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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.
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.
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.
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
Patients with leukemia, lymphoma, or certain inherited metabolic or immune system disorders have diseased blood-forming cells. For some patients, an umbilical cord blood or bone marrow transplant (also called a BMT) may be their best treatment option.
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.
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
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.
After the baby is delivered, according to the procedures of cord blood banking, the umbilical cord is initially clamped and then cut out in the natural and usual manner. Here, the procedure for clamping and cutting remains the same for vaginal deliveries and c-section deliveries. However, while convening the procedure, make sure to get it done under the supervision of a competent and efficient professional.
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.
Marketing materials by Viacord and Cord Blood Registry, the two largest companies, do not mention that cord blood stem cells cannot be used by the child for genetic diseases, although the fine print does state that cord blood may not be effective for all of the listed conditions.
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.
‡ Payment Plan Disclosures for in-house CBR 6-Month Plan (interest free) – No credit check required. The 6-month plan requires a $10/month administrative fee. The plans may be prepaid in full at any time.
Kasamon YL, Jones RJ, Piantadosi S, et al. High-dose therapy and blood or marrow transplantation for non-Hodgkin lymphoma with central nervous system involvement. Biol Blood Marrow Transplant.2005;11 :93– 100
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.
Private cord blood banking costs $2,000 to $3,000 for the initial fee, and around another $100 per year for storage. While that may seem like a hefty price tag, many expectant parents may see it as an investment in their child’s long-term health.
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 holds promise for future medical procedures. Scientists are still studying more ways to treat more diseases with cord blood. At Duke University, for example, researchers are using patients’ own cord blood in trials for cerebral palsy and Hypoxic ischemic encephalopathy (a condition in which the brain does not receive enough oxygen). Trials are also under way for the treatment of autism at the Sutter Neuroscience Institute in Sacramento, California.
* Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord t style=”list-style-type: initial;”issue and long-term storage of umbilical cord-derived stem cells. Cbr Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
As you’re making your cord blood bank comparisons, you may want to factor in the stability of the bank. You’re choosing to store your baby’s cord blood in case it might be needed in the future, so you don’t want the bank to go out of business. Parentsguidecordblood.org offers detailed reviews of every public and private cord blood bank in the U.S.
Currently, cord blood stem cells have been approved by the FDA in the treatment nearly 80 diseases. In addition to these approved regenerative therapies, there are close to 350 clinical trials underway investigating the use of umbilical cord blood and umbilical cord tissue for stem cell transplantation, and this number promises to steadily increase. Cord blood stem cells are approved for numerous types of malignancies, anemias, inherited metabolic disorders and deficiencies of the immune system. The majority of cord blood transplants to date have been performed in patients younger than 18 years; however, advancements in regenerative medicine show promise for all ages. See all the diseases currently being treated.
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.
Now when you know what is cord blood, you might be wondering how it is collected. Well, cord blood is collected right after the birth of your little one. The procedure is completely painless and free from risks as well. The procedure is so quick, hassle-free and painless that neither a newborn nor a new mother realizes the entire procedure has taken place. Following is a list of steps depicting how the procedure is actually convened. Read on, to grasp a better insight on cord blood banking and its proceedings.
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.
Options for Umbilical Cord Blood Banking and Donation—As expectant parents, learn how umbilical cord blood can help others through public donation, family (private) cord blood banking, or directed donation for a biological sibling.
Your baby’s cord blood could be a valuable resource for another family. From foundations to non-profit blood banks and medical facilities, there are numerous locations that will collect, process, and use the stem cells from your baby’s cord blood to treat other people.
There is little doubt that scientists believe umbilical cord blood stem cells hold promise for the future. Cord blood stem cells are already used to treat blood disorders such as aplastic anemia, and research is underway to determine if they can treat other more common conditions like type 1 diabetes. But many experts question whether many companies’s marketing materials confuse or even mislead parents about the usefulness of private banking.
To explain why cord blood banking is so expensive in the United States, we wrote an article with the CEO of a public cord blood bank that lists the steps in cord blood banking and itemizes the cost of each one.
