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Medical shipping: Some cord blood companies use medical shipping companies to deliver cord blood; these companies guarantee that cord blood is kept a certain temperature and delivered to the facility by a certain time, typically within 24 hours of collection.
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.
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Yes, if you have any sick children who could benefit from umbilical cord blood. Public banks such as Carolinas Cord Bank at Duke University and private banks such as FamilyCord in Los Angeles offer programs in which the bank will assist with cord blood processing and storage if your baby has a biological sibling with certain diseases. FamilyCord will provide free cord blood storage for one year. See a list of banks with these programs at parentsguidecordblood.org/help.php.
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.
The policy also points out that if cord clamping is done too soon after birth, the infant may be deprived of a placental blood transfusion, resulting in lower blood volume and increased risk for anemia later in life.
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.
The “cell recovery rate” is often used to compare processing methods. Expressed as a percentage, the cell recovery rate tells you how many cells are retrieved from the original cord blood collection, once plasma has been removed and red blood cells have been reduced or removed. It is expected that some cells will be lost during processing, and most processing methods have published cell recovery rates between 80%—99%
In the past years, there have been dramatic medical advances in the arena of stem cell research, and more discoveries are announced practically every month. Many doctors and researchers see great potential in the use of stem cells to reverse or cure many severe, life-threatening diseases. With these facts in mind, many parents are choosing to preserve the stems cells found in umbilical cord blood after birth. There are no health risks in doing so. The primary risk is that the $100 yearly fee for storage will be wasted in the event that the stem cells are never needed.
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.
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.
Donating your baby’s cord blood to a public bank is always free. The limitations of the public banking network in the United States are: they only collect donations at large birthing hospitals in ethnically diverse communities, the mother must pass a health screening, they prefer registration by 34 weeks of pregnancy, and they only save the largest cord blood collections. The potential reward of public donation is that your baby could Be The Match to save a life!
Refer-a-friend program: The New England Cord Blood Bank gives families $100 for each friend they refer to the company, so customers have further incentive to choose the company for storage and processing.
One of the key things you’ll want the cord blood bank’s representative to explain to you is how the cord blood bank collects and stores cord blood. Collection and storage methods may differ across cord blood banking companies, and you’ll want to be sure that the cord blood bank complies with all federal standards.2
Learning about cord blood banking shouldn’t have to be confusing – or boring. Watch one of our stem cell experts who also happens to be a former RN and Labor & Delivery nurse, talk cord blood banking 101. She answers the questions every parent has about banking cord blood and ViaCord.
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.
Frances Verter, PhD, founded the Parent’s Guide to Cord Blood in 1998 and has been a Scientific Advisor to Community Blood Services since 2007. In 2011 the NMDP presented her with their Lifeline Award in recognition of her efforts to improve public education about cord blood donation.
Myers LA, Hershfield MS, Neale WT, Escolar M, Kurtzberg J. Purine nucleoside phosphorylase deficiency (PNP-def) presenting with lymphopenia and developmental delay: successful correction with umbilical cord blood transplantation. J Pediatr.2004;145 :710– 712
2. Diabetes. For the many Americans with type 1 diabetes, whose insulin-making pancreatic cells have been killed off by their immune system, stem cells may be the answer. Last year, scientists reported that they had coaxed human embryonic stem cells into becoming insulin-producing, blood sugar-regulating cells in diabetic mice. The aim: to someday do the same for people.
The cord blood collection process is simple, safe, and painless. The process usually takes no longer than five minutes. Cord blood collection does not interfere with delivery and is possible with both vaginal and cesarean deliveries.
Prior to the cord blood being harvested you will need to complete a health history questionnaire, and provide a blood sample to check for disease. In most situations, you will also be required to sign a consent form to confirm your intention to have the cord blood harvested.
* Annual storage fees will be charged automatically to the credit/debit card on file, on or around your baby’s birthday, unless you’ve chosen a prepay option and are subject to change until they are paid.
Four main types of physical conditions are treated with stem cell transplants: cancers, blood disorders, congenital metabolic disorders, and immunodeficiencies (see Table 1). Examples of cancers that are treated with stem cells are both lymphoma and leukemia. Nonmalignant hemologic disorders also account for a fair share of the recipients of stem cells. Examples of these blood disorders are various types of anemias, such as sickle-cell anemia and Fanconi’s anemia (the first disorder treated with umbilical cord blood stem cells). Stem cells have also been used to treat various metabolic disorders, such as adrenoleukodystrophy. The fourth major category of uses for stem cells is in treating immunodeficiencies, such as Duncan’s disease or adenosine deaminase deficiency (Drew, 2005; Moise, 2005).
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There are two main types of cord blood banks: public and private. Public cord blood banks are usually nonprofit companies that store your donated cord blood for free, to be used for any sick child in another family or for research purposes, so accessing and using your own cord blood is not guaranteed. Private cord blood banks are companies that require a registration fee (plus annual storage fees) for your cord blood, but it is saved specifically for your own family, so you’ll have ready access to it.
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.
As a trusted resource for families, CBR offers Genetic Counselors on staff to help families make informed choices about newborn stem cell banking. Our team of certified professionals are available to:
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
Initially, cord blood stem cell transplantation using allogeneic umbilical cord blood was performed in relatively small children, because the cell dose per weight of recipient was shown to be important.19,20 However, older children, adolescents, and adults have benefited from unrelated allogeneic umbilical cord blood transplantation.34,55–61 Because of the relationship between cell dose per recipient weight and transplant outcome, the number of cord blood cells needed for marrow reconstitution in older children or young adults is much larger than that needed when cord blood is used for transplantation in small children. Cord blood transplants using multiple cryopreserved units from separate donors have been performed successfully in adults, and the approach is currently under investigation as a strategy to increase the dose of cells for transplantation in a single recipient.62 Cord blood is collected in observance of good obstetric and pediatric practice.45
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.
Another important disadvantage that is not well understood by the general public is the limited use of an infant’s own umbilical cord blood stem cells later in life, called an autologous transplant. Commercial cord blood banks often advertise the banking of the infant’s cord blood as “biologic insurance.” However, the chance that a child would be able to use his or her own cord blood is extremely small: from a 1:400 to a 1:200,000 chance over the child’s lifetime (Sullivan, 2008). In fact, there are certain instances in which the use of one’s own umbilical cord blood is contraindicated, as in cases when the defect is of a genetic origin. For example, autologous cord blood stem cells cannot be used to treat malignant cancers such as leukemia because the genetic mutations for the cancer already exist on the DNA of the cord blood. Using one’s own stem cells would be, in effect, “contaminating” oneself with the same disease process (Percer, 2009).
Proponents of cord blood banking are convinced that instead of being medical waste, the fetal cells within are biological gold. In this post, and the two that follow, I’ll take a look at the evidence for those claims, and sort through some of the questions that arise as parents consider whether to bank their baby’s cord blood.
3. Heart disease. It’s the leading cause of death in the United States, and stem cells may provide some relief. Research is underway to see if injecting the cells into the heart could help regenerate heart muscle damaged by, for example, a heart attack. Again, researchers have reported success in rodents.
Current trials show promise for cord blood in the treatment of strokes, heart disease, diabetes and more. Umbilical cord–derived stem cells, meanwhile, are undergoing clinical trials for the treatment of multiple sclerosis, sports-related injuries and various neurodegenerative diseases including ALS (known also as Lou Gehrig’s disease) and Alzheimer’s.
Barker JN, Weisdorf DJ, DeFor TE, Blazar BR, Miller JS, Wagner JE. Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning. Blood.2003;102 :1915– 1919
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.
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.
The stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling. Cord blood stem cells have similar ability to treat disease as bone marrow but with significantly less rejection.
Check if the cord blood bank you’re considering is accredited with the American Association of Blood Banks (AABB). AABB is an international, not-for-profit organization that has been setting standards for both public and private cord blood banking companies for over 20 years. LifebankUSA is registered with the FDA and accredited by AABB. Click here for a list of AABB-accredited cord blood banking companies in the U.S. and around the world.
If the doubts of the AAP, weren’t enough to turn you off cord banking, the cost is enormous. At Viacord, (see ad on left) the price begins at $1550 at birth, plus $150 for a courier to deliver the blood, plus $95 dollars for storage a year. At these prices, that will cost you $2840 by the time your baby is 21.
Karanes C, Confer D, Walker T, Askren A, Keller C. Unrelated donor stem cell transplantation: the role of the National Marrow Donor Program. Oncology (Williston Park).2003;17 :1036– 1068, 1043–104, 1164–1167
Currently, ViaCord has released the most cord blood units for medical transplant and has the highest cord blood transplant survival rate among companies who have disclosed complete transplant data. The one-year survival rate of patients who were treated with ViaCord cord blood units is 88%, and the long-term patient survival rate is 82%.1
Part of the reason for the dominance of these three companies in terms of the total number of units stored is that they are three of the oldest cord blood banks within the U.S., founded in 1992, 1993, and 1989, respectively. All three of these cord blood banks also support cord blood research and clinical trials.
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.
A history of releasing cord blood units for therapy. “This shows they’re not just selling contracts to parents — there are doctors who are actually accepting units of cord blood that have been stored there for therapy,” 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.
Back in the 1980s, umbilical cord blood caught the attention of researchers who suspected that the often-discarded tissue could be a valuable source of shape-shifting stem cells. These cells, which can become several different types of blood cells, are similar to the specialized stem cells found in bone marrow that can churn out new blood cells. Such stem cells are found in adult blood, too, but not as abundantly.
This web page was researched by Frances Verter, PhD, Alexey Bersenev, MD PhD, and Pedro Silva Couto, MSc ©2016-2018. Sources of information about established therapies were publications in the medical literature found via PubMed and Google Scholar. Sources of clinical trials were searches of ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), Japan University hospital Medical Information Network Clinical Trial Registry (UMIN-CTR), Japan Medical Association Clinical Trial Registry (JMA-CTR), Clinical Research Information Service from South Korea (CRiS), EU Clinical Trials Register (EudraCT), World Health Organization International Clinical Trials Registry Platform (ICTRP), Netherlands Trial Register (NTR), Australian New Zealand Clinical Trial Registry (ANZCTR), Clinical Trials Registry-India (CTRI), German Clinical Trials Register (DRKS), and Iranian Registry of Clinical Trials (IRCT).