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In addition to the stem cells, researchers are discovering specific uses for the other types of cells in the treatment of certain conditions. Cord blood Treg cells hold potential for preventing graft-versus-host disease in stem cell transplantations and ameliorating the effects of autoimmune diseases such as diabetes, rheumatoid arthritis and multiple sclerosis. Cord blood natural killer cells also hold future potential. These cells have been programmed to target specific cancers and tumors in clinical trials. This could make them exceptionally strong candidates for chronic or treatment-resistant cases of cancer.
Private storage of one’s own cord blood is unlawful in Italy and France, and it is also discouraged in some other European countries. The American Medical Association states “Private banking should be considered in the unusual circumstance when there exists a family predisposition to a condition in which umbilical cord stem cells are therapeutically indicated. However, because of its cost, limited likelihood of use, and inaccessibility to others, private banking should not be recommended to low-risk families.” The American Society for Blood and Marrow Transplantation and the American Congress of Obstetricians and Gynecologists also encourage public cord banking and discourage private cord blood banking. Nearly all cord blood transplantations come from public banks, rather than private banks, partly because most treatable conditions can’t use a person’s own cord blood. The World Marrow Donor Association and European Group on Ethics in Science and New Technologies states “The possibility of using one’s own cord blood stem cells for regenerative medicine is currently purely hypothetical….It is therefore highly hypothetical that cord blood cells kept for autologous use will be of any value in the future” and “the legitimacy of commercial cord blood banks for autologous use should be questioned as they sell a service which has presently no real use regarding therapeutic options.”
Cord blood banks may be public or commercial. Public cord blood banks accept donations of cord blood and may provide the donated stem cells to another matched individual in their network. In contrast, commercial cord blood banks will store the cord blood for the family, in case it is needed later for the child or another family member.
Generally, cord blood can only be used to treat children up to 65 lbs. This is because there simply aren’t enough stem cells on average in one unit of cord blood to treat an adult. Through our Cord Blood 2.0 technology, we have been able to collect up to twice as many stem cells as the industry average. Getting more stem cells increases the chance of being able to treat someone later in life.
In this way, cord blood offers a useful alternative to bone marrow transplants for some patients. It is easier to collect than bone marrow and can be stored frozen until it is needed. It also seems to be less likely than bone marrow to cause immune rejection or complications such as Graft versus Host Disease. This means that cord blood does not need to be as perfectly matched to the patient as bone marrow (though some matching is still necessary).
Founded in 1992, CBR has stored more than 600,000 cord blood and cord tissue collections from 3,500 hospitals in over 100 countries and partnered with institutions to establish multiple FDA-regulated clinical trials. CBR has helped more than 400 families use their cord blood stem cells for established and experimental medical treatments, more than any other family cord blood bank. CBR’s goal is to expand the potential scope of newborn stem cell therapies that may be available to patients and their families.
Umbilical cord blood can save lives. Cord blood is rich in stem cells that can morph into all sorts of blood cells, which can be used to treat diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. There are a few ways for transplant patients to get blood cells (umbilical and placenta, bone marrow, peripheral/circulation), but cord blood is easier to match with patients, and because it is gathered during birth from the umbilical cord, it’s a painless procedure.
We’d like to extend our sincere gratitude to the thousands of obstetricians, nurses, midwives, and childbirth educators who support placenta and umbilical cord blood banking. There is no doubt that these efforts save lives.
In addition, CBR offers Genetic Counselors on staff to help families make informed decisions about newborn stem cell banking. Phone 1-888-CORDBLOOD1-888-CORDBLOOD to speak with a CBR Genetic Counselor.
As a rich source of Hematopoietic Stem Cells (HSCs), cord blood has a number of advantages, including decreased risk of severity of Graft-Versus-Host-Disease (GCHD) and a lower risk of transmissible infectious disease. However, the usefulness of cord blood in stem cell therapy has been limited by the relatively small amount of blood that can be collected using standard procedures. With Cord Blood 2.0™, Americord® is making cord blood banking a lifelong investment with the possibility of treating patients well into adulthood.
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.
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.
Private or family banks store cord blood for autologous use or directed donation for a family member. Private banks charge a yearly fee for storage. Blood stored in a private bank must meet the same standards as blood stored in a public bank. If you have a family member with a disorder that may potentially be treated with stem cells, some private banks will store the cord blood free of charge.
The process is safe, painless, easy and FREE. Your physician or midwife collects the cord blood after your baby has delivered, so it does not interfere with the birthing process. The collection will not take place if there is an concern for your safety or that of your baby.
