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If you do decide to bank your baby’s cord blood, there’s one more thing to keep in mind: It’s best not to make it a last-minute decision. You should coordinate with the bank before your baby is born so nothing is left to chance.
An HLA match helps ensure the body accepts the new cell and the transplant is successful. It also reduces the risk of graft-versus-host disease (GVHD), which is when the transplanted cells attack the recipient’s body. GVHD occurs in 30%–40% of recipients when they aren’t a perfect match but the donor is still related. If the donor and recipient are not related, it increases to a 60%–80% risk. The better the match, the more likely any GVHD symptoms will be mild, if they suffer from GVHD at all. Unfortunately, GVHD can also be deadly.
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.
The cord blood collection process is simple, safe, and painless. The process usually takes no longer than five minutes. Cord blood collection does not interfere with delivery and is possible with both vaginal and cesarean deliveries.
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.
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.
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.
Tracey said she felt lucky since she banked Anthony’s cord blood with a private company. And Osteopetrosis is one of 80 diseases listed by many cord blood companies in their marketing material as treatable with stem cells.
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.
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.
^ Caseiro, AR; Pereira, T; Ivanova, G; Luís, AL; Maurício, AC (2016). “Neuromuscular Regeneration: Perspective on the Application of Mesenchymal Stem Cells and Their Secretion Products”. Stem Cells International. 2016: 9756973. doi:10.1155/2016/9756973. PMC 4736584 . PMID 26880998.
There are so many things to think about when you have a child. One of them is the blood from your baby’s umbilical cord (which connects the baby to the mother while in the womb). It used to be thrown away at birth, but now, many parents store the blood for the future health of their child. Should you do it?
A list of U.S. transplant centers that perform allogeneic transplants can be found at BeTheMatch.org/access. The list includes descriptions of the centers, their transplant experience, and survival statistics, as well as financial and contact information.
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.
Cade Hildreth is the Founder of BioInformant.com, the world’s largest publisher of stem cell industry news. Cade is a media expert on stem cells, recently interviewed by the Wall Street Journal, Los Angeles Business Journal, Xconomy, and Vogue Magazine.
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.
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.
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.
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.
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.
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, 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.
With allogeneic transplants, GVHD sometimes develops when white blood cells from the donor (the graft) identify cells in the patient’s body (the host) as foreign and attack them. The most commonly damaged organs are the skin, liver, and intestines. This complication can develop within a few weeks of the transplant (acute GVHD) or much later (chronic GVHD). To prevent this complication, the patient may receive medications that suppress the immune system. Additionally, the donated stem cells can be treated to remove the white blood cells that cause GVHD in a process called “T-cell depletion.” If GVHD develops, it can be very serious and is treated with steroids or other immunosuppressive agents. GVHD can be difficult to treat, but some studies suggest that patients with leukemia who develop GVHD are less likely to have the cancer come back. Clinical trials are being conducted to find ways to prevent and treat GVHD.
The parents who make the decision to store their baby’s cord blood and cord tissue are thinking ahead, wanting to do right from the start (even before the start), and taking steps to do whatever they can to protect their baby down the road. Today, many conscientious parents are also considering delayed cord clamping (DCC), a practice in which the umbilical cord is not clamped immediately but rather after it continues to pulse for an average of 30 seconds to 180 seconds. Many parents don’t realize that they can delay the clamping of the cord and still bank their baby’s cord blood. As noted early, our premium processing method, PrepaCyte-CB, is able to capture more immune system cells and reduce the greatest number of red blood cell contaminants. This makes it go hand in hand with delayed cord clamping because it is not as affected by volume, effectively making up for the smaller quantity with a superior quality. You can read more about delayed cord clamping vs. cord blood banking here.
The use of cord blood is determined by the treating physician and is influenced by many factors, including the patient’s medical condition, the characteristics of the sample, and whether the cord blood should come from the patient or an appropriately matched donor. Cord blood has established uses in transplant medicine; however, its use in regenerative medicine is still being researched. There is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.
Cord blood is collected by your obstetrician or the staff at the hospital where you give birth. Not all hospitals offer this service. Some charge a separate fee that may or may not be covered by insurance.
The umbilical cord blood contains haematopoietic stem cells – similar to those found in the bone marrow – and which can be used to generate red blood cells and cells of the immune system. Cord blood stem cells are currently used to treat a range of blood disorders and immune system conditions such as leukaemia, anaemia and autoimmune diseases. These stem cells are used largely in the treatment of children but have also started being used in adults following chemotherapy treatment.
As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
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.
If a sibling of a child whose cord blood you banked needs a transplant, then your chances of a match will be far higher than turning to the public. However, the safest bet is to bank the cord blood of all your children, safeguarding them against a number of diseases and ensuring a genetic match if necessary.
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.
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.
Some financial aid is available for families that opt for private cord blood banking. If you have a sick child who could benefit from umbilical cord blood, some cord blood banks offer programs in which the bank will cover free cord blood processing and storage if the baby has a biological sibling with certain diseases. Certain insurance companies may pitch in if that sibling needs to be treated with the cord blood in the near future, Dr. Verter says.
However, parents should know that a child’s own cord blood (stored at birth), would rarely be suitable for a transplant today. It could not be used at present to treat genetic diseases, for example, because the cord blood stem cells carry the same affected genes and. if transplanted, would confer the same condition to the recipient. (See the story of Anthony Dones.) In addition, most transplant physicians would not use a child’s own cord blood to treat leukemia. There are two reasons why the child’s own cord blood is not safe as a transplant source. First, in most cases of childhood leukemia, cells carrying the leukemic mutation are already present at birth and can be demonstrated in the cord blood. Thus, pre-leukemic cells may be given back with the transplant, since there is no effective way to remove them (purge) today. Second, in a child with leukemia, the immune system has already failed to prevent leukemia. Since cord blood from the same child re-establishes the child’s own immune system, doctors fear it would have a poor anti-leukemia effect.
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.
^ 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.
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 all is said and done, the cost to collect, test, process and store a donated cord blood collection at a public bank is estimated to be $1,200 to $1,500 dollars for each unit banked. That does not include the expense for the regulatory and quality systems needed to maintain licensure, or the cost of collecting units that are discarded because they don’t meet standards.
Potential long-term risks include complications of the pretransplant chemotherapy and radiation therapy, such as infertility (the inability to produce children); cataracts (clouding of the lens of the eye, which causes loss of vision); secondary (new) cancers; and damage to the liver, kidneys, lungs, and/or heart.
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.
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
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
Through these two means, we are always producing more cells. In fact, much of your body is in a state of constant renewal because many cells can live for only certain periods of time. The lifespan for a cell in the stomach lining is about two days. Red blood cells, about four months. Nerve and brain cells are supposed to live forever. This is why these cells rarely regenerate and take a long time if they do.
Hematopoietic stem cells can be used to treat more than 70 types of diseases, including diseases of the immune system, genetic disorders, neurologic disorders, and some forms of cancer, including leukemia and lymphoma. For some of these diseases, stem cells are the primary treatment. For others, treatment with stem cells may be used when other treatments have not worked or in experimental research programs.
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.
Sutter Neuroscience Institute has conducted a landmark FDA-regulated phase II clinical trial to assess the use of autologous stem cells derived from cord blood to improve language and behavior in certain children with autism.