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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.
There is not one right answer. Your family’s medical history and personal preferences will play a major role in this decision process. However, we can help you make sense of the available options. Continue to follow our guide on cord blood to understand what is the best choice for your family.
Cord blood is also being studied as a substitute for normal blood transfusions in the developing world. More research is necessary prior to the generalized utilization of cord blood transfusion.
After entering the bloodstream, the stem cells travel to the bone marrow, where they begin to produce new white blood cells, red blood cells, and platelets in a process known as “engraftment.” Engraftment usually occurs within about 2 to 4 weeks after transplantation. Doctors monitor it by checking blood counts on a frequent basis. Complete recovery of immune function takes much longer, however—up to several months for autologous transplant recipients and 1 to 2 years for patients receiving allogeneic or syngeneic transplants. Doctors evaluate the results of various blood tests to confirm that new blood cells are being produced and that the cancer has not returned. Bone marrow aspiration (the removal of a small sample of bone marrow through a needle for examination under a microscope) can also help doctors determine how well the new marrow is working.
Your cells didn’t start out knowing how to come together to form your bones, heart or blood; they begun with more of a blank slate. These completely undifferentiated cells can be found during gestation, or the time the baby is in the womb, and are called embryonic stem cells. These early stage stem cells are master cells that have the potential to become any type of cell in the body.
Research is being conducted using cord blood cells to analyze immune response and other factors that may eventually shed light on causes and treatment of MS. However, at present there is no treatment available involving cord blood cells. Nor do we know of any sites that are looking for cord blood specifically for MS research.
The Medical Letter On Drugs and Therapeutics also recently addressed aspects of public and private cord blood banks, asking the question: “Does Private Banking Make Sense?” After citing various statistics on the actual uses of privately stored cord blood, they concluded that: “At the present time, private storage of umbilical cord blood is unlikely to be worthwhile. Parents should be encouraged to contribute, when they can, to public cord blood banks instead.” [Access The Medical Letter at www.medicalletter.org].
Marketing materials by Viacord and Cord Blood Registry, the two largest companies, do not mention that cord blood stem cells cannot be used by the child for genetic diseases, although the fine print does state that cord blood may not be effective for all of the listed conditions.
We believe that every family should have the opportunity to preserve their baby’s newborn stem cells. That’s why CBR offers transparent costs of cord blood banking, and various payment options to fit this important step into almost every family budget.
Sometimes, not enough cord blood can be collected. This problem can occur if the baby is preterm or if it is decided to delay clamping of the umbilical cord. It also can happen for no apparent reason. If an emergency occurs during delivery, priority is given to caring for you and your baby over collecting cord blood.
Cord blood cannot be used if the donor (baby) contains the same genetic illness as the recipient. Most cord blood banks glaze over this, but it is important to understand that the odds of using cord blood for the same child are much lower than the odds of using them for a sibling.
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.
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.
Cord tissue is rich in another type of stem cell. Although there are no current uses, researchers are excited about the benefits cord tissue stem cells may offer in potential future users, such as regenerative medicine. By storing both, you’ll have potential access to more possibilities
^ Roura, S; Pujal, JM; Gálvez-Montón, C; Bayes-Genis, A (2 July 2015). “The role and potential of umbilical cord blood in an era of new therapies: a review”. Stem cell research & therapy. 6: 123. doi:10.1186/s13287-015-0113-2. PMC 4489204 . PMID 26133757.
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.
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.
Most cells can make copies only of themselves. For example, a skin cell only can make another skin cell. Hematopoietic stem cells, however, can mature into different types of blood cells in the body. Hematopoietic stem cells also are found in blood and bone marrow in adults and children.
The syringe or bag should be pre-labeled with a unique number that identifies your baby. Cord blood may only be collected during the first 15 minutes following the birth and should be processed by the laboratory within 48 hours of collection.
Osteopetrosis is a genetic disease, so this means that doctors could use a sibling’s cord blood cells to treat Anthony, but they cannot use his own cells because the disease is in every cell in his body. In fact, a majority of the diseases listed in private banking firms’ marketing material as treatable with stem cells are genetic diseases.
CBR Cord Blood Education Specialists are available 7 days a week (Monday – Friday 6 AM – 9 PM PST and Saturday – Sunday 6 AM – 4 PM PST) to respond to consumer inquiries. In addition, consumers may request to schedule a call with a CBR Cord Blood Education Specialist at a specific date and time.
The evolution of stem cell therapies has paved the way for further research being conducted through FDA-regulated clinical trials to uncover their potential in regenerative medicine applications. Cord Blood Registry is the first family newborn stem cell company to partner with leading research institutions to establish FDA-regulated clinical trials exploring the potential regenerative ability of cord blood stem cells to help treat conditions that have no cure today, including: acquired hearing loss, autism, cerebral palsy, and pediatric stroke. In fact, 73% of the stem cell units released by CBR have been used for experimental regenerative therapies – more than any other family cord blood bank in the world.
