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There are over 130 public cord blood banks in 35 countries. They are regulated by Governments and adhere to internationally agreed standards regarding safety, sample quality and ethical issues. In the UK, several NHS facilities within the National Blood Service harvest and store altruistically donated umbilical cord blood. Trained staff, working separately from those providing care to the mother and newborn child, collect the cord blood. The mother may consent to donate the blood for research and/or clinical use and the cord blood bank will make the blood available for use as appropriate.
Blood from the umbilical cord and placenta is put into a sterile bag. (The blood is put into the bag either before or after the placenta is delivered, depending upon the procedure of the cord blood bank.)
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.
A major limitation of cord blood transplantation is that the blood obtained from a single umbilical cord does not contain as many haematopoeitic stem cells as a bone marrow donation. Scientists believe this is the main reason that treating adult patients with cord blood is so difficult: adults are larger and need more HSCs than children. A transplant containing too few HSCs may fail or could lead to slow formation of new blood in the body in the early days after transplantation. This serious complication has been partially overcome by transplanting blood from two umbilical cords into larger children and adults. Results of clinical trials into double cord blood transplants (in place of bone marrow transplants) have shown the technique to be very successful. Some researchers have also tried to increase the total number of HSCs obtained from each umbilical cord by collecting additional blood from the placenta.
However, cord blood transplants also have limitations. Treatment of adults with cord blood typically requires two units of cord blood to treat one adult. Clinical trials using “double cord blood transplantation” for adults have demonstrated outcomes similar to use of other sources of HSCs, such as bone marrow or mobilized peripheral blood. Current studies are being done to expand a single cord blood unit for use in adults. Cord blood can also only be used to treat blood diseases. No therapies for non-blood-related diseases have yet been developed using HSCs from either cord blood or adult bone marrow.
You’ve just visited the doctor and the good news is that you’re going to have a baby and everything looks good. Thirty years ago, your doctor may have given you a baby book and information about products that sponsors want you to buy for your new addition. Today, along with pretty much the same materials, you’ll be asked to consider saving the blood of your newborn that’s left over in the umbilical cord and placenta after the delivery. Another big decision, and possibly a costly one.
Options for Umbilical Cord Blood Banking and Donation—As expectant parents, learn how umbilical cord blood can help others through public donation, family (private) cord blood banking, or directed donation for a biological sibling.
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.
The stem cells used in PBSCT come from the bloodstream. A process called apheresis or leukapheresis is used to obtain PBSCs for transplantation. For 4 or 5 days before apheresis, the donor may be given a medication to increase the number of stem cells released into the bloodstream. In apheresis, blood is removed through a large vein in the arm or a central venous catheter (a flexible tube that is placed in a large vein in the neck, chest, or groin area). The blood goes through a machine that removes the stem cells. The blood is then returned to the donor and the collected cells are stored. Apheresis typically takes 4 to 6 hours. The stem cells are then frozen until they are given to the recipient.
Tissue typed and listed on the registry of the C.W. Bill Young Cell Transplantation Program, also called the Be The Match Registry®. (The registry is a listing of potential marrow donors and donated cord blood units. When a patient needs a transplant, the registry is searched to find a matching marrow donor or cord blood unit.)
Since 1989, umbilical cord blood has been used successfully to treat children with leukaemia, anaemias and other blood diseases. Researchers are now looking at ways of increasing the number of haematopoietic stem cells that can be obtained from cord blood, so that they can be used to treat adults routinely too.
You need to plan ahead if you decide to store cord blood. Banks need to be notified four to six weeks before your due date if you’re interested in donating blood. Once you do decide on a public bank, those affiliated with the Be the Match registry (bethematch.org/cord) will cover the costs of collecting, processing, and storing cord blood units.
Banked cord blood is most abundant in white blood cells and stem cells. While a lot of attention is paid to the stem cells, there are approximately 10 times more total nucleated cells (TNCs) than stem cells in any cord blood collection. TNCs are basically white blood cells, or leukocytes; they are the cells of the immune system that protect the body. Despite stem cells comprising one-tenth of most collections, cord blood is still considered a rich source of hematopoietic (he-mah-toe-po-ee-tic) stem cells (HSCs). HSCs are often designated by the marker CD34+. Hematopoietic stem cells can become two categories of cells: myeloid and lymphoid cells. Myeloid cells go on to form your red blood cells, platelets, and other cells of the blood. Lymphoid cells go on to become the B cells and T cells and are the basis for the immune system. Cord blood also contains mesenchymal (meh-sen-ki-mal) stem cells (MSCs), but they are much more abundant in cord tissue, which we will discuss in a minute.
Bone marrow transplantation, also called hemopoietic stem cell transplantation, is under investigation for the treatment of severe forms of multiple sclerosis. The long-term benefits of this experimental procedure have not yet been established. In this procedure, the individual receives grafts of his or her own blood stem cells, and thus donor stem cells are not used or needed.
