nonpartisan in our dissemination of information, but we believe that discarding your baby’s cord blood is a waste of a once-in-a-lifetime valuable resource.
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.
Cancellations prior to CBR’s storage of the samples(s) are subject to an administrative fee of $150. If you terminate your agreement with CBR after storage of the sample(s), you will not receive a refund.
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.
3. Heart disease. It’s the leading cause of death in the United States, and stem cells may provide some relief. Research is underway to see if injecting the cells into the heart could help regenerate heart muscle damaged by, for example, a heart attack. Again, researchers have reported success in rodents.
Despite the benefits of using umbilical cord blood stem cells for transplant, the process also has some disadvantages (see Table 3). For stem cell transplants to be successful, measurable signs of engraftment must occur. Engraftment is the opposite of rejection and indicates that the stem cell transplant is “working.” Two measurable signs of engraftment are the recovery of both neutrophil (a type of white blood cell) and platelet (a clotting factor) production. These two clinical signs of recovery take longer to occur in umbilical cord blood stem cell transplants than in bone marrow stem cell transplants. In other words, the lab values for white blood cell production and platelet production take longer to increase after umbilical cord blood stem cell transplants than after bone marrow stem cell transplants (Hess, 1997; Moise, 2005).
Preserving stem cells does not guarantee that the saved stem cells will be applicable for every situation. Ultimate use will be determined by a physician. Please note: Americord Registry’s activities are limited to collection of umbilical cord tissue from autologous donors. Americord Registry’s possession of a New York State license for such collection does not indicate approval or endorsement of possible future uses or future suitability of cells derived from umbilical cord tissue.
Right after the cord is clamped and cut, your medical practitioner uses a needle and gets it inserted into the umbilical vein of the cord. Only that part is cut which is still attached to the placenta. High quality and proper needles are used and they do not go anywhere near your baby.
5. Alzheimer’s disease. Likewise, embryonic stem cells may come in handy against Alzheimer’s disease, a progressive and deadly disorder that degrades and kills brain cells, leading to memory loss, cognitive decline, and behavioral problems. Stem cells may give rise to new treatments or even, some say, a cure; other experts have expressed skepticism.
Physicians or other professionals who recruit pregnant women and their families for for-profit placental cord blood stem cell banking should disclose any financial interest or other potential conflict of interest they have in the procedure to their patients.
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.
Since 1988, cord blood transplants have been used to treat over 80 diseases in hospitals around the world. Inherited blood disorders such as sickle cell disease and thalassemia can be cured by cord blood transplant. Over the past decade, clinical trials have been developing cord blood therapies for conditions that affect brain development in early childhood, such as cerebral palsy and autism.
Not all moms can donate their cord blood. Moms who are not eligible are those who: are younger than 18 years old (in most states), have been treated for cancer or have received chemotherapy for another illness, have had malaria in the last three years, or have been treated for a blood disease such as HIV or hepatitis. It’s also not possible to donate cord blood if a mom has delivered her baby prematurely (there may not be enough blood to collect) or delivered multiples (but it’s possible to bank your cord blood of multiples privately).
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.