Are public banks and family banks the same, except for who may use the cord blood and the cost to the parents? No. Public banks are subject to much higher regulatory requirements, and compliance with regulations carries costs. At a family bank you pay the bank enough to cover the cost of storing your baby’s cord blood, plus they make a profit. When you donate to a public bank, it costs you nothing, but the bank pays more on processing each blood collection than at a family bank. Let’s look at the steps that take place in the laboratory.
ViaCord’s Lab is FDA registered, AABB accredited, CLIA certified and equipped with the same freezers used by major research institutions such as Centers for Disease Control and Prevention and the National Institutes of Health.
To recap, we have certain types of stem cells that can become a variety of different cells—they are like the renaissance men of cells—but there is one more thing that makes stem cells special. This has to do with how they replicate themselves.
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.
^ a b Thornley, I; et al. (March 2009). “Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians”. Pediatrics. 123 (3): 1011–7. doi:10.1542/peds.2008-0436. PMC 3120215 . PMID 19255033.
To prevent graft-versus-host disease and help ensure engraftment, the stem cells being transfused need to match the cells of the patient completely or to a certain degree (depending on what is being treated). Cord blood taken from a baby’s umbilical cord is always a perfect match for the baby. In addition, immediate family members are more likely to also be a match for the banked cord blood. Siblings have a 25 percent chance of being a perfect match and a 50 percent chance of being a partial match. Parents, who each provide half the markers used in matching, have a 100% chance of being a partial match. Even aunts, uncles, grandparents and other extended family members have a higher probability of being a match and could possibly benefit from the banked cord blood. Read more reasons why you should bank cord blood.
All medical costs for the donation procedure are covered by Be The Match®, or by the patient’s medical insurance, as are travel expenses and other non-medical costs. The only costs to the donor might be time taken off from work.
Because only a small amount of bone marrow is removed, donating usually does not pose any significant problems for the donor. The most serious risk associated with donating bone marrow involves the use of anesthesia during the procedure.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
Both public and family cord blood banks must register with the US Food and Drug Administration (FDA), and since Oct. 2011 public banks also need to apply for an FDA license. All cord blood banks are required by federal law to test the blood of the mother for infectious diseases. At public banks the screening is usually more extensive, similar to the tests performed when you donate blood. The typical expense to a public bank is $150 per unit.
It depends on who you ask. Although commercial cord blood banks often bill their services as “biological insurance” against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
Collected cord blood is cryopreserved and then stored in a cord blood bank for future transplantation. Cord blood collection is typically depleted of red blood cells before cryopreservation to ensure high rates of stem cell recovery.
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.
For example, in the UK the NHS Cord Blood Bank has been collecting and banking altruistically donated umbilical cord blood since 1996. The cord blood in public banks like this is stored indefinitely for possible transplant, and is available for any patient that needs this special tissue type. There is no charge to the donor but the blood is not stored specifically for that person or their family.
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.
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.
A major limitation of cord blood transplantation is that the blood obtained from a single umbilical cord does not contain as many haematopoeitic stem cells as a bone marrow donation. Scientists believe this is the main reason that treating adult patients with cord blood is so difficult: adults are larger and need more HSCs than children. A transplant containing too few HSCs may fail or could lead to slow formation of new blood in the body in the early days after transplantation. This serious complication has been partially overcome by transplanting blood from two umbilical cords into larger children and adults. Results of clinical trials into double cord blood transplants (in place of bone marrow transplants) have shown the technique to be very successful. Some researchers have also tried to increase the total number of HSCs obtained from each umbilical cord by collecting additional blood from the placenta.
^ a b c d e f Juric, MK; et al. (9 November 2016). “Milestones of Hematopoietic Stem Cell Transplantation – From First Human Studies to Current Developments”. Frontiers in Immunology. 7: 470. doi:10.3389/fimmu.2016.00470. PMC 5101209 . PMID 27881982.
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.
The body has two ways to create more cells. The first is usually taught in middle school science. Known as cell division, it’s where a cell replicates within its membrane before dividing into two identical cells. Cells do this as needed for regeneration, which we will touch on in a second.
Cord blood is the blood from the baby that is left in the umbilical cord and placenta after birth. It contains special cells called hematopoietic stem cells that can be used to treat some types of diseases.
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.
There are over 130 public cord blood banks in 35 countries. They are regulated by Governments and adhere to internationally agreed standards regarding safety, sample quality and ethical issues. In the UK, several NHS facilities within the National Blood Service harvest and store altruistically donated umbilical cord blood. Trained staff, working separately from those providing care to the mother and newborn child, collect the cord blood. The mother may consent to donate the blood for research and/or clinical use and the cord blood bank will make the blood available for use as appropriate.
Lead image of baby’s umbilical cord from Wikimedia Commons. Possible human blood stem cell image by Rajeev Gupta and George Chennell. Remaining images of blood sample bags and red blood cells from Wellcome Images.
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.