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Families that are predisposed to certain diseases, that are ethnically mixed, that are adopting a newborn child, or that have a family member who may need a stem cell transplant should take special care to understand the value the cells may provide and their storage options.
Well, this is how the entire procedure of cord blood banking. Right after the blood is extracted, it is sent for to the bank. In the bank, the cord blood is checked, tested, processed and finally preserved. This preservation is ensured by controlled freezing under high end freezing conditions. Certain private banks collect a certain segment of the umbilical cord along with the cord blood. The umbilical cord tissue contains various stem cells that are quite different from the general cord blood cells. Research experts are studying in order to understand the possible use of the stem cells in medicine.
Research on stem cell transplants began in the 1950s, with successful bone marrow transplants occurring in the 1970s, often to treat cancer patients whose own bone marrow was destroyed by chemotherapy and radiation. The first successful umbilical cord blood stem cell transplant was reported as occurring in the late 1980s. The recipient was a 6-year-old American boy from North Carolina who was treated for Fanconi’s anemia (a genetic disorder) at Hospital St. Louis in Paris, France, using cord blood obtained from his younger sister’s birth. Interestingly, more than 20 years after the transplant, this young man is alive and well. Not only did he survive long term, but both his immune system and his blood were transformed by the transplant of his sister’s cord blood stem cells. Soon after this first documented cord blood stem cell transplant, the first public umbilical cord blood bank was established in 1991 in New York (McGuckin & Forraz, 2008).
Donating your baby’s cord blood is a wonderful gift. The cells may be the perfect match for someone in desperate need of a stem cell transplant. Unfortunately, cord blood banking is still an extremely new industry; there are only a small handful of public banks in certain regions, and those banks are primarily focused on collecting cord blood stem cells from Hispanic and African American families due to the genetic diversity associated with those families. Please visit http://www.marrow.org/ for a list of public banks with their contact information. One other note: It is also a wonderful gift to be a bone marrow donor, and becoming one is much more available to the public, unlike cord blood banking. Please call your local blood bank or the American Red Cross for additional information on how to become a bone marrow donor.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
Families with a history of diseases can greatly benefit from cord blood banking, as an insurance policy against possible future diseases. However, cord blood banking is expensive, can’t be used to treat everything, and your child may not even need it—at private cord blood banks, most is eventually discarded. Lastly, you should be aware that if the child develops certain genetic diseases, the cord blood will have the same genetic flaws.
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.
The next step at either a public or family bank is to process the cord blood to separate the blood component holding stem cells. The final product has a volume of 25 milliliters and includes a cryoprotectant which prevents the cells from bursting when frozen. Typical cost, $250 to $300 per unit.
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.
The most obvious argument against is that the odds of needing cord blood for medical treatment is very, very slim. Below is a news release on a policy published in the July,1999 issue of Pediatrics, the peer-reviewed scientific journal of the American Academy of Pediatrics (AAP):
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.
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.
Finally, there is a significant lack of regulation for umbilical cord blood banking. The lack of quality control, in turn, affects the quality of the specimen available for transplant. Some cord blood banks have submitted to voluntary accreditation, but the process of accreditation varies from bank to bank, whether public or private (McGuckin & Forraz, 2008; Moise, 2005).
Private cord blood banks store cord blood for you in case your child or someone in your immediate family needs it in the future. These private collections are owned by you and you decide how your baby’s cord blood is used. There are processing and storage fees associated with private cord blood banks.
Cord blood is the fastest growing source of stem cells in pediatric transplants, and ongoing research indicates that we’ve only just begun to harness the healing power of these amazing cells.3, 15 By collaborating with some of the country’s leading hospitals and research centers, ViaCord is helping to advance critical research in cord blood stem cell therapy and to unlock the promise of cord tissue stem cells.
Regulatory agencies (eg, FDA, Federal Trade Commission, and state equivalents of these federal agencies) are encouraged to have an active role in providing oversight of the cord blood program. All cord blood–banking programs should comply with FACT or equivalent accreditation standards.
Prices subject to change until they are paid. Fees apply to single-birth, U.S. customers only. Cancellation fees may apply. All major credit cards accepted. Payment plans cover first-year fees only; future annual storage fees are not included. If not paying by credit/debit card, total first year fees are due at the time of enrollment.
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.
The procedure of cord clamping can be delayed for a considerable period of time. However, the delay has to be a brief one. It cannot be delayed more than one or two minutes. If the procedure of clamping the cord is delayed for too long, the blood present in the cord might clot and once the blood clots it does not benefit anyone. Neither does it help your baby nor can it be collected for storage.
The American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics don’t recommend routine cord blood storage. The groups say private banks should only be used when there’s a sibling with a medical condition who could benefit from the stem cells. Families are encouraged to donate stem cells to a public bank to help others.
Certain public cord blood banks let you mail in your cord blood. You have to decide before the birth if you want to donate your cord blood. If the hospital where you’re delivering doesn’t accept donations, you can contact a lab that offers a mail-in delivery program. After you’ve passed the lab’s screening process, they’ll send you a kit that you can use to package your blood and mail it in, explains Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation (parentsguidecordblood.org), a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists.
When considering cord blood, cord tissue, and placenta tissue banking, you want all of the facts. Americord’s® Cord Blood Comparison Chart gives you information not only on our costs and services, but also on how other companies measure up.
‡ 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.
Cord blood can be used in the treatment of nearly 80 life-threatening diseases – from cancers to blood disorders. It’s also being used in regenerative medicine research to help kids with conditions like Autism and Cerebral Palsy.
Private cord blood banking is recommended for families with a history of certain diseases. Specifically, these are families with diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. Why? The type of stem cells in cord blood can form all kinds of blood cells that can help treat these diseases.
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.
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
When you consider that public banks can only expect to ship 1-2% of their inventory for transplant, you can quickly understand why most public banks are struggling to make ends meet. That struggle means that fewer collection programs are staffed, and there are fewer opportunities for parents to donate to the public good. We said earlier that public banks only keep cord blood donations over a minimum of 900 million cells, but today most public banks have raised that threshold to 1.5 billion cells. The reason is that the largest units are the ones most likely to be used for transplants that bring income to the bank. Family cord blood banks do not need to impose volume thresholds because they have a profit margin on every unit banked.
1. Spinal cord injury. In January, the Food and Drug Administration OK’d its first-ever human study of a medical treatment derived from human embryonic stem cells. The objective: help people with acute spinal cord injuries. While expected to assess only the safety of the treatment, the study also might show if the paralyzed volunteers can regain some feeling in and control over their lower extremities.
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
“This is a medical service that has to be done when your baby’s cells arrive and you certainly want them to be handled by good equipment and good technicians,” says Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists. “It’s just not going to be cheap.” 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 reduce costs.