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Bunin N, Aplenc R, Leahey A, et al. Outcomes of transplantation with partial T-cell depletion of matched or mismatched unrelated or partially matched related donor bone marrow in children and adolescents with leukemias. Bone Marrow Transplant.2005;35 :151– 158
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.
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).
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.
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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:
Private cord blood banks usually charge an enrolment and collection fee ranging from about $775 to $2,150, plus annual storage fees ranging from about $85 to $150. Some banks include the first year’s storage as part of your initial payment and lower your annual payment if you put down more money initially.
Professionals affiliated with institutions or organizations that promote for-profit placental blood stem cell banking should make annual financial-disclosure and potential-conflicts-of-interest statements to an appropriate institutional review committee that possesses oversight authority.
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.
Cord blood banking means preserving the newborn stem cells found in the blood of the umbilical cord and the placenta. After a baby is born, and even after delayed cord clamping, there is blood remaining in the umbilical cord and placenta that holds valuable newborn stem cells. Parents have a choice between donating cord blood to a public bank for free, or paying to store it for their family in a private bank. Cord blood banking includes the whole process from collection through storage of newborn stem cells for future medical purposes.
Some ethical concerns over umbilical cord blood banking warrant mention. As previously stated, the AAP (2007) acknowledges that claims in advertisements for private cord blood banks are not accurate. In fact, some of the statements made by private cord blood banks are outright misleading (Fox et al., 2007), which raises questions about how informed consent for cord blood collection is obtained. Legally, the cord blood belongs to the child, but the consent of the mother alone is usually obtained for collection, and the consent of the father is rarely considered (Ballen, 2006). Because the cord blood now has a “value,” the person who obtains consent and that same person’s professional connection to the private cord blood bank may come into question (Pinch, 2001).
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.
Shai was a feisty little girl whose mother used her scientific background to search for the best approach to cure her cancer. Shai narrowly escaped death many times, including a recovery that even her doctors considered a miracle, yet she died at dawn on the day that she would have begun kindergarten. Her mother went on to found this website and charity in her memory. Read more…
Cord blood banking takes blood from the umbilical cord at the time of birth, and donates it to a public blood bank, or stores it in a private one. Since this blood is so rich in stem cells, which have the potential to become any human cell, it could someday be used as a treatment for the child or their family members.
A typical cord blood collection only contains enough stem cells to transplant a large child or small adult. This website has a page explaining the optimum transplant dose. At one time it was believed that cell dose limitations restricted the use of cord blood transplants to children. In recent years growing numbers of adults are also receiving cord blood transplants, either by growing the cells in a lab prior to transplant or by transplanting more than one cord blood unit at a time. More information about these trials is available on the web page about Research on Cord Blood Transplants.
Tom Moore, CEO of Cord Blood Registry, the largest private cord blood banking firm, told ABC News conceded that there was no proof that the transplants worked, but added that there is strong anecdotal evidence.
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.
Americord offers parents the ability to collect stem cells from the placenta and umbilical cord soon after the child’s birth. These stem cells, obtained from cord blood, cord tissue and placenta tissue, can be used to help treat genetic diseases and other threats to the baby’s life. Placenta tissue stem cells can also be used to benefit the mother.
Many public banking proponents believe that the greater good to society is to donate your baby’s cord blood stem cells to a public bank for use by someone who may need it, since the likelihood of your baby needing it is very small.
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.
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
The cord blood cell recovery data reported by CBR and others is consistently higher than the published, available data of other processing methods including PrepaCyte® and Hespan, when combined with CPD.
‡ 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.
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.
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 specimens for non-clinical scientific research studies are also available through the Cord Blood Transplantation (COBLT) Study, funded by the National Heart Lung and Blood Institute (NHLBI)
Prior to transplanting any type of tissue, a “matching” process must occur to increase the success of the transplant and decrease the likelihood that the transplant will be rejected. The rejection of a transplanted tissue is called “graft versus host disease.” The matching process dates back to the late 1950s when the human leukocyte antigens were discovered. There are two classes of human leukocyte antigens. The first class is located on the surface of almost all of the cells with a nucleus within the body of the cell. The second class of human leukocyte antigens is located on the surface of immune cells. Each of the two classes of antigens has three subgroups, creating six antigens for which matching can occur. Thus, a “6 of 6” matching of the antigens represents a “perfect” match. Beyond the matching process, other factors contribute to the success or failure of a stem cell transplant. These factors include, but are not limited to, the age of both the donor and the patient, the type of disease being treated, and the number of stem cells being transplanted (Moise, 2005).
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).
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.
A courier collection service. Private banks have a person pick up your donated cord blood, which helps ensure that it arrives at your chosen bank quickly and doesn’t get lost along the way, and that the temperature will remain consistent enough to be accepted at the lab. (Public banks usually send an insulated kit for you to preserve and mail the cord blood.)
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.
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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).
Publicly banking your baby’s cord blood is a wonderful gift. Unfortunately, however, your chance of donating your baby’s cord blood is very low due to the regional and financial constraints of public cord blood banks. It is estimated that cord blood from less than 3% of all U.S. births can be collected and stored by the public banks. We support any efforts to increase the resources available for public banking.
A “clinical trial” is a study in human patients for an emerging therapy that has not been adopted as standard therapy. This website has pages that enable patients to search worldwide for currently recruiting clinical trials with ether cord blood or umbilical cord tissue MSC. The table below checks off all diagnoses that have ever been treated in clinical trials with cord blood or cord tissue, regardless of whether the trials are still open.
After harvesting, the umbilical cord blood is taken to a cord blood bank where it will be tested to make sure that it is clear of disease and other contaminants. Before being frozen, a cryopreservant is added to the cord blood so that the stem cells are able to be frozen without damaging them, after which they are stored in a liquid nitrogen Cord Blood storage tank at –196 Celsius.