After being treated with high-dose anticancer drugs and/or radiation, the patient receives the stem cells through an intravenous (IV) line just like a blood transfusion. This part of the transplant takes 1 to 5 hours.
Most text on the National Cancer Institute website may be reproduced or reused freely. The National Cancer Institute should be credited as the source and a link to this page included, e.g., “Blood-Forming Stem Cell Transplants was originally published by the National Cancer Institute.”
Once it arrives at the storage facility, the cord blood will be processed and placed in storage. The cord blood will either be completely immersed in liquid nitrogen or it will be stored in nitrogen vapor.
Umbilical cord blood is the blood left over in the placenta and in the umbilical cord after the birth of the baby. The cord blood is composed of all the elements found in whole blood. It contains red blood cells, white blood cells, plasma, platelets and is also rich in hematopoietic stem cells. There are several methods for collecting cord blood. The method most commonly used in clinical practice is the “closed technique”, which is similar to standard blood collection techniques. With this method, the technician cannulates the vein of the severed umbilical cord using a needle that is connected to a blood bag, and cord blood flows through the needle into the bag. On average, the closed technique enables collection of about 75 ml of cord blood.
In some types of leukemia, the graft-versus-tumor (GVT) effect that occurs after allogeneic BMT and PBSCT is crucial to the effectiveness of the treatment. GVT occurs when white blood cells from the donor (the graft) identify the cancer cells that remain in the patient’s body after the chemotherapy and/or radiation therapy (the tumor) as foreign and attack them.
Further advancements were made in 1978, when stem cells were discovered in cord blood and in 1988, when cord blood stem cells were first used in a transplant. Stem cells extracted from the umbilical cord blood or tissue have since been shown to be more advantageous than those extracted from other sources such as bone marrow. In many ways, this is because stem cells from the umbilical cord can be considered naïve and immature compared to stem cells from other sources. Cord stem cells haven’t been exposed to disease or environmental pollutants, and they are more accepting of foreign cells. In this case, inexperience makes them stronger.
Chloe Savannah Metz’ mother donated her baby girl’s cord blood to the NCBP in December 2000. “Many thanks to the New York Blood Center for giving us the opportunity to donate our cord — we hope to give someone a second chance!” – Christine Metz
The main reason for this requirement is to give the cord blood bank enough time to complete the enrollment process. For the safety of any person who might receive the cord blood donation, the mother must pass a health history screening. And for ethical reasons, the mother must give informed consent.
For example, in the UK the NHS Cord Blood Bank has been collecting and banking altruistically donated umbilical cord blood since 1996. The cord blood in public banks like this is stored indefinitely for possible transplant, and is available for any patient that needs this special tissue type. There is no charge to the donor but the blood is not stored specifically for that person or their family.
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
CBR Clients: Did you know that when you refer a friend, and they preserve their baby’s stem cells with us, you receive a free year of cord blood storage? After your first referral, you start earning even more rewards. (exclusions apply). Refer a friend now: http://bit.ly/2JAGrcu
Cord blood is currently approved by the FDA for the treatment for nearly 80 diseases, and cord blood treatments have been performed more than 35,000 times around the globe to treat cancers (including lymphoma and leukemia), anemias, inherited metabolic disorders and some solid tumors and orthopedic repair. Researchers are also exploring how cord blood has the ability to cross the blood–brain barrier and differentiate into neurons and other brain cells, which may be instrumental in treating conditions that have been untreatable up to this point. The most exciting of these are autism, cerebral palsy and Alzheimer’s.
The first successful cord blood transplant (CBT) was done in 1988 in a child with Fanconi anemia. Early efforts to use CBT in adults led to mortality rates of about 50%, due somewhat to the procedure being done in very sick people, but perhaps also due to slow development of immune cells from the transplant. By 2013, 30,000 CBT procedures had been performed and banks held about 600,000 units of cord blood.
There are some diseases on the list (like neuroblastoma cancer) where a child could use his or her own cord blood. However, most of the diseases on the proven treatment list are inherited genetic diseases. Typically, a child with a genetic disease would require a cord blood unit from a sibling or an unrelated donor.
If you want the blood stored, after the birth, the doctor clamps the umbilical cord in two places, about 10 inches apart, and cuts the cord, separating mother from baby. Then she inserts a needle and collects at least 40 milliliters of blood from the cord. The blood is sealed in a bag and sent to a lab or cord blood bank for testing and storage. The process only takes a few minutes and is painless for mother and baby.
Prices subject to change until they are paid. Fees apply to single-birth, U.S. customers only. Cancellation fees may apply. All major credit cards accepted. Payment plans cover first-year fees only; future annual storage fees are not included. If not paying by credit/debit card, total first year fees are due at the time of enrollment.