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Umbilical cord blood transplants are now used to treat numerous types of immune- and blood-related disorders and genetic diseases. Cord blood (CB) banks play an important role in these transplants by processing and storing CB units. In addition to their therapeutic potential, these banks raise ethical and regulatory questions, especially in emerging markets in the Arab world. In this article, the authors review CB banking in five countries in the region, Jordan, Saudi Arabia, Egypt, Qatar, and the United Arab Emirates, selected for their different CB banking policies and initiatives. In assessing these case studies, the authors present regional trends and issues, including religious perspectives, policies, and demographic risk factors. This research suggests strong incentives for increasing the number of CB units that are collected from and available to Arab populations. In addition, the deficit in knowledge concerning public opinion and awareness in the region should be addressed to ensure educated decision-making.
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.
Parents have the option to privately store their newborn’s cord blood stem cells. There are now over a dozen private cord blood banks, and more open every year. Some have their own labs, while others contract with a lab. Cord blood stem cell banking is not a regulated industry; there are no certifications or licensing requirements to open a cord blood bank. Several banks are accredited by the American Association of Blood Banks. Please keep in mind there is a big difference between being accredited by the AABB and being a member of the AABB. To be accredited, the lab must follow strict standards and be inspected by the association.
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.
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.
Richardson SM, Hoyland JA, Mobasheri R, Csaki C, Shakibaei M, Mobasheri A. Mesenchymal Stem Cells in Regenerative Medicine: Opportunities and Challenges for Articular Cartilage and Intervertebral Disc Tissue Engineering. J Cell Physiol. 2010; 222(1):23-32.
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.
Lewis ID, Almeida-Porada G, Du J, et al. Umbilical cord blood cells capable of engrafting in primary, secondary, and tertiary xenogeneic hosts are preserved after ex vivo culture in a noncontact system. Blood.2001;97 :3441– 3449
Cade Hildreth is the Founder of BioInformant.com, the world’s largest publisher of stem cell industry news. Cade is a media expert on stem cells, recently interviewed by the Wall Street Journal, Los Angeles Business Journal, Xconomy, and Vogue Magazine.
All cord blood is screened and tested. Whether you use a public or private bank, you’ll still need to be tested for various infections (such as hepatitis and HIV). If tests come back positive for disease or infection, you will not be able to store your cord blood.
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.
Only three to five ounces of blood is collected from each umbilical cord. This small amount is enough to treat a sick child, but not an adult, unless multiple units of matched cord blood are used, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston.
Cancellations prior to CBR’s storage of the samples(s) are subject to an administrative fee of $150. If you terminate your agreement with CBR after storage of the sample(s), you will not receive a refund.
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.
Nagatoshi Y, Kawano Y, Okamura J. Comparison of the outcomes of allogeneic bone marrow transplantation from partially mismatched related donors, matched sibling donors, and matched unrelated donors in Japanese pediatric patients: a single center result. Pediatr Transplant.2004;8 :260– 266
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.
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
Families with a history of diseases can store cord blood in a bank. These families can access it should a person get sick with an immune system or blood disease, like leukemia or sickle-cell anemia, later in life.
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.
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.
Choosing a bank (specifically a private bank) for her daughter’s cord blood made perfect sense to Julie Lehrman, a mom based in Chicago. “We wanted the extra assurance that we were doing everything we could to keep Lexi healthy,” Lehrman says. “I was older when Lexi was born, and there’s a lot we didn’t know about my mom’s health history, so we felt that we were making a smart decision.” Fortunately, Lexi was born healthy, and neither she nor anyone else in the family has needed the cord blood since it was stored seven years ago. But Lehrman has no regrets; she still feels the family made a wise investment. “Lexi or her brother or even one of us could still need that blood in the future, so I’m thankful that we have it.” But banking your child’s cord blood may not be the right decision for you. Read on to see if you should opt for private cord blood banking.
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.
Of particular interest are the flexible hematopoietic stem cells important in that initial transplant. In certain cases, transplanting these cells might be able to reboot a person’s body and get rid of a disease-related defect. Cord blood transplants are similar to bone marrow transplants. A person with leukemia, for instance, might have his own cancerous blood cells wiped out with chemotherapy and radiation. Healthy, non-cancerous stem cells from a donor can then repopulate the blood.
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.
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.
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 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.
Americord offers parents the ability to save stem cells from the umbilical cord and placenta after giving birth. This blood banking service uses new technology to ensure that children can receive treatment for genetic diseases. Find out more
Accurate information about the potential benefits and limitations of allogeneic and autologous cord blood banking and transplantation should be provided. Parents should be informed that autologous cord blood would not be used as a stem cell source if the donor developed leukemia later in life. Parents should recognize that there are no scientific data to support the claim that autologous cord blood is a tissue source proven to be of value for regenerative medical purposes. The current standard uses of cord blood transplantation are listed in Table 1.
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.
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.
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.
Cord tissue contains a special type of stem cell that has the potential to treat injuries and diseases affecting cartilage, muscle, and nerve cells.19 Since 2007 there have been about 150 clinical trials that have used cord tissue stem cells in human patients.
Anyway, the excitement over the embryonic cells comes from their remarkable ability, as biological blank slates, to become virtually any of the body’s cell types. Many observers believe the president’s move will accelerate the hunt for cures for some of our most vexing diseases. However, the benefits are largely hypothetical, given the infancy of the field, and are offset by some real obstacles: The risks of embryonic stem cells, as well as cells programmed to become like them, including the possibility they will actually cause cancers in people who receive them. Nonetheless, here’s a look at 10 health problems that stem cells might someday cure or at least help treat.
An accredited lab. In the United States, the FDA requires all public banks to have a Biologics License Application, but not private banks, though they are registered and inspected. Both public and private banks should have extra accreditation, which means banks are evaluated for the quality and accuracy of work. The two companies that handle accreditation are the American Association of Blood Banks (AABB) and the Foundation for the Accreditation of Cellular Therapy (FACT). Look for a bank with its own lab (some banks use labs at other banks), which means more regular quality control and testing standards.
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.
Cord blood contains stem cells that can save lives. Patients requiring a stem cell transplant will receive cells from one of three sources: bone marrow, circulating blood, or umbilical cord blood. The first two exist in all healthy adults, but cord blood can only be harvested and stored at birth
Wall DA, Carter SL, Kernan NA, et al. Busulfan/melphalan/antithymocyte globulin followed by unrelated donor cord blood transplantation for treatment of infant leukemia and leukemia in young children: the Cord Blood Transplantation study (COBLT) experience. Biol Blood Marrow Transplant.2005;11 :637– 646
A number of private for-profit companies have been established that encourage parents to bank their children’s cord blood for their own autologous use or for directed donor allogeneic use for a family member should the need arise. Parents have been encouraged to bank their infants’ cord blood as a form of “biological insurance.” Physicians, employees, and/or consultants of such companies may have potential conflicts of interest in recruiting patients because of their own financial gain. Annual disclosure of the financial interest and potential conflicts of interest must be made to institutional review boards that are charged with the responsibility of mitigation of these disclosures and risks. Families may be vulnerable to the emotional effects of marketing for cord blood banking 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 cord blood stem cells in the future. The range of available estimates is from 1 in 1000 to more than 1 in 200000.51 The potential for children needing their own cord blood stem cells for future autologous use is controversial presently.51 There also is no evidence of the safety or effectiveness of autologous cord blood stem cell transplantation for the treatment of malignant neoplasms.51 Indeed, there is evidence demonstrating the presence of DNA mutations in cord blood obtained from children who subsequently develop leukemia.52 Thus, an autologous cord blood transplantation might even be contraindicated in the treatment of a child who develops leukemia.
Barker JN, Davies SM, DeFor T, Ramsay NK, Weisdorf DJ, Wagner JE. Survival after transplantation of unrelated donor umbilical cord blood is comparable to that of human leukocyte antigen-matched unrelated donor bone marrow: results of a matched-pair analysis. Blood.2001;97 :2957– 2961
When parents donate cord blood to a public bank, they are supporting patients around the world who are searching for an unrelated Allogeneic donor. When parents save cord blood in a family bank, they are reserving the options that the baby can use its own stem cells for an Autologous treatment, or an immediate relative (sibling or parents) can use the stem cells for an Allogeneic treatment.