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Advances in treatment methods, including the use of PBSCT, have reduced the amount of time many patients must spend in the hospital by speeding recovery. This shorter recovery time has brought about a reduction in cost. However, because BMT and PBSCT are complicated technical procedures, they are very expensive. Many health insurance companies cover some of the costs of transplantation for certain types of cancer. Insurers may also cover a portion of the costs if special care is required when the patient returns home.
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.
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.
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
Cord blood can’t be used to treat everything. If your child is born with a genetic condition such as muscular dystrophy or spina bifida, then the stem cells would have that condition, says Dr. Kurtzberg. But if the cord blood donor is healthy and there is a sibling or another immediate family member who has a genetic condition, the cord blood could be a good match for them.
Certain public cord blood banks let you mail in your cord blood. You have to decide before the birth if you want to donate your cord blood. If the hospital where you’re delivering doesn’t accept donations, you can contact a lab that offers a mail-in delivery program. After you’ve passed the lab’s screening process, they’ll send you a kit that you can use to package your blood and mail it in, explains Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation (parentsguidecordblood.org), a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists.
When considering cord blood, cord tissue, and placenta tissue banking, you want all of the facts. Americord’s® Cord Blood Comparison Chart gives you information not only on our costs and services, but also on how other companies measure up.
^ a b Ballen, KK; Gluckman, E; Broxmeyer, HE (25 July 2013). “Umbilical cord blood transplantation: the first 25 years and beyond”. Blood. 122 (4): 491–8. doi:10.1182/blood-2013-02-453175. PMC 3952633 . PMID 23673863.
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.
Prior to freezing the cells, samples are taken for quality testing. Banks measure the number of cells that are positive for the CD34 marker, a protein that is used to estimate the number of blood-forming stem cells present. Typical cost, $150 to $200 per unit. They also measure the number of nucleated cells, another measure of stem cells, both before and after processing to determine the cell recovery rate. Typical expense, $35 per unit. A portion of the sample is submitted to check that there is no bacterial or fungal contamination. Typical expense, $75 per unit. Public banks will also check the ability of the sample to grow new cells by taking a culture called the CFU assay. Typical expense, $200 to $250 per unit.
The blood within your baby’s umbilical cord is called ‘cord blood’ for short. Cord blood contains the same powerful stem cells that help your baby develop organs, blood, tissue, and an immune system during pregnancy. After your baby is born, and even after delayed cord clamping, there is blood left over in the umbilical cord that can be collected and saved, or ‘banked.’
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.
Current applications for newborn stem cells include treatments for certain cancers and blood, metabolic and immune disorders. Additionally, newborn stem cell preservation has a great potential to benefit the newborn’s immediate family members with stem cell samples preserved in their most pristine state.
Apheresis usually causes minimal discomfort. During apheresis, the person may feel lightheadedness, chills, numbness around the lips, and cramping in the hands. Unlike bone marrow donation, PBSC donation does not require anesthesia. The medication that is given to stimulate the mobilization (release) of stem cells from the marrow into the bloodstream may cause bone and muscle aches, headaches, fatigue, nausea, vomiting, and/or difficulty sleeping. These side effects generally stop within 2 to 3 days of the last dose of the medication.
After your baby is born, the umbilical cord and placenta are usually thrown away. Because you are choosing to donate, the blood left in the umbilical cord and placenta will be collected and tested. Cord blood that meets standards for transplant will be stored at the public cord blood bank until needed by a patient. (It is not saved for your family.)
The mother signs an informed consent which gives a “public” cord blood bank permission to collect the cord blood after birth and to list it on a database that can be searched by doctors on behalf of patients. The cord blood is listed purely by its genetic type, with no information about the identity of the donor. In the United States, Be The Match maintains a national network of public cord blood banks and registered cord blood donations. However, all the donation registries around the world cooperate with each other, so that a patient who one day benefits from your child’s cord blood may come from anywhere. It is truly a gift to the benefit of humankind.
