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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
At the end of a recent childbirth class, I found two couples engaged in a lengthy discussion. In the course of the conversation, both couples agreed that their goal was to do the best things for their pregnancy and birth. They were attending childbirth classes to learn how to support normal birth. They each were planning to attend breastfeeding classes. As their conversation continued, the first couple described their decision to bank the umbilical cord blood of their yet unborn daughter. They were adamant that their decision was the best action for them because they had a strong family history of myasthenia gravis. They stated that they had researched the issue by talking to several different cord blood banks, and they had decided on one particular bank because it processed the cord blood without the use of the anticoagulant drug, heparin. The couple went on to parrot back the information that the cord blood bank had told them. It was evident that the first couple wanted what was best for their yet unborn child.
Regenerative therapy is the practice of delivering cells and cell products to renew diseased or damaged tissues in a specific area. It is one of the fastest growing fields of medical research. Each year, new regenerative therapies using stem cells from cord blood and cord tissue enter into clinical trials for the treatment of chronic and life-threatening diseases. If proven successful, these clinical trials will lead to approval from the Food and Drug Administration (FDA). With FDA-approval, these treatments can then be administered as a general practice.
According to the statement, “Families may be vulnerable to emotional marketing at the time of birth of a child and may look to their physicians for advice. No accurate estimates exist of the likelihood of children to need their own stored cells. The range of available estimates is from 1 in 1,000 to 1 in 200,000.” For this and other reasons, it is difficult to recommend that parents store their children’s cord blood for future use. The AAP policy states:
Fox N. S., Stevens C., Cuibotariu R., Rubinstein P., McCullough L. B., & Chervenak F. A. (2007). Umbilical cord blood collection: Do patients really understand? Journal of Perinatal Medicine, 35, 314–321 [PubMed]
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.
There are several advantages of using umbilical cord blood stem cells over bone marrow stem cells for transplants (see Table 2). The first advantage is that umbilical cord blood is relatively easy to collect and process. Once considered a substance to be thrown away after a birth, now the cord blood can be easily saved. After it is saved and sent to a storage facility, the cord blood is quickly available for use within days to weeks after processing. In contrast, bone marrow stem cells can take much longer to find a match, collect the sample, and process. The process for bone marrow transplantation can take from weeks to months. The collection process for cord blood is not painful to either mother or child and can be done either prior to or after the delivery of the placenta (Gonzalez-Ryan, VanSyckle, Coyne, & Glover, 2000; Percer, 2009). Bone marrow transplants, on the other hand, require the donor to be hospitalized, anesthetized, and experience postcollection pain and discomfort. Thus, compared to cord blood, bone marrow collection and transplantation of stem cells are more costly (Drew, 2005; Moise, 2005).
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.
ViaCord collaborates with leading research and medical centers across the country to help advance medical treatments using cord blood, discover treatments using cord tissue, and connect families to relevant clinical trials.
Are public banks and family banks the same, except for who may use the cord blood and the cost to the parents? No. Public banks are subject to much higher regulatory requirements, and compliance with regulations carries costs. At a family bank you pay the bank enough to cover the cost of storing your baby’s cord blood, plus they make a profit. When you donate to a public bank, it costs you nothing, but the bank pays more on processing each blood collection than at a family bank. Let’s look at the steps that take place in the laboratory.
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
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.
The American Academy of Pediatrics (AAP) takes the issue of privacy very seriously. See our Privacy Statement for information about how AAP collects, uses, safeguards and discloses the information collected on our Website from visitors and by means of technology.
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).
Let’s look back at the expectant couple in my childbirth class who asked about banking their infant’s umbilical cord blood. They should not base their decision to bank the umbilical cord blood on the type of anticoagulant used to preserve the sample; likewise, they should not obtain all of their information on cord blood banking from the private cord blood bank, whose major agenda is to gain another client. Instead, they must be encouraged to research various resources for reliable information (see Table 4). If they have evidence that stem cells are used currently to treat a specific disease process that is affecting a family member, and is not simply a proposed idea, then it might be in their best interest to privately bank the umbilical cord blood. However, they should be aware that simply banking the cord blood does not ensure a cure, and they would most likely be banking the blood not for the current baby, but for some other family member. They must also be aware of the cost involved in the banking process. Finally, if they do not have a relative with a disease process treated with stem cells or there is no evidence that stem cells are used to treat the diseases that are known to be in their family, then they should consider public banking of the umbilical cord blood (if they have access to a public cord blood bank).
This web page was researched by Frances Verter, PhD, Alexey Bersenev, MD PhD, and Pedro Silva Couto, MSc ©2016-2018. Sources of information about established therapies were publications in the medical literature found via PubMed and Google Scholar. Sources of clinical trials were searches of ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), Japan University hospital Medical Information Network Clinical Trial Registry (UMIN-CTR), Japan Medical Association Clinical Trial Registry (JMA-CTR), Clinical Research Information Service from South Korea (CRiS), EU Clinical Trials Register (EudraCT), World Health Organization International Clinical Trials Registry Platform (ICTRP), Netherlands Trial Register (NTR), Australian New Zealand Clinical Trial Registry (ANZCTR), Clinical Trials Registry-India (CTRI), German Clinical Trials Register (DRKS), and Iranian Registry of Clinical Trials (IRCT).
