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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.
The University of Texas Health Science Center at Houston is conducting a pioneering FDA-regulated phase I/II clinical trial to compare the safety and effectiveness of two forms of stem cell therapy in children diagnosed with cerebral palsy. The randomized, double-blinded, placebo-controlled study aims to compare the safety and efficacy of an intravenous infusion of autologous cord blood stem cells to bone marrow stem cells.
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.
Brigham and Women’s Hospital and Dana-Farber Cancer Institute jointly oversee the Cord Blood Donation Program to provide hope to all patients in need of a life-saving stem cell transplant. For more information about the stem cell transplant program please visit The Stem Cell/Bone Marrow Transplant Program at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) web site.
Stem cells from cord blood can be given to more people than those from bone marrow. More matches are possible when a cord blood transplant is used than when a bone marrow transplant is used. In addition, the stem cells in cord blood are less likely to cause rejection than those in bone marrow.
Umbilical cord blood was once discarded as waste material but is now known to be a useful source of blood stem cells. Cord blood has been used to treat children with certain blood diseases since 1989 and research on using it to treat adults is making progress. So what are the current challenges for cord blood research and how may it be used – now and in the future?
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.
CBR Clients: Did you know that when you refer a friend, and they preserve their baby’s stem cells with us, you receive a free year of cord blood storage? After your first referral, you start earning even more rewards. (exclusions apply). Refer a friend now: http://bit.ly/2JAGrcu
Your cells didn’t start out knowing how to come together to form your bones, heart or blood; they begun with more of a blank slate. These completely undifferentiated cells can be found during gestation, or the time the baby is in the womb, and are called embryonic stem cells. These early stage stem cells are master cells that have the potential to become any type of cell in the body.
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.
When a child develops a condition that can be treated with stem cells, they undergo transplant. A doctor infuses stem cells from cord blood or bone marrow into the patient’s bloodstream, where they will turn into cells that fight the disease and repair damaged cells—essentially, they replace and rejuvenate the existing immune system.
Though uses of cord blood beyond blood and immunological disorders is speculative, some research has been done in other areas. Any such potential beyond blood and immunological uses is limited by the fact that cord cells are hematopoietic stem cells (which can differentiate only into blood cells), and not pluripotent stem cells (such as embryonic stem cells, which can differentiate into any type of tissue). Cord blood has been studied as a treatment for diabetes. However, apart from blood disorders, the use of cord blood for other diseases is not in routine clinical use and remains a major challenge for the stem cell community.
Each cord blood bank has different directions for returning the consent form. Some banks may ask you to mail the consent form along with the health history forms or to bring the original consent form with you to the hospital. Other banks may have you finish the form at the hospital. Follow the directions from your public cord blood bank.
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.
Cord blood is currently approved by the FDA for the treatment for nearly 80 diseases, and cord blood treatments have been performed more than 35,000 times around the globe to treat cancers (including lymphoma and leukemia), anemias, inherited metabolic disorders and some solid tumors and orthopedic repair. Researchers are also exploring how cord blood has the ability to cross the blood–brain barrier and differentiate into neurons and other brain cells, which may be instrumental in treating conditions that have been untreatable up to this point. The most exciting of these are autism, cerebral palsy and Alzheimer’s.
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 Leading the Way LifeSaving Ambassadors Club is a recognition program honoring sponsor groups for outstanding performance in reaching or exceeding blood drive collections goals. CBC presents a Leading the Way plaque to winning sponsors on an annual basis. The award is based on three levels of achievement:
Cord blood cannot be used if the donor (baby) contains the same genetic illness as the recipient. Most cord blood banks glaze over this, but it is important to understand that the odds of using cord blood for the same child are much lower than the odds of using them for a sibling.
You certainly should, especially if you have a family history of any diseases or conditions that could be treated with cord blood stem cells. Since there is only a 25% chance of a match, you should bank the cord blood of each individual child if you have the means.
* Annual storage fees will be charged automatically to the credit/debit card on file, on or around your baby’s birthday, unless you’ve chosen a prepay option and are subject to change until they are paid.
The majority of programs that accept cord blood donations require the mother to sign up in advance. In the united States, the current requirement is to sign up by the 34th week of pregnancy. This cannot be over-stressed; time and time again, mothers who want to donate are turned away because they did not inquire about donation until it was too late.
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.
Most text on the National Cancer Institute website may be reproduced or reused freely. The National Cancer Institute should be credited as the source and a link to this page included, e.g., “Blood-Forming Stem Cell Transplants was originally published by the National Cancer Institute.”
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.
If you’re looking to attain cord blood from a public bank, be aware that matched cord blood, as with bone marrow, can be difficult to obtain through a public cord blood bank. Once a match is ascertained, it may take valuable weeks, even months, to retrieve the match, and the cost of acquiring the cord blood from a public bank can be upwards of $40,000. When the newborn’s umbilical cord blood is banked privately, they can be retrieved quickly, and since the parents own the cord blood, banks can perform the retrieval free of charge. Learn more about public versus private cord blood banking here.
Chloe Savannah Metz’ mother donated her baby girl’s cord blood to the NCBP in December 2000. “Many thanks to the New York Blood Center for giving us the opportunity to donate our cord — we hope to give someone a second chance!” – Christine Metz
The stem cells used in BMT come from the liquid center of the bone, called the marrow. In general, the procedure for obtaining bone marrow, which is called “harvesting,” is similar for all three types of BMTs (autologous, syngeneic, and allogeneic). The donor is given either general anesthesia, which puts the person to sleep during the procedure, or regional anesthesia, which causes loss of feeling below the waist. Needles are inserted through the skin over the pelvic (hip) bone or, in rare cases, the sternum (breastbone), and into the bone marrow to draw the marrow out of the bone. Harvesting the marrow takes about an hour.
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.
Another way scientists are working with stem cells is through expansion technologies that spur replication of the cord blood stem cells. If proven effective and approved by the U.S. Food and Drug Administration, these expansion technologies will allow scientists to culture many stem cells from a small sample. This could provide doctors and researchers with enough stem cells to treat multiple family members with one cord blood collection or provide the baby with multiple treatments over time. To better prepare for the day when these expansion technologies are more easily accessible, some cord blood banks have begun to separate their cord blood collections into separate compartments, which can easily be detached from the rest of the collection and used independently. You can learn more about Cryo-Cell’s five-chambered storage bag here.
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.
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.
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.
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.
BMT and PBSCT are most commonly used in the treatment of leukemia and lymphoma. They are most effective when the leukemia or lymphoma is in remission (the signs and symptoms of cancer have disappeared). BMT and PBSCT are also used to treat other cancers such as neuroblastoma (cancer that arises in immature nerve cells and affects mostly infants and children) and multiple myeloma. Researchers are evaluating BMT and PBSCT in clinical trials (research studies) for the treatment of various types of cancer.
However, the American Academy of Pediatrics strongly encourages umbilical cord donations for general research purposes. Donors are encouraged to contact a cord blood bank by the 35th week of pregnancy.
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.
The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. The purpose of this is to help with education and create better conversations between patients and their healthcare providers.
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).