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Your child may never need it. Stem cell-rich cord blood can be used to treat a range of diseases, but Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, estimates that there’s only a 1 in 217 chance that your child will ever need a stem cell transplant with cord blood (or bone marrow). This is particularly true if the child doesn’t have a family history of diseases such as leukemia, lymphoma, or sickle cell anemia. 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 cut down on expenditures.
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.
When researching cord blood banks, make sure they’re registered with the Food and Drug Administration (FDA), and comply with FDA regulations including current good tissue practice regulations, donor screening and testing for infectious diseases. Check for accreditations with American Association of Blood Banks or the Foundation for the Accreditation of Cellular Therapy. Other factors to consider are the bank’s shipping and delivery methods, clinical experience, processing options, payments and costs.
Donating to research is another alternative. In some areas, you may be able to donate your newborn’s cord blood stem cells to a university or biotech firm. There are also now several private banks who offer to bank your baby’s cord blood as a donation, but they will typically sell it to a research facility. Cord Blood Options will be compiling additional data for this section in the near future.
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
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.
Of particular interest are the flexible hematopoietic stem cells important in that initial transplant. In certain cases, transplanting these cells might be able to reboot a person’s body and get rid of a disease-related defect. Cord blood transplants are similar to bone marrow transplants. A person with leukemia, for instance, might have his own cancerous blood cells wiped out with chemotherapy and radiation. Healthy, non-cancerous stem cells from a donor can then repopulate the blood.
“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:
Part of the reason for the dominance of these three companies in terms of the total number of units stored is that they are three of the oldest cord blood banks within the U.S., founded in 1992, 1993, and 1989, respectively. All three of these cord blood banks also support cord blood research and clinical trials.
In recent years, umbilical cord blood, which contains a rich source of hematopoietic stem and progenitor cells, has been used successfully as an alternative allogeneic donor source to treat a variety of pediatric genetic, hematologic, immunologic, and oncologic disorders. Because there is diminished risk of graft-versus-host disease after transplantation of cord stem cells using matched related donors, the use of less-than-completely matched HLA cord blood stem cells may incur less risk of graft-versus-host disease than mismatched cells from either a related or unrelated “walking” donor, although this remains to be proven. Gene-therapy research involving modification of autologous cord blood stem cells for the treatment of childhood genetic disorders, although experimental at the present time, may prove to be of value. These scientific advances have resulted in the establishment of not-for-profit and for-profit cord blood–banking programs for allogeneic and autologous cord blood transplantation. Many issues confront institutions that wish to establish or participate in such programs. Parents often seek information from their physicians about this new biotechnology option. This document is intended to provide information to guide physicians in responding to parents’ questions about cord blood donation and banking and the types and quality of cord blood banks. Provided also are recommendations about appropriate ethical and operational standards, including informed consent policies, financial disclosures, and conflict-of-interest policies for physicians, institutions, and organizations that operate or have a relationship with cord blood–banking programs.
Ozkaynak MF, Sandoval C, Levendoglu-Tugal O, Jayabose S. A pilot trial of tandem autologous peripheral blood progenitor cell transplantation following high-dose thiotepa and carboplatin in children with poor-risk central nervous system tumors. Pediatr Hematol Oncol.2004;21 :635– 645
Medical shipping: Some cord blood companies use medical shipping companies to deliver cord blood; these companies guarantee that cord blood is kept a certain temperature and delivered to the facility by a certain time, typically within 24 hours of collection.
BioInformant is the first and only market research firm to specialize in the stem cell industry. BioInformant research has been cited by major news outlets that include the Wall Street Journal, Nature Biotechnology, Xconomy, and Vogue Magazine. Serving Fortune 500 leaders that include GE Healthcare, Pfizer, and Goldman Sachs. BioInformant is your global leader in stem cell industry data.
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.
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.
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.
Thornley I., Eapen M., Sung L., Lee S., Davies S., & Joffe S. (2009). Private cord blood banking: Experiences and views of pediatric hematopoietic cell transplantation physicians. Pediatrics, 123(3), 1011–1017 [PMC free article] [PubMed]
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.
As with all important decisions you make, the more educated you are, the better. After all, you only get one chance to bank your baby’s cord blood and you want to make sure that you choose a cord blood bank you can trust. Cord blood banking companies—especially private ones—vary widely in terms of quality, experience, and even the technology they use to collect, process, and store cord blood.
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These are diagnoses for which stem cell treatments are being studied either in the laboratory with cell cultures or in animals that mimic the human disease. The experimental therapies are not yet in human clinical trials. In experimental research, it is often not clear whether an eventual therapy, if developed, would be Autologous or Allogeneic.
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.
Current applications for newborn stem cells include treatments for certain cancers and blood, metabolic and immune disorders. Additionally, newborn stem cell preservation has a great potential to benefit the newborn’s immediate family members with stem cell samples preserved in their most pristine state.
Umbilical cord blood can save lives. Cord blood is rich in stem cells that can morph into all sorts of blood cells, which can be used to treat diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. There are a few ways for transplant patients to get blood cells (umbilical and placenta, bone marrow, peripheral/circulation), but cord blood is easier to match with patients, and because it is gathered during birth from the umbilical cord, it’s a painless procedure.
Four main types of physical conditions are treated with stem cell transplants: cancers, blood disorders, congenital metabolic disorders, and immunodeficiencies (see Table 1). Examples of cancers that are treated with stem cells are both lymphoma and leukemia. Nonmalignant hemologic disorders also account for a fair share of the recipients of stem cells. Examples of these blood disorders are various types of anemias, such as sickle-cell anemia and Fanconi’s anemia (the first disorder treated with umbilical cord blood stem cells). Stem cells have also been used to treat various metabolic disorders, such as adrenoleukodystrophy. The fourth major category of uses for stem cells is in treating immunodeficiencies, such as Duncan’s disease or adenosine deaminase deficiency (Drew, 2005; Moise, 2005).
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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.
After all is said and done, the cost to collect, test, process and store a donated cord blood collection at a public bank is estimated to be $1,200 to $1,500 dollars for each unit banked. That does not include the expense for the regulatory and quality systems needed to maintain licensure, or the cost of collecting units that are discarded because they don’t meet standards.
Eapen M, Horowitz MM, Klein JP, et al. Higher mortality after allogeneic peripheral-blood transplantation compared with bone marrow in children and adolescents: the Histocompatibility and Alternate Stem Cell Source Working Committee of the International Bone Marrow Transplant Registry. J Clin Oncol.2004;22 :4872– 4780
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.
Your baby’s newborn stem cells are transported to our banking facilities by our medical courier partner, and you can receive tracking updates. Each sample is processed and stored with great care at our laboratory in Tucson, Arizona. CBR’s Quality Standard means we test every cord blood sample for specific quality metrics.
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).
The choices expectant parents make today go beyond finding out the gender of their baby. They span beyond deciding whether to find out if their child, still in the womb, may potentially have a genetic disorder. Today, many parents must decide whether to store their baby’s umbilical cord blood so it will be available to heal their child if at any point in the child’s lifetime he or she becomes sick.
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.
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.
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.
CBR’s quality control team performs over 5 million sample checks per year which includes 3 million temperature checks, 20,000 environmental sterility tests, and 95 control checks on each sample to ensure processes are working correctly so that your family’s stem cells are kept protected. At CBR we take the safe storage of your stem cells seriously.
Make no mistake, cord banks are businesses to the core. And just like any other business, there’s always the possibility of a cord bank failing. Which is why we suggest begining your search by checking the company’s experience, the number cord blood units stored, and how many of these cord blood units have been used for transplants.
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.
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.