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So what are your options? You have three choices. One is to store the cord blood with a private company at a cost to you ranging from $1,500 to $2,500 and an annual storage fee in the ballpark of $125. Secondly, you can donate the cord blood to a public bank, if there is one working with your hospital, and your doctor is on board with the idea. There are also public banks that accept mail-in donations, if you register during your second trimester and your doctor is willing to take a short training class on-line. Zero cost to you. The third option is to do nothing and have the cord blood, umbilical cord, and placenta destroyed as medical waste.
Prior to freezing the cells, samples are taken for quality testing. Banks measure the number of cells that are positive for the CD34 marker, a protein that is used to estimate the number of blood-forming stem cells present. Typical cost, $150 to $200 per unit. They also measure the number of nucleated cells, another measure of stem cells, both before and after processing to determine the cell recovery rate. Typical expense, $35 per unit. A portion of the sample is submitted to check that there is no bacterial or fungal contamination. Typical expense, $75 per unit. Public banks will also check the ability of the sample to grow new cells by taking a culture called the CFU assay. Typical expense, $200 to $250 per unit.
Blood from the umbilical cord and placenta is put into a sterile bag. (The blood is put into the bag either before or after the placenta is delivered, depending upon the procedure of the cord blood bank.)
Potential long-term risks include complications of the pretransplant chemotherapy and radiation therapy, such as infertility (the inability to produce children); cataracts (clouding of the lens of the eye, which causes loss of vision); secondary (new) cancers; and damage to the liver, kidneys, lungs, and/or heart.
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.
Donors to public banks must be screened for blood or immune system disorders or other problems. With a cord blood donation, the mother’s blood is tested for genetic disorders and infections, and the cord blood also is tested after it is collected. Once it arrives at the blood bank, the cord blood is “typed.” It is tracked by a computer so that it can be found quickly for any person who matches when needed.
Umbilical cord blood is blood that remains in the placenta and in the attached umbilical cord after childbirth. Cord blood is collected because it contains stem cells, which can be used to treat hematopoietic and genetic disorders.
In Europe, Canada, and Australia use of cord blood is regulated as well. In the United Kingdom the NHS Cord Blood Bank was set up