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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.
Sutter Neuroscience Institute has conducted a landmark FDA-regulated phase II clinical trial to assess the use of autologous stem cells derived from cord blood to improve language and behavior in certain children with autism.
In the rare event of a processed sample not adhering to quality standards, CBR’s certified genetic counselors will work with potential clients to help them understand their options. Under this scenario, clients will have the option to discontinue storage and receive a refund.
^ a b c American Academy of Pediatrics Section on Hematology/Oncology; American Academy of Pediatrics Section on Allergy/Immunology; Lubin, BH; Shearer, WT (January 2007). “Cord blood banking for potential future transplantation”. Pediatrics. 119 (1): 165–70. doi:10.1542/peds.2006-2901. PMID 17200285.
Both public and family cord blood banks must register with the US Food and Drug Administration (FDA), and since Oct. 2011 public banks also need to apply for an FDA license. All cord blood banks are required by federal law to test the blood of the mother for infectious diseases. At public banks the screening is usually more extensive, similar to the tests performed when you donate blood. The typical expense to a public bank is $150 per unit.
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.
If someone doesn’t have cord blood stored, they will have to rely on stem cells from another source. For that, we can go back to the history of cord blood, which really begins with bone marrow. Bone marrow contains similar although less effective and possibly tainted versions of the same stem cells abundant in cord blood. Scientists performed the first bone marrow stem cell transplant in 1956 between identical twins. It resulted in the complete remission of the one twin’s leukemia.
The major risk of both treatments is an increased susceptibility to infection and bleeding as a result of the high-dose cancer treatment. Doctors may give the patient antibiotics to prevent or treat infection. They may also give the patient transfusions of platelets to prevent bleeding and red blood cells to treat anemia. Patients who undergo BMT and PBSCT may experience short-term side effects such as nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions.
Are public banks and family banks the same, except for who may use the cord blood and the cost to the parents? No. Public banks are subject to much higher regulatory requirements, and compliance with regulations carries costs. At a family bank you pay the bank enough to cover the cost of storing your baby’s cord blood, plus they make a profit. When you donate to a public bank, it costs you nothing, but the bank pays more on processing each blood collection than at a family bank. Let’s look at the steps that take place in the laboratory.
Umbilical cord blood contains haematopoietic (blood) stem cells. These cells are able to make the different types of cell in the blood – red blood cells, white blood cells and platelets. Haematopoietic stem cells, purified from bone marrow or blood, have long been used in stem cell treatments for leukaemia, blood and bone marrow disorders, cancer (when chemotherapy is used) and immune deficiencies.
Umbilical cord blood is being studied for potential use in a wide variety of life-threatening diseases because it is a rich source of blood stem cells. Transplantation of blood stem cells from umbilical cords has been used successfully to treat several pediatric blood diseases, including sickle cell anemia and cancers such as leukemia and lymphoma. This procedure is still considered investigational. There is currently no solid evidence that umbilical cord blood stem cells have the ability to be transformed into other types of cells, such as replacement nerve tissue or myelin-making cells.
Though uses of cord blood beyond blood and immunological disorders is speculative, some research has been done in other areas. Any such potential beyond blood and immunological uses is limited by the fact that cord cells are hematopoietic stem cells (which can differentiate only into blood cells), and not pluripotent stem cells (such as embryonic stem cells, which can differentiate into any type of tissue). Cord blood has been studied as a treatment for diabetes. However, apart from blood disorders, the use of cord blood for other diseases is not in routine clinical use and remains a major challenge for the stem cell community.
The term “cord blood” is used for the blood remaining in the umbilical cord and the placenta after the birth of a baby. Cord Blood contains stem cells that can grow into blood and immune system cells, as well as other types of cells. Today cord blood is often used as a substitute for bone marrow in stem cell transplants. There are over 80 diseases treated this way, including cancers, blood disorders, genetic and metabolic diseases.
Umbilical cord blood can save lives. Cord blood is rich in stem cells that can morph into all sorts of blood cells, which can be used to treat diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. There are a few ways for transplant patients to get blood cells (umbilical and placenta, bone marrow, peripheral/circulation), but cord blood is easier to match with patients, and because it is gathered during birth from the umbilical cord, it’s a painless procedure.
