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4. If your family, especially your children, are of mixed ethnic background, it may be impossible to find an adult bone marrow donor who is a perfect match. In that event, cord blood from even a partially matched sibling would be invaluable if a stem cell transplant is necessary.
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.
It’s hard to ignore the ads for cord blood banks, offering a lifetime of protection for your children. If you’re an expectant mom, there’s information coming at you constantly from your doctor’s office, magazines, online, and perhaps even your yoga class.
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.
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)
RENECE WALLER-WISE is a licensed clinical nurse specialist and childbirth educator at Southeast Alabama Medical Center in Dothan, Alabama. She is also an adjunct faculty member at Troy University in Troy, Alabama.
Jaing TH, Hung IJ, Yang CP, Chen SH, Sun CF, Chow R. Rapid and complete donor chimerism after unrelated mismatched cord blood transplantation in 5 children with beta-thalassemia major. Biol Blood Marrow Transplant.2005;11 :349– 353
Cord tissue use is still in early research stages, and there is no guarantee that treatments using cord tissue will be available in the future. Cord tissue is stored whole. Additional processing prior to use will be required to extract and prepare any of the multiple cell types from cryopreserved cord tissue. Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue 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.
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.
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
Childbirth educators may be one of the first resources that an expectant family turns to in order to gain more knowledge to make an informed decision about collecting umbilical cord blood in the birthing process. Therefore, the childbirth educator should be well versed on the topic, so that as questions from class participants arise, the multiple facets of umbilical cord blood banking can be explored.
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.
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.
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).
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
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.
The blood that remains in the umbilical cord and the placenta after birth is called “cord blood”. Umbilical cord blood, umbilical cord tissue, and the placenta are all very rich sources of newborn stem cells. The stem cells in the after birth are not embryonic. Most of the stem cells in cord blood are blood-forming or hematopoietic stem cells. Most of the stem cells in cord tissue and the placenta are mesenchymal stem cells.
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.
Some brochures advertising private cord blood banking show children with cerebral palsy, a neurological disorder, who were treated with their own stem cells. In the case of Cord Blood Registry, the company lists all stem cell transplants conducted at Duke University. In a list of individuals treated in their “stem cell therapy data” cerebral palsy is listed. However, transplants were part of an early research study and studies of efficacy are just now underway.
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.
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).
When it comes to raising kids, good advice and strong evidence can be hard to come by. The Growth Curve blog brings an accessible and metered approach to new studies and popular parenting topics. Growth Curve is a blog of Science News, which gives readers a concise overview of the most important science news from all fields and applications of science and technology.
ViaCord’s Sibling Connection Program, a dedicated transplant program for siblings, was designed to help families in need of a stem cell transplant. This program provides ViaCord’s cord blood banking services at no cost to expecting parents. A family with a child with an established diagnosis of a disease that is currently treatable with sibling cord blood may be eligible.
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.
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.
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
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.
Cord blood banking is not always cheap. It’s completely free to donate blood to a public cord blood bank, but private banks charge $1,400 to $2,300 for collecting, testing, and registering, plus an annual $95 to $125 storing fee.
M.A.Z.E. Cord Blood Laboratories is an FDA-approved and regulated storage facility that partners with Community Blood Services for processing. The company has processed over 30,000 units of cord blood since opening in 1997.