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Genes: Segments of DNA that contain instructions for the development of a person’s physical traits and control of the processes in the body. They are the basic units of heredity and can be passed down from parent to offspring.
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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.
Unlike traditional BMT or PBSCT, cells from both the donor and the patient may exist in the patient’s body for some time after a mini-transplant. Once the cells from the donor begin to engraft, they may cause the GVT effect and work to destroy the cancer cells that were not eliminated by the anticancer drugs and/or radiation. To boost the GVT effect, the patient may be given an injection of the donor’s white blood cells. This procedure is called a “donor lymphocyte infusion.”
Experts believe that umbilical cord blood is an important source of blood stem cells and expect that its full potential for treatment of blood disorders is yet to be revealed. Other types of stem cell such as induced pluripotent stem cells may prove to be better suited to treating non-blood-related diseases, but this question can only be answered by further research.
Chemotherapy and radiation therapy generally affect cells that divide rapidly. They are used to treat cancer because cancer cells divide more often than most healthy cells. However, because bone marrow cells also divide frequently, high-dose treatments can severely damage or destroy the patient’s bone marrow. Without healthy bone marrow, the patient is no longer able to make the blood cells needed to carry oxygen, fight infection, and prevent bleeding. BMT and PBSCT replace stem cells destroyed by treatment. The healthy, transplanted stem cells can restore the bone marrow’s ability to produce the blood cells the patient needs.
Cord blood banking is not always cheap. It’s completely free to donate blood to a public cord blood bank, but private banks charge $1,400 to $2,300 for collecting, testing, and registering, plus an annual $95 to $125 storing fee.
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.
Donors to public banks must be screened for blood or immune system disorders or other problems. With a cord blood donation, the mother’s blood is tested for genetic disorders and infections, and the cord blood also is tested after it is collected. Once it arrives at the blood bank, the cord blood is “typed.” It is tracked by a computer so that it can be found quickly for any person who matches when needed.
Properly preserved cord blood is long-lasting. Cord blood is stored in a nitrogen freezer (the same technology used to freeze donated sperm), so it can last for a long time. “The scientist who first developed cord blood preservation methods in 1990 has confirmed that some of the first specimens he stored 23 plus years ago are just as potent as fresh cord blood,” says Mary Halet, Director, Central Region at Be The Match, which is operated by the National Bone Marrow Foundation.
Because of the invasive procedure required to obtain the bone marrow, scientist continued to look for a better source, which eventually lead to the discovery of similar stem cells in cord blood in 1978. Cord blood was used in its first transplant in 1988, and cord blood has since been shown to be more advantageous than other means of acquiring similar stem cells and immune system cells. This is because umbilical cord blood can be considered naïve and immature compared to other sources. Cord blood has not been exposed to disease or environmental pollutants, and it is more accepting of foreign cells. In this case, inexperience makes it stronger.
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.)
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Haematopoietic stem cells (HSCs) can make every type of cell in the blood – red cells, white cells and platelets. They are responsible for maintaining blood production throughout our lives. They have been used for many years in bone marrow transplants to treat blood diseases.
Scientists first found ways to use stem cells in bone marrow, and following this discovery, the first stem cell transplant was performed in 1956 via bone marrow between identical twins. It resulted in the complete remission of the one twin’s leukemia.
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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.
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.
Cord Blood Registry offers two ways to save your newborn’s stem cells, and convenient payment options to fit your family’s needs. CBR recognizes that each family’s budget is unique. As a result, CBR does not take a one-size-fits-all approach to pricing and payments for cord blood and tissue banking. Calculate your stem cell banking costs and CBR will recommend payment plans that may fit your family’s budget.
As a mother-to-be, you can decide that your baby’s first act may be saving another person’s life. You can do this by choosing to donate your baby’s umbilical cord blood to the St. Louis Cord Blood Bank’s First Gift℠ Donation Program.
FAQ172: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.
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.
Not all moms can donate their cord blood. Moms who are not eligible are those who: are younger than 18 years old (in most states), have been treated for cancer or have received chemotherapy for another illness, have had malaria in the last three years, or have been treated for a blood disease such as HIV or hepatitis. It’s also not possible to donate cord blood if a mom has delivered her baby prematurely (there may not be enough blood to collect) or delivered multiples (but it’s possible to bank your cord blood of multiples privately).
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.
Phone 1-888-932-6568 to connect with a CBR Cord Blood Education Specialist or submit an online request. International callers should phone 650-635-1420 to connect with a CBR Cord Blood Education Specialist.
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].
There are a number of different processing methods out there for a cord blood bank to use, and the processing method can ultimately affect the purity of the final product, which we’ll explain in a minute. Once the stem and immune system cells have been isolated and extracted from the plasma and red blood cell, they are mixed with a cryo-protectant and stored in a cryo-bag. We overwrap our bags for added protection and use a technique called “controlled-rate freezing” to prepare the cells for long-term storage. The overwrapped cryo-bag is housed in a protective metal cassette and placed in vapor-phase liquid nitrogen freezer for long-term preservation.
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.
Frances Verter, PhD, founded the Parent’s Guide to Cord Blood in 1998 and has been a Scientific Advisor to Community Blood Services since 2007. In 2011 the NMDP presented her with their Lifeline Award in recognition of her efforts to improve public education about cord blood donation.
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.
Cord blood in public banks is available to unrelated patients who need haematopoietic stem cell transplants. Some banks, such as the NHS bank in the UK, also collect and store umbilical cord blood from children born into families affected by or at risk of a disease for which haematopoietic stem cell transplants may be necessary – either for the child, a sibling or a family member. It is also possible to pay to store cord blood in a private bank for use by your own family only.
Bone marrow is the soft, sponge-like material found inside bones. It contains immature cells known as hematopoietic or blood-forming stem cells. (Hematopoietic stem cells are different from embryonic stem cells. Embryonic stem cells can develop into every type of cell in the body.) Hematopoietic stem cells divide to form more blood-forming stem cells, or they mature into one of three types of blood cells: white blood cells, which fight infection; red blood cells, which carry oxygen; and platelets, which help the blood to clot. Most hematopoietic stem cells are found in the bone marrow, but some cells, called peripheral blood stem cells (PBSCs), are found in the bloodstream. Blood in the umbilical cord also contains hematopoietic stem cells. Cells from any of these sources can be used in transplants.
A mini-transplant uses lower, less toxic doses of chemotherapy and/or radiation to prepare the patient for an allogeneic transplant. The use of lower doses of anticancer drugs and radiation eliminates some, but not all, of the patient’s bone marrow. It also reduces the number of cancer cells and suppresses the patient’s immune system to prevent rejection of the transplant.
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.
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.
Cord blood is used the same way that hematopoietic stem cell transplantation is used to reconstitute bone marrow following radiation treatment for various blood cancers, and for various forms of anemia. Its efficacy is similar as well.
There are several cord blood banks that are accredited by the American Association of Blood Banks. Most offer information on cord blood banking and provide private cord blood banking services. With a little research, you should be able to locate a credible cord blood bank online.
We are genetically closest to our siblings. That’s because we inherit half of our DNA from our mother and half from our father, so the genes we inherit are based on a chance combination of our parents’. Our siblings are the only other people inheriting the same DNA.
CBR created the world’s only collection device designed specifically for cord blood stem cells. CBR has the highest average published cell recovery rate in the industry – 99% – resulting in the capture of 20% more of the most important cells than other common processing methods.
Cord tissue use is still in early research stages, and there is no guarantee that treatments using cord tissue will be available in the future. Cord tissue is stored whole. Additional processing prior to use will be required to extract and prepare any of the multiple cell types from cryopreserved cord tissue. Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue and long-term storage of umbilical cord–derived stem cells. Cbr Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
Umbilical cord blood stem cells are different from embryonic stem cells. Umbilical cord blood stem cells are collected by your ob-gyn or a nurse from the umbilical cord after you give birth (but before your placenta is delivered). Embryonic stem cells are collected when a human embryo is destroyed.
The American Pediatric Association in 2008 recommended that physicians recommend that cord blood be donated instead of saved privately for family families. One of the major proponents for this was Joanne Kurtzberg, who profited from this by getting funding for her public cord blood bank at Duke University. She has since started her own private cord blood bank after doing more research on Cerebral Palsy. Interesting.
Because identical twins have the same genes, they have the same set of HLA antigens. As a result, the patient’s body will accept a transplant from an identical twin. However, identical twins represent a small number of all births, so syngeneic transplantation is rare.