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What is cord blood and why should we care? Cord blood contains stem cells that have huge potential to help your family. It can only be collected from a newborn’s umbilical cord immediately after birth. They’re unique and can be used to treat life threatening diseases such as anemia and leukemia. We’re just beginning to tap into its potential.
Your body has many different types of cells (more than 200 to be more exact) each geared towards specific functions. You have skin cells and blood cells, and you have bone cells and brain cells. All your organs comprise specific cells, too, from kidney cells to heart cells.
In an allogenic transplant, another person’s stem cells are used to treat a child’s disease. This kind of transplant is more likely to be done than an autologous transplant. In an allogenic transplant, the donor can be a relative or be unrelated to the child. For an allogenic transplant to work, there has to be a good match between donor and recipient. A donor is a good match when certain things about his or her cells and the recipient’s cells are alike. If the match is not good, the recipient’s immune system may reject the donated cells. If the cells are rejected, the transplant does not work.
Private cord blood banking costs $2,000 to $3,000 for the initial fee, and around another $100 per year for storage. While that may seem like a hefty price tag, many expectant parents may see it as an investment in their child’s long-term health.
This is the time of year when many employers and insurance companies hold open enrollment for insurance plans, for the upcoming year. Along with the usual medical, dental, and life insurance plans, many families also opt to enroll in a Medical Flexible Spending Account (or FSA). This type of account offers tax advantages for eligible healthcare costs throughout the year for you and all your dependents. Your Medical FSA is funded by pre-taxed payroll deductions in the amount you choose and covers a wide range of eligible medical expenses including those that result from the diagnosis, care, treatment, or prevention of disease or illness.
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.
Sign a consent form. While there is a chance of the donor family using their child’s cord blood, by signing the consent form, you’re giving the public bank rights to your child’s blood. They can use it as a treatment for any patient, unless your family needs the stem cells first.
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.
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.
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.
Parents sign a consent form, giving the public bank permission to add their child’s cord blood to a database. This database will match transplant patients with a suitable donor. No information about the donor, or their family, is displayed online. The website used in America is Be The Match. They maintain a database of donations and banks across the country, while also working with foreign banks. Your child’s cord blood could save someone living anywhere in the world.
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.
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.
A cord blood bank may be private (i.e. the blood is stored for and the costs paid by donor families) or public (i.e. stored and made available for use by unrelated donors). While public cord blood banking is widely supported, private cord banking is controversial in both the medical and parenting community. Although umbilical cord blood is well-recognized to be useful for treating hematopoietic and genetic disorders, some controversy surrounds the collection and storage of umbilical cord blood by private banks for the baby’s use. Only a small percentage of babies (estimated at between 1 in 1,000 to 1 in 200,000) ever use the umbilical cord blood that is stored. The American Academy of Pediatrics 2007 Policy Statement on Cord Blood Banking stated: “Physicians should be aware of the unsubstantiated claims of private cord blood banks made to future parents that promise to insure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood.” and “private storage of cord blood as ‘biological insurance’ is unwise” unless there is a family member with a current or potential need to undergo a stem cell transplantation. The American Academy of Pediatrics also notes that the odds of using a person’s own cord blood is 1 in 200,000 while the Institute of Medicine says that only 14 such procedures have ever been performed.
The American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics don’t recommend routine cord blood storage. The groups say private banks should only be used when there’s a sibling with a medical condition who could benefit from the stem cells. Families are encouraged to donate stem cells to a public bank to help others.
The therapuetic potential of cord blood continues to grow. Over the last few years cord blood use has expanded into an area known as regenerative medicine. Regenerative medicine is the science of living cells being used to potentially regenerate or facilitate the repair of cells damaged by disease, genetics, injury or simply aging. Research is underway with the hope that cord blood stem cells may prove beneficial in young patients facing life-changing medical conditions once thought untreatable – such as autism and cerebral palsy.
^ Reddi, AS; Kuppasani, K; Ende, N (December 2010). “Human umbilical cord blood as an emerging stem cell therapy for diabetes mellitus”. Current stem cell research & therapy. 5 (4): 356–61. doi:10.2174/157488810793351668. PMID 20528762.
