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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).
Korthof ET, Snijder PP, de Graaff AA, et al. Allogeneic bone marrow transplantation for juvenile myelomonocytic leukemia: a single center experience of 23 patients. Bone Marrow Transplant.2005;35 :455– 461
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.
Cord Blood Registry is a cord blood storage company that collects, processes and stores stem cells to help families with medical needs later in life. Founded in 1992, it is the world’s largest newborn stem cell company.
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.
StemCyte™ has extensive experience providing cord blood units for transplants in children and adults with life-threatening diseases. Other private cord blood banks may have provided family-related cord blood for transplants, but only StemCyte™’s cord blood units have been used to 2000 plus transplants to date.
According to the statement, “Families may be vulnerable to emotional marketing at the time of birth of a child and may look to their physicians for advice. No accurate estimates exist of the likelihood of children to need their own stored cells. The range of available estimates is from 1 in 1,000 to 1 in 200,000.” For this and other reasons, it is difficult to recommend that parents store their children’s cord blood for future use. The AAP policy states:
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.
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.
Despite the benefits of using umbilical cord blood stem cells for transplant, the process also has some disadvantages (see Table 3). For stem cell transplants to be successful, measurable signs of engraftment must occur. Engraftment is the opposite of rejection and indicates that the stem cell transplant is “working.” Two measurable signs of engraftment are the recovery of both neutrophil (a type of white blood cell) and platelet (a clotting factor) production. These two clinical signs of recovery take longer to occur in umbilical cord blood stem cell transplants than in bone marrow stem cell transplants. In other words, the lab values for white blood cell production and platelet production take longer to increase after umbilical cord blood stem cell transplants than after bone marrow stem cell transplants (Hess, 1997; Moise, 2005).
In a number of genetic, hematologic, immunologic, metabolic, and oncologic disorders, reconstitution of bone marrow (transplantation) can be a potentially life-saving procedure.1–16 Allogeneic (related or unrelated) or autologous (self) bone marrow or peripheral blood stem cells are the usual sources of hematopoietic progenitor cells to achieve this goal. If autologous stem cells are not available or cannot be used, the best option for successful reconstitution therapy is to secure stem cells from an HLA-matched sibling.1,3,11 Close matching confers a higher probability of successful engraftment and minimizes the risk of potentially fatal graft-versus-host disease. Unfortunately, there is only a 25% chance for identifying a full HLA match in a sibling donor.17,18
There are several advantages of using umbilical cord blood stem cells over bone marrow stem cells for transplants (see Table 2). The first advantage is that umbilical cord blood is relatively easy to collect and process. Once considered a substance to be thrown away after a birth, now the cord blood can be easily saved. After it is saved and sent to a storage facility, the cord blood is quickly available for use within days to weeks after processing. In contrast, bone marrow stem cells can take much longer to find a match, collect the sample, and process. The process for bone marrow transplantation can take from weeks to months. The collection process for cord blood is not painful to either mother or child and can be done either prior to or after the delivery of the placenta (Gonzalez-Ryan, VanSyckle, Coyne, & Glover, 2000; Percer, 2009). Bone marrow transplants, on the other hand, require the donor to be hospitalized, anesthetized, and experience postcollection pain and discomfort. Thus, compared to cord blood, bone marrow collection and transplantation of stem cells are more costly (Drew, 2005; Moise, 2005).
* 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.
Cord blood can only be collected at birth, that’s why it’s important to do your research well before your baby’s due date. Watch this short video to learn exactly how cord blood is collected, processed and stored.
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.
Many expectant parents would love the opportunity to bank their baby’s cord blood and cord tissue, but with an initial fee of $1600–$1800 for a quality service and an annual fee of $150–$175, the cost of banking cord blood may seem out of reach. At Cryo-Cell, we are committed to offering a high standard of service at the best price possible, with absolutely no unexpected fees or hidden surcharges. To help keep cord blood banking in everyone’s budget, we offer in-house financing options that begin for as little as $199 down and $128 per month. In addition, we regularly offer specials and have a number of discounts for current clients, referrals, multiple birthes and medical professionals. We will even meet the price of any reputable competitor through our best-price guarantee.
Anthony’s doctors found a match for him through the New York Blood Center’s National Cord Blood Program, a public cord blood bank. Unlike private banks, public banks do not charge to collect cord blood, they charge a patients insurance company when cells are used. And once it is entered in the public system, the blood is available to anyone who needs it.
There are several cord blood banks that are accredited by the American Association of Blood Banks. Most offer information on cord blood banking and provide private cord blood banking services. With a little research, you should be able to locate a credible cord blood bank online.
6. Lou Gehrig’s disease. There’s hope that stem cells could help those with Lou Gehrig’s disease, also known as amyotrophic lateral sclerosis, or ALS. The crippling disease comes with a grim prognosis: Many die within three to five years of diagnosis, as their bodies progressively damage muscle-controlling motor neurons in the brain and spinal cord. Scientists are exploring ways to coax stem cells into becoming motor neurons that could be transplanted into ALS patients, restoring their ability to move.
Another important consideration for autologous use is that, currently, it is unknown how long umbilical cord blood will maintain its usefulness while frozen. Research indicates that cord blood stem cells can be maintained up to 15 years, but it is unknown if the cells would be preserved over the entire lifetime of a person (Ballen et al., 2001; Hess, 1997). Furthermore, financial costs are associated with maintaining the cord blood over time. Kaimal, Smith, Laros, Caughey, and Cheng (2009) studied the cost-effectiveness of private umbilical cord blood banking for autologous use and concluded that it was not cost-effective in most instances because the chances that it would be used are extremely small.
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.
At the end of a recent childbirth class, I found two couples engaged in a lengthy discussion. In the course of the conversation, both couples agreed that their goal was to do the best things for their pregnancy and birth. They were attending childbirth classes to learn how to support normal birth. They each were planning to attend breastfeeding classes. As their conversation continued, the first couple described their decision to bank the umbilical cord blood of their yet unborn daughter. They were adamant that their decision was the best action for them because they had a strong family history of myasthenia gravis. They stated that they had researched the issue by talking to several different cord blood banks, and they had decided on one particular bank because it processed the cord blood without the use of the anticoagulant drug, heparin. The couple went on to parrot back the information that the cord blood bank had told them. It was evident that the first couple wanted what was best for their yet unborn child.
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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.
New England Cord Blood Bank was founded in 1971 and is one of the pioneers in processing and cryopreservation of human cells and tissue. The company is continuing to expand its research and development center.
These are diseases for which transplants of blood-forming stem cells (Hematopoietic Stem Cell Transplants, HSCT) are a standard treatment. For some diseases they are the only therapy, and in other diseases they are only employed when front-line therapies have failed or the disease is very aggressive. The lists below include ALL therapies that use blood-forming stem cells, without distinction as to whether the stem cells were extracted from bone marrow, peripheral blood, or cord blood.
Cord blood transplantation has been shown to be curative in patients with a variety of serious diseases. Physicians should be familiar with the rationale for cord blood banking and with the types of cord blood–banking programs available. Physicians consulted by prospective parents about cord blood banking can provide the following information: