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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.
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.
As noted earlier, with better matching, there is a greater chance of success and less risk of graft-versus-host disease (GvHD) in any stem cell transplant. With cord blood, the baby’s own cells are always a perfect match and share little risk. When using cord blood across identical twins, there is also a very low chance of GvHD although mutations and biological changes caused by epigenetic factors can occur. Other blood-related family members have a 35%–45% chance of GvHD, and unrelated persons have a 60%–80% chance of suffering from GvHD.
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.
^ Li, T; Xia, M; Gao, Y; Chen, Y; Xu, Y (2015). “Human umbilical cord mesenchymal stem cells: an overview of their potential in cell-based therapy”. Expert Opinion on Biological Therapy. 15 (9): 1293–306. doi:10.1517/14712598.2015.1051528. PMID 26067213.
Checked to make sure it has enough blood-forming cells for a transplant. (If there are too few cells, the cord blood unit may be used for research to improve the transplant process for future patients or to investigate new therapies using cord blood, or discarded.)
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
The immune system has a way to identify foreign cells; it’s what allows the body to defend itself. So although transplants were proving successful after the first in 1956, they were limited to twins because their shared genetic makeup made them 100 percent compatible. This took a turn in 1958, when scientists discovered a protein present on the surface of almost all cells that lets the body know if the cell is one of its own cells or a foreign cell. In 1973, we finally learned enough about these compatibility markers (called human leukocyte antigens or HLAs) to perform the first unrelated bone marrow transplant.
Banking a baby’s blood and stem cells in a cord blood bank is a type of insurance. Ideally, you would not need to access your baby’s stem cells in order to address a medical concern. However, using a cord blood bank can provide peace of mind in knowing that you have a valuable resource if you need it.
It’s now possible to preserve up to twice the number of stem cells – exclusively available through cord blood banking with Americord®. With Cord Blood 2.0™, you now have the opportunity to treat your child into adolescence and even adulthood. Learn more >
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.
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.
Since most banks require mothers to sign up for donation between the 28th and 34th week of pregnancy, families must decide to donate ahead of time. If you are considering a public bank for your child’s cord blood, contact the bank and make sure you still have time.
This is great news for families who have chosen to bank their newborn’s blood because someone in the family, typically a sibling, is suffering from a genetic disease or disorder, that cord blood is currently being used to treat.
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.
Some parents-to-be are sold on the advertising that banking their child’s cord blood could potentially treat an array of diseases the child, or his siblings, could encounter in their lives. Other parents-to-be may find all the promises too good to be true.
Find a public bank that participates with your hospital. Public banks usually partner with specific hospitals, so you will usually only have one choice. If your hospital doesn’t partner with a public bank, or if you don’t like the facility they work with, several private banks offer a donation option, which means public banking may still be possible.
HSCs can become any type of blood cell or cellular blood component inside the body, including white blood cells and red blood cells. These cells are found in umbilical cord blood and are multipotent, which means they can develop into more than one cell type.
When you bank your child’s cord blood with ViaCord, your child will have access to stem cells that are a perfect genetic match. Some cancers like neuroblastoma are autologous treatments. Ongoing regenerative medicine clinical trials are using a child’s own stem cells for conditions like autism and cerebral palsy. 104, 109 To date, of the 400+ families that have used their cord blood 44% were for regenerative medicine research.
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.
Tom Moore, CEO of Cord Blood Registry, the largest private cord blood banking firm, told ABC News conceded that there was no proof that the transplants worked, but added that there is strong anecdotal evidence.
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.
Remaining in the umbilical cord and placenta is approx. 40–120 milliliters of cord blood. The healthcare provider will extract the cord blood from the umbilical cord at no risk or harm to the baby or mother.
CBR was the first family bank accredited by AABB (formerly the American Association of Blood Banks) and the company’s quality standards have been recognized through ISO 9001:2008 certification—the global business standard for quality. The Federal Drug Administration (FDA) has issued cord blood regulations, and the states of California, Illinois, Maryland, New York and New Jersey have mandatory licensing for cord blood banking. The stringent laboratory processes, record keeping, quality control and quality assurance of CBR are designed to meet all federal and state guidelines and regulations.
Women typically sign up for cord blood banking between the 28th and 34th week of pregnancy. Some private banks will allow for early or late sign up, but most public storage facilities won’t accept any mother past her 34th week. While most banks don’t officially sign up mothers until a certain time, it’s never too early to research.
Current research aims to answer these questions in order to establish whether safe and effective treatments for non-blood diseases could be developed in the future using cord blood. An early clinical trial investigating cord blood treatment of childhood type 1 diabetes was unsuccessful. Other very early stage clinical trials are now exploring the use of cord blood transplants to treat children with brain disorders such as cerebral palsy or traumatic brain injury. However, such trials have not yet shown any positive effects and most scientists believe much more laboratory research is needed to understand how cord blood cells behave and whether they may be useful in these kinds of treatments
Another contributor to cord blood banking costs is the quality of the collection kit. Cheaper banks typically use flimsy collection kits. To insure the survival of newborn stem cells, the shipping container should be thermally insulated to maintain kit temperature during cord blood shipments.
Donating cord blood can help families and researchers. If a mother qualifies, the umbilical cord processing and storage is free, and can protect a child from over 80 different diseases. In the next several years, researchers will find new ways to treat even more conditions.
FAQ172: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.