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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.
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.
The range of diseases that doctors can treat with cord blood is vast. More than 80 diseases are currently known to respond to cord blood stem cells transplants and, as more are studied and tested, that number is sure to grow.
Finally, the healthy stem cells are placed into long-term cryogenic storage. Compared to other stem cell sources, cord blood units are available very quickly since a doctor can remove them from storage and send them to the transplant hospital within a few days.
Tissue is 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.) It’s frozen in a liquid nitrogen freezer and stored, so if the unit is selected as a match for a patient needing a transplant, it will be available.
There was a time before the 1990s when the umbilical cord and its blood were considered medical waste. Today, parents bank or store their baby’s umbilical cord blood because the stem cells it contains are currently utilized or show promise in the treatment of life-threatening and debilitating diseases.
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.
Donating cord blood to a public cord blood bank involves talking with your doctor or midwife about your decision to donate and then calling a cord blood bank (if donation can be done at your hospital). Upon arriving at the hospital, tell the labor and delivery nurse that you are donating umbilical cord blood.
^ 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.
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.
In New Zealand, a hopeful couple are participating in a study that will use one of their son’s cord blood stem cells to research treatment for another son’s cystic fibrosis. In Chicago, people are using their sibling’s stem cells to successfully treat sickle cell disease. And countless other families have banked their second child’s cord blood after their first child was diagnosed with leukemia. Many of those children are alive and well today thanks to their sibling’s stem cells. Since the first successful cord blood stem cell transplant on a sibling in 1988, over 30,000 cord blood transplants have been performed worldwide.
Private companies offer to store cord blood for anyone who wants it done, whether or not there is any medical reason known to do so at the time. The fee for private storage varies, but averages about $1,500 up front and $100 per year for storage. When there is no one in the family who needs a transplant, private storage of a newborn’s cord blood is done for a purely speculative purpose that some companies have termed “biological insurance.”
Stem cells are injected into the veins during a peripheral blood transplant, and naturally work their way to the bone marrow. Once there, the new cells start increasing healthy blood count. Compared to bone marrow transplants, cells from peripheral blood are usually faster, creating new blood cells within two weeks.
Cord Blood Registry (CBR) is a private bank that offers collection and long-term storage of both cord blood and cord tissue. With more than 700,000 stored units, CBR is one of the largest of the cord blood banks.
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Beyond these blood-related disorders, the therapeutic potential of umbilical cord blood stem cells is unclear. No therapies for non-blood-related diseases have yet been developed using HSCs from either cord blood or adult bone marrow. There have been several reports suggesting that umbilical cord blood contains other types of stem cells that are able to produce cells from other tissues, such as nerve cells. Some other reports claim that umbilical cord blood contains embryonic stem cell-like cells. However, these findings are highly controversial among scientists and are not widely accepted.
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.
Within 24 hours of giving birth, your doctor will take a small blood sample. In most cases, the blood sample is sent to the bank along with your child’s cord blood. This helps the storage facility staff when checking the blood for diseases and contamination. Some hospitals may decide to test the mother’s blood for diseases themselves.
Once donated cord blood is listed on the Be the Match registry, doctors can access it to treat patients who need stem cell transplants. Public cord blood banks keep the names of both mothers and babies confidential to protect the privacy of families.
Much research is focused on trying to increase the number of HSCs that can be obtained from one cord blood sample by growing and multiplying the cells in the laboratory. This is known as “ex vivo expansion”. Several preliminary clinical trials using this technique are underway. The results so far are mixed: some results suggest that ex vivo expansion reduces the time taken for new blood cells to appear in the body after transplantation; however, adult patients still appear to need blood from two umbilical cords. More research is needed to understand whether there is a real benefit for patients, and this approach has yet to be approved for routine clinical use.
After a baby is born, cord blood is left in the umbilical cord and placenta. It is relatively easy to collect, with no risk to the mother or baby. It contains haematopoietic (blood) stem cells: rare cells normally found in the bone marrow.
Congratulations to the Marepalli family, this week’s winners of a free year of storage! CBR Clients: Enter for a chance to win by tagging a family photo with #CBRFamilyContest! #MyStemCellsLiveAtCBR pic.twitter.com/RLIx54bLqS
* 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.