First isolated in 1998, there is a lot of controversy around acquiring embryonic stem cells. Thankfully, we can also acquire the stem cells that form just a little bit later down the road, like in the umbillical cord tissue. These stem cells, known as adult stem cells, stay with us for life. (Later, we will learn why not all adult stem cells are equal.) Adult stem cells are more limited in the types of cells they can become, something known as being tissue-specific, but share many of the same qualities. Hematopoietic stem cells (Greek “to make blood” and pronounced he-mah-toe-po-ee-tic) found in the umbilical cord’s blood, for instance, can become any of the different types of blood cells found in the body and are the foundation of our immune system. Another example is mesenchymal (meh-sen-ki-mal) stem cells, which can be found in the umbilical cord tissue and can become a host of cells including those found in your nervous system, sensory organs, circulatory tissues, skin, bone, cartilage, and more.
Another way scientists are working with stem cells is through expansion technologies that spur replication of the cord blood stem cells. If proven effective and approved by the U.S. Food and Drug Administration, these expansion technologies will allow scientists to culture many stem cells from a small sample. This could provide doctors and researchers with enough stem cells to treat multiple family members with one cord blood collection or provide the baby with multiple treatments over time. To better prepare for the day when these expansion technologies are more easily accessible, some cord blood banks have begun to separate their cord blood collections into separate compartments, which can easily be detached from the rest of the collection and used independently. You can learn more about Cryo-Cell’s five-chambered storage bag here.
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.
Just like other blood donations, there is no cost to the donor of cord blood. If you do not choose to store your baby’s blood, please consider donating it. Your donation could make a difference in someone else’s life.
Your child may never need it. Stem cell-rich cord blood can be used to treat a range of diseases, but Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, estimates that there’s only a 1 in 217 chance that your child will ever need a stem cell transplant with cord blood (or bone marrow). This is particularly true if the child doesn’t have a family history of diseases such as leukemia, lymphoma, or sickle cell anemia. Although the American Academy of Pediatrics (AAP) states cord blood has been used to treat certain diseases successfully, there isn’t strong evidence to support cord blood banking. If a family does choose to bank cord blood, the AAP recommends public cord blood banking (instead of private) to cut down on expenditures.
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.
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.
Anthony’s doctors found a match for him through the New York Blood Center’s National Cord Blood Program, a public cord blood bank. Unlike private banks, public banks do not charge to collect cord blood, they charge a patients insurance company when cells are used. And once it is entered in the public system, the blood is available to anyone who needs it.
For families that choose to bank cord blood, the American Academy of Pediatrics (AAP) recommends public cord blood banking. Estimates vary, but the chances of a child having a stem cell transplant, with either bone marrow or cord blood, are 1 in 217 over a lifetime. Although the AAP states cord blood has been used to treat certain diseases successfully, there isn’t strong evidence to support cord blood banking. If a family does decide on cord blood banking, the AAP recommends public cord blood banking (instead of private) to cut down on costs. If you donate cord blood and your child eventually needs it, you can get it back as long as it hasn’t been discarded or used.
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.
Your baby may be able to use his or her own cord blood in the treatment of certain non-genetic diseases and cancers, like neuroblastoma. Participation in some clinical trials, like recent autism and cerebral palsy trials, require children to have access to their own cord blood.
In Europe, Canada, and Australia use of cord blood is regulated as well. In the United Kingdom the NHS Cord Blood Bank was set up in 1996 to collect, process, store and supply cord blood; it is a public cord blood bank and part of the NHS.
Parents who wish to donate cord blood are limited by whether there is a public bank that collects donations from the hospital or clinic where their baby will be born. Search our list of public banks in your country. Parents who wish to store cord blood and/or cord tissue for their family can find and compare private banks in your country. Family banks usually offer payment plans or insurance policies to lower the cost of cord blood banking.
The area where the bone marrow was taken out may feel stiff or sore for a few days, and the donor may feel tired. Within a few weeks, the donor’s body replaces the donated marrow; however, the time required for a donor to recover varies. Some people are back to their usual routine within 2 or 3 days, while others may take up to 3 to 4 weeks to fully recover their strength.
You certainly should, especially if you have a family history of any diseases or conditions that could be treated with cord blood stem cells. Since there is only a 25% chance of a match, you should bank the cord blood of each individual child if you have the means.
Private cord blood banking can benefit those with a strong family history of certain diseases that harm the blood and immune system, such as leukemia and some cancers, sickle-cell anemia, and some metabolic disorders. Parents who already have a child (in a household with biological siblings) who is sick with one of these diseases have the greatest chance of finding a match with their baby’s cord blood. Parents who have a family history of autism, Alzheimer’s, and type 1 diabetes can benefit from cord blood. Although these diseases aren’t currently treated with umbilical cord steam cells, researchers are exploring ways to treat them (and many more) with cord blood.
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.
^ 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.