There is often confusion over who can use cord blood stem cells in treatment — the baby they were collected from or a sibling? The short answer is both, but it very much depends on the condition being treated. And it’s ultimately the treating physician’s decision.
Stem cells also may be retrieved from umbilical cord blood. For this to occur, the mother must contact a cord blood bank before the baby’s birth. The cord blood bank may request that she complete a questionnaire and give a small blood sample.
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.
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.
Close relatives, especially brothers and sisters, are more likely than unrelated people to be HLA-matched. However, only 25 to 35 percent of patients have an HLA-matched sibling. The chances of obtaining HLA-matched stem cells from an unrelated donor are slightly better, approximately 50 percent. Among unrelated donors, HLA-matching is greatly improved when the donor and recipient have the same ethnic and racial background. Although the number of donors is increasing overall, individuals from certain ethnic and racial groups still have a lower chance of finding a matching donor. Large volunteer donor registries can assist in finding an appropriate unrelated donor.
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
Because the body’s immune system is designed to find and get rid of what it believes to be outside contaminants, stem cells and other cells of the immune system cannot be transfused into just anyone. For stem cell transfusions of any type, the body’s immune system can mistakenly start attacking the patient’s own body. This is known as graft-versus-host disease (GvHD) and is a big problem post-transplant. GvHD can be isolated and minimal, but it can also be acute, chronic and even deadly.
Umbilical cord blood stem cells have the unique ability to help rebuild a healthy immune system damaged by disease. Cord blood has been used in transplant medicine for nearly 30 years and can be used in the treatment of nearly 80 different diseases today.1 Over the last few years, cord blood use has expanded beyond transplant medicine into clinical research trials for conditions like autism and brain injuries.
There are usually two fees involved in cord blood banking. The first is the initial fee that covers enrollment, collection, and storage for at least the first year. The second is an annual storage fee. Some facilities vary the initial fee based upon the length of a predetermined period of storage.
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.
* Disclaimer: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used. Cord tissue stem cells are not approved for use in treatment, but research is ongoing.
The procedure for obtaining the cord blood involves clamping the umbilical cord at the time of birth. The small amount of blood remaining in the umbilical cord is drained and taken to a cord blood bank. It is free to donate.
After your baby is born the umbilical cord will be clamped and cut. Using ViaCord’s collection kit, your medical professional will insert a needle into the umbilical cord and let the remaining blood drain into our collection bag.
Donating cord blood to a public bank adds to the supply and can potentially help others. Donating to a public bank is especially important for ethnic minorities, who are not well represented in cord blood banks. Public cord blood donation increases the chance of all groups finding a match.
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.
Depending on the predetermined period of storage, the initial fee can range from $900 to $2100. Annual storage fees after the initial storage fee are approximately $100. It is common for storage facilities to offer prepaid plans at a discount and payment plans to help make the initial storage a more attractive option for you and your family.
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.
Along with cord blood, Wharton’s jelly and the cord lining have been explored as sources for mesenchymal stem cells (MSC), and as of 2015 had been studied in vitro, in animal models, and in early stage clinical trials for cardiovascular diseases, as well as neurological deficits, liver diseases, immune system diseases, diabetes, lung injury, kidney injury, and leukemia.
Cord blood is the blood that remains in the umbilical cord and placenta following birth. This blood is usually discarded. However, cord blood banking utilizes facilities to store and preserve a baby’s cord blood. If you are considering storing your baby’s cord blood, make sure to use a cord blood bank accredited by the American Association of Blood Banks (AABB), like Viacord.
There is a high likelihood that immediate biological family members could benefit from the baby’s cord tissue stem cells, with parents having a 100% likelihood of being compatible, siblings having a 75% likelihood of being compatible, and grandparents having a 25% likelihood of being compatible.16,50 Another reason why parents today are choosing to bank their baby’s cord tissue for the future.
Shai was a feisty little girl whose mother used her scientific background to search for the best approach to cure her cancer. Shai narrowly escaped death many times, including a recovery that even her doctors considered a miracle, yet she died at dawn on the day that she would have begun kindergarten. Her mother went on to found this website and charity in her memory. Read more…