As most parents would like to bank their babies’ cord blood to help safeguard their families, it is often the cost of cord blood banking that is the one reason why they do not. Most cord blood banks have an upfront fee for collecting, processing and cryo-preserving the cord blood that runs between $1,000 and $2,000. This upfront fee often also includes the price of the kit provided to collect and safely transport the cord blood, the medical courier service used to expedite the kit’s safe shipment, the testing of the mother’s blood for any infectious diseases, the testing of the baby’s blood for any contamination, and the cost of the first full year of storage. There is then often a yearly fee on the baby’s birthday for continued storage that runs around $100 to $200 a year.
With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.
If clients need to use the cord blood stem cells stored with CBR for transplantation and the cells fail to engraft, clients receive a full refund of all fees paid to CBR for cord blood services plus an additional $50,000.
Stem cells are able to transform into other types of cells in the body to create new growth and development. They are also the building blocks of the immune system. The transformation of these cells provides doctors with a way to treat leukemia and some inherited health disorders.
Why should you consider donating the cord blood to a public bank? Simply because, besides bringing a new life into the world, you could be saving an individual whose best chance at life is a stem cell transplant with your baby’s donated cord blood. This can only happen if you donate and if your baby is a close enough match for a patient in need. If you chose to reserve the cord blood for your family, then siblings who have the same parents have a 25% chance of being an exact match.
When the medical courier delivers the cord blood collection kit to the cord blood bank, it is quickly processed to ensure the continued viability of the stem cells and immune system cells found in the cord blood. Firstly, a sample of the cord blood is tested for microbiological contamination, and the mother’s blood is tested for infectious diseases. As these tests are being conducted, the cord blood is processed to reduce the number of red blood cells and its total volume and isolate the stem cells and immune cells.
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The harvested bone marrow is then processed to remove blood and bone fragments. Harvested bone marrow can be combined with a preservative and frozen to keep the stem cells alive until they are needed. This technique is known as cryopreservation. Stem cells can be cryopreserved for many years.
Clinical trials that include BMT and PBSCT are a treatment option for some patients. Information about ongoing clinical trials is available from NCI’s CIS at 1–800–422–6237 (1–800–4–CANCER) or on NCI’s website.
The next step at either a public or family bank is to process the cord blood to separate the blood component holding stem cells. The final product has a volume of 25 milliliters and includes a cryoprotectant which prevents the cells from bursting when frozen. Typical cost, $250 to $300 per unit.
Most of the diseases on the proven treatment list are inherited genetic diseases. Typically, a child with a genetic disease would require cord blood unit from a sibling or an unrelated donor. Having a sibling cord blood unit can be a great advantage as research shows that treatments using cord blood from a family member are about twice as successful as treatments using cord blood from a non-relative.9a, 17
In Europe and other parts of the world, cord blood banking is more often referred to as stem cell banking. As banking cord blood is designed more to collect the blood-forming stem cells and not the actual blood cells themselves, this term may be more appropriate.
A stem cell has the potential to become one of many different types of cells. Stem cells are unique cells: They have the ability to become many different types of cells, and they can replicate rapidly. Stem cells play a huge part in the body’s healing process, and the introduction of new stem cells has always showed great promise in the treatment of many conditions. It wasn’t until we found out where and how to isolate these cells that we started using them for transplants. Although a person’s own stem cells are always 100 percent compatible, there are risks in using someone else’s stem cells, especially if the donor and recipient are not immediately related. The discovery of certain markers allows us to see how compatible a donor’s and host’s cells will be. The relatively recent discovery of stem cells in the umbilical cord’s blood has proven advantageous over acquiring stem cells from other sources. Researchers are currently conducting clinical trials with stem cells, adding to the growing list of 80 diseases which they can treat.
Cord blood transplants aren’t entirely new — they’ve been in use for about 20 years. In fact, the outcome of transplants has improved in the last 10 years, says Joanne Kurtzberg, M.D., director of the pediatric bone marrow and stem cell transplant program at Duke University.