Private cord blood banking (also known as family banking), is preferred for families in a situation, where they currently have a family member suffering from a genetic disorder or have a family history of this type of disorder. By using a private cord blood bank, such as CariCord, your baby’s cord blood and tissue are stored for exclusive use by your family. It will always be there and readily available if it is ever needed. If it is donated to a public bank it can be accessed by anyone who is a match to it and there are no guarantees that it would be available, should your family ever need it later.
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.
CBR collection kits have been designed to shield the samples from extreme temperatures (shielding for more than 1 hour at extreme hot and cold). Samples remain at room temperature and are shipped directly to the CBR lab for processing.
Donating cord blood to a public bank adds to the supply and can potentially help others. Donating to a public bank is especially important for ethnic minorities, who are not well represented in cord blood banks. Public cord blood donation increases the chance of all groups finding a match.
When a patient needs bone marrow for a transplant, stem cells are thawed and injected into the bloodstream. The cells then make their way to the bone marrow, and start producing new blood cells – this process usually takes a few weeks.
The choices expectant parents make today go beyond finding out the gender of their baby. They span beyond deciding whether to find out if their child, still in the womb, may potentially have a genetic disorder. Today, many parents must decide whether to store their baby’s umbilical cord blood so it will be available to heal their child if at any point in the child’s lifetime he or she becomes sick.
The proteins stem from three HLA genes, and you inherit one HLA from each parent, or half your HLA markers from your mother and half from your father. This gives siblings a 25 percent chance of being a perfect match, a 50 percent chance of being a partial match and another one-in-four chance of not being a match at all. Unfortunately, about seven out 10 patients who need a transplant don’t have a suitable donor in their family. They can either rely on their own stem cells, isolated before treatment or previously preserved, or try to find a match through a public donor.
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.
^ a b Walther, Mary Margaret (2009). “Chapter 39. Cord Blood Hematopoietic Cell Transplantation”. In Appelbaum, Frederick R.; Forman, Stephen J.; Negrin, Robert S.; Blume, Karl G. Thomas’ hematopoietic cell transplantation stem cell transplantation (4th ed.). Oxford: Wiley-Blackwell. ISBN 9781444303537.
nbiased and factual information. The Foundation educates parents, health professionals and the general public about the need to preserve this valuable medical resource while providing information on both public cord blood donation programs and private family cord blood banks worldwide. Learn more about our global community.
Cord blood is one of three sources of blood-regenerating cells used in stem cell transplantation; the other two sources are bone marrow and peripheral blood stem cells. Stem cells have ability to transform themselves into different types of cells that help replace or heal impaired cells such as bone, nerve and blood cells.
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.
Stem cells are powerful, adaptable cells that can be used to promote healing and reverse damage. Stem cells are found in various places within the human body, but the purest stem cells are found in the umbilical cord.
^ 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.
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.
When doctors remove bone marrow, the patient receives anesthesia. This puts them to sleep and numbs any pain from the surgery. Doctors then insert a large needle, and pull the liquid marrow out. Once enough bone marrow is harvested, the solution is filtered and cryogenically frozen.
During the harvesting procedure, doctors use a catheter to draw out blood. The blood moves through a machine, which separates stem cells and allows these cells to be put into storage. This process takes a few hours, and may be repeated over several days in order for doctors to get enough stem cells.
Adverse effects are similar to hematopoietic stem cell transplantation, namely graft-versus-host disease if the cord blood is from a genetically different person, and the risk of severe infection while the immune system is reconstituted. There is a lower incidence with cord blood compared with traditional HSCT, despite less stringent HLA match requirements. 
Tissue 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.)
Private cord blood banking can benefit those with a strong family history of certain diseases that harm the blood and immune system, such as leukemia and some cancers, sickle-cell anemia, and some metabolic disorders. Parents who already have a child (in a household with biological siblings) who is sick with one of these diseases have the greatest chance of finding a match with their baby’s cord blood. Parents who have a family history of autism, Alzheimer’s, and type 1 diabetes can benefit from cord blood. Although these diseases aren’t currently treated with umbilical cord steam cells, researchers are exploring ways to treat them (and many more) with cord blood.