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After the baby is born and the umbilical cord has been cut, blood is retrieved from the umbilical cord and placenta. This process poses minimal health risk to the mother or the child. If the mother agrees, the umbilical cord blood is processed and frozen for storage by the cord blood bank. Only a small amount of blood can be retrieved from the umbilical cord and placenta, so the collected stem cells are typically used for children or small adults.
Some controversial studies suggest that cord blood can help treat diseases other than blood diseases, but often these results cannot be reproduced. Researchers are actively investigating if cord blood might be used to treat various other diseases.
Banking of stem cells from cord blood began in 1994 with the foundation of the New York Blood Centre Cord Blood Bank. The field of umbilical cord blood storage has matured considerably over the last two decades. We continue to learn more about the long-term effects of cryo-preservation on the cells, which has resulted in increased storage times.
Certain public cord blood banks let you mail in your cord blood. You have to decide before the birth if you want to donate your cord blood. If the hospital where you’re delivering doesn’t accept donations, you can contact a lab that offers a mail-in delivery program. After you’ve passed the lab’s screening process, they’ll send you a kit that you can use to package your blood and mail it in, explains Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation (parentsguidecordblood.org), a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists.
2 Cordblood.com, (2014). Cord Blood Stem Cell Banking | Cord Blood Registry | CBR. [online] Available at: http://www.cordblood.com/cord-blood-banking-cost/cord-blood-stem-cells [Accessed 22 March. 2017].
In most cases, the success of allogeneic transplantation depends in part on how well the HLA antigens of the donor’s stem cells match those of the recipient’s stem cells. The higher the number of matching HLA antigens, the greater the chance that the patient’s body will accept the donor’s stem cells. In general, patients are less likely to develop a complication known as graft-versus-host disease (GVHD) if the stem cells of the donor and patient are closely matched.
The first cord blood banks were private cord blood banks. In fact, Cryo-Cell is the world’s first private cord blood bank. It wasn’t until later that the government realized the need to preserve cord blood for research and public welfare. As a result, 31 states have adopted a law or have a piece of pending legislation that requires or encourages OBGYNs to educate expectant parents about cord blood banking and many states now have publicly held cord blood banks. As a result, parents have the option of banking their baby’s cord blood privately for the exclusive use of the child and the rest of the family or donating the cord blood to a public bank so that it can be used in research or by any patient who is a match and in need.
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.
The National Marrow Donor Program® (NMDP), a nonprofit organization, manages the world’s largest registry of more than 11 million potential donors and cord blood units. The NMDP operates Be The Match®, which helps connect patients with matching donors.
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.
All cord blood is screened and tested. Whether you use a public or private bank, you’ll still need to be tested for various infections (such as hepatitis and HIV). If tests come back positive for disease or infection, you will not be able to store your cord blood.
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.
*Fee schedule subject to change without notice. If a client has received a kit and discontinues services prior to collection, there is no cancelation fee if the kit is returned unused within two weeks from cancelation notice; otherwise, a $150 kit replacement fee will be assessed. †Additional courier service fee applies for Alaska, Hawai’i and Puerto Rico. ††Applies to one-year plan and promotional plan only. After the first year, an annual storage fee will apply. Cryo-Cell guarantees to match any written offer for product determined to be similar at Cryo-Cell’s sole discretion. ** Promotional Plan cannot be combined with any other promotional offers, coupons or financing.
Umbilical cord blood is useful for research. For example, researchers are investigating ways to grow and multiply haematopoietic (blood) stem cells from cord blood so that they can be used in more types of treatments and for adult patients as well as children. Cord blood can also be donated altruistically for clinical use. Since 1989, umbilical cord blood transplants have been used to treat children who suffer from leukaemia, anaemias and other blood diseases.
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.
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.
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.
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.
The major risk of both treatments is an increased susceptibility to infection and bleeding as a result of the high-dose cancer treatment. Doctors may give the patient antibiotics to prevent or treat infection. They may also give the patient transfusions of platelets to prevent bleeding and red blood cells to treat anemia. Patients who undergo BMT and PBSCT may experience short-term side effects such as nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions.
If everyone donated cord blood to public registries for the ‘common good’ this would increase the chances of someone benefiting from a double cord blood transplant. This far outweights the actual probability of the person who donated the sample being able to usefully use it for themself.
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.
Medical staff at the public cord blood bank will check to see if you can donate. If you have had a disease that can be given to another person through blood-forming cells, such as hepatitis B, hepatitis C, or HIV (the AIDS virus), you will likely not be able to donate. However, other medical reasons may still allow you to donate, for example, hepatitis A or diabetes only during your pregnancy (gestational diabetes). The staff at the public cord blood bank will tell you.
^ 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.
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.
The term “cord blood” is used for the blood remaining in the umbilical cord and the placenta after the birth of a baby. Cord Blood contains stem cells that can grow into blood and immune system cells, as well as other types of cells. Today cord blood is often used as a substitute for bone marrow in stem cell transplants. There are over 80 diseases treated this way, including cancers, blood disorders, genetic and metabolic diseases.
After your baby is born the umbilical cord will be clamped and cut. Using ViaCord’s collection kit, your medical professional will insert a needle into the umbilical cord and let the remaining blood drain into our collection bag.