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.
With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.
As a result of these advances, it is not unreasonable to hope that cord blood may eventually be used to treat a wider variety of auto-immune and degenerative diseases than is currently being done. If so, (and there are solid indications by researchers that this indeed is the case), it makes perfect sense to consider private cord blood banking.
Another advantage of using umbilical cord blood stem cells is the decreased risk of the transmission of infectious disease. This particular advantage is partly because umbilical cord blood is almost never contaminated by Epstein-Barr virus or cytomegalovirus (Drew, 2005; Gonzalez-Ryan et al., 2000). Additionally, the processing of cord blood includes collecting data on the history of infection during the mother’s pregnancy. For example, if the pregnant woman has a history of group B streptococcus, active genital herpes, or prolonged rupture of membranes and chorioamnionitis, umbilical cord blood is not saved. Generally, samples of the mother’s blood are also drawn to test for infectious diseases, such as hepatitis, human immunodeficiency virus, and syphilis (Moise, 2005). Furthermore, after the cord blood units are collected, they are screened for disease, and any units that are deemed contaminated or infected are thrown away (Gunning, 2007).
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.
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.
Some researchers suspect that umbilical cord blood contains other cells that may have therapeutic effects beyond the blood. Specialized immune cells may be able to tweak brain function, for instance. Trials around the world are studying umbilical cord blood’s capabilities in a wide range of diseases (see Table 2 here): Cerebral palsy, autism, diabetes and lupus are currently under investigation. The cells are even being tested for an ameliorating role in Alzheimer’s disease and other neurodegenerative conditions.
AlphaCord has a 100% success rate of viable specimens upon thaw. It has been in business for over a decade and is FDA-approved. The company aims to provide a low-cost means of collecting and processing cord blood for customers.
CBR works with Quick International, a private courier service with 30 years of experience as the market leader in the transport of cord blood, tissue, organs, and the U.S. blood inventory. CBR offers our clients a unique “Track My Kit” system to provide progress updates as the kit containing the cord blood travels to our lab. If it gets lost or damaged while in transit with Quick International, you are covered by a $2,500 warranty.
The term “Cord Blood harvesting” has a slightly morbid sound, but in reality, it is a very worthwhile and potentially lifesaving field of medical science. Umbilical Cord blood is blood that remains in the umbilical cord after birth. This umbilical cord blood is full of stem cells, and these powerful cells can be harvested for use in medical testing, or for transplantation into another host. A transplantation of harvested umbilical cord blood can have a profound effect on the recovery of patients with a host of medical conditions such as leukemia, cancers, thalassemia, Diabetes and some other diseases.
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.
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.
Cord Blood Registry is a cord blood storage company that collects, processes and stores stem cells to help families with medical needs later in life. Founded in 1992, it is the world’s largest newborn stem cell company.
* Annual storage fees will be charged automatically to the credit/debit card on file, on or around your baby’s birthday, unless you’ve chosen a prepay option and are subject to change until they are paid.
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.
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.
Cord blood contains stem cells that can save lives. Patients requiring a stem cell transplant will receive cells from one of three sources: bone marrow, circulating blood, or umbilical cord blood. The first two exist in all healthy adults, but cord blood can only be harvested and stored at birth
Karanes C, Confer D, Walker T, Askren A, Keller C. Unrelated donor stem cell transplantation: the role of the National Marrow Donor Program. Oncology (Williston Park).2003;17 :1036– 1068, 1043–104, 1164–1167
10. Organ failure. What better way to ease the shortage of organs for transplantation than to grow new ones? That’s what some scientists think, and with stem cells, that vision may become more than a pipe dream. Last year, researchers grew a beating rat heart in the lab with the help of heart cells from newborn rats, preliminary proof of the concept.
CBR presented data, in the form of a poster, at the 2008 joint annual meeting of the Center for International Blood and Marrow Transplant Research (CIBMTR) and the American Society of Blood and Marrow Transplants (ASMBT). In the poster, CBR showed results obtained during implementation of the AXP System. The published abstract reported that, under the controlled conditions of the study, the average recovery rate of the mononucleated cell (MNC) population was approximately 99% (specifically 98.7%). The results presented at this meeting are consistent with some of the high MNC recovery rates reported by other groups that have adopted AXP System (Rubinstein P. Cord blood banking for clinical transplantation. Bone Marrow Transplantation. 2009;44:635-642).
A person will always be a 100% match to his or her cord blood, which is the best fit as there are some conditions that can only be treated with one’s own cord blood stem cells (or a perfect match). However, other conditions can be treated using donor stem cells that are partial genetic matches.
Public umbilical cord blood banks accept altruistic donations of cord blood and do not charge donation fees. Donated units are also processed, antigen typed, and frozen, ready for use. Unlike private banks, public banks do not reserve the units for the family that donated them; rather, units are available to the general public. In fact, a family that donates the blood would be no more likely to be a recipient of the blood than anyone else in the general population. Public cord blood banks function much like venous blood banks. The blood is released on an “as-needed” basis, and a processing fee may be charged to recoup some of the cost of storage (Moise, 2005; Percer, 2009).
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.