Gluckman E, Broxmeyer HA, Auerbach AD, et al. Hematopoietic reconstitution in a patient with Fanconi’s anemia by means of umbilical-cord blood from an HLA-identical sibling. N Engl J Med.1989;321 :1174– 1178
Parents often complain about cord blood banking costs. This is not an industry where costs can be cut by running a turn-key operation. Each cord blood unit must be individually tested and processed by trained technicians working in a medical laboratory.
Harvesting and banking cord blood is a fairly simple procedure that can be performed during vaginal or cesarian deliveries without interrupting the birth process. The doctor or nurse will collect the cord blood after the umbilical cord has been clamped. The collection of cord blood is not painful, intrusive or risky to the mother or baby.
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.
The potential powers of these cells have researchers excited. But what that scientific hope means for expectant parents facing decisions about cord blood banking is far from clear. For all of the promise, there are lots of reasons why umbilical cord cells may turn out to be less useful than thought. Read my next post for more about these potential drawbacks.
Cord blood has been shown to contain pluripotent stem cells that have the potential to differentiate into nonhematopoietic tissue, such as cardiac, neurologic, pancreatic, and skin tissue, in vitro.53,54 Extensive laboratory research is taking place to explore the potential therapeutic benefit of cord blood under these circumstances. The results of this research will be necessary to formulate future recommendations regarding autologous cord blood banking.
Blood naturally starts to clot when its outside the body. An anticoagulant is used to help prevent the cord blood from clotting while it is in transit to the laboratory for processing. CBR deliberately chose to use lyophilized (dry) heparin as the anticoagulant because of some potential advantages, including:
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).
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.
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.
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.
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.
Why should you consider donating the cord blood to a public bank? Simply because, besides bringing a new life into the world, you could be saving an individual whose best chance at life is a stem cell transplant with your baby’s donated cord blood. This can only happen if you donate and if your baby is a close enough match for a patient in need. If you chose to reserve the cord blood for your family, then siblings who have the same parents have a 25% chance of being an exact match.
Lifebank USA is another private bank, located in Cedar Knolls, New Jersey, that’s accredited by the AABB. What sets this bank apart from the others: it’s one of the few banks that store umbilical cord blood and placenta blood (this is done for free). Stem cells from placenta tissue can turn into skeletal tissue types such as bone, cartilage, fat tissue, and connective tissue, whereas cells from cord blood turn into different types of blood cells.
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.
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.
Back in the 1980s, umbilical cord blood caught the attention of researchers who suspected that the often-discarded tissue could be a valuable source of shape-shifting stem cells. These cells, which can become several different types of blood cells, are similar to the specialized stem cells found in bone marrow that can churn out new blood cells. Such stem cells are found in adult blood, too, but not as abundantly.
Hard numbers are tricky to pin down, but between that first transplant in 1988 and 2015, an estimated 35,000 umbilical cord blood transplants had been performed globally. That number includes people treated for leukemia and other types of cancer, blood disorders and immune diseases. And the utility of umbilical cord cells may stretch well beyond the disorders that the cells are currently being used for. “If you read the literature, it’s pretty exciting,” says pediatrician and immunologist William Shearer of Baylor College of Medicine and Texas Children’s Hospital.
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
*Fee schedule subject to change without notice. If a client has received a kit and discontinues services prior to collection, there is no cancelation fee if the kit is returned unused within two weeks from cancelation notice; otherwise, a $150 kit replacement fee will be assessed. †Additional courier service fee applies for Alaska, Hawai’i and Puerto Rico. ††Applies to one-year plan and promotional plan only. After the first year, an annual storage fee will apply. Cryo-Cell guarantees to match any written offer for product determined to be similar at Cryo-Cell’s sole discretion. ** Promotional Plan cannot be combined with any other promotional offers, coupons or financing.
Wagner JE, Rosenthal J, Sweetman R, et al. Successful transplantation of HLA-matched and HLA-mismatched umbilical cord blood from unrelated donors: analysis of engraftment and acute graft-versus-host disease. Blood.1996;88 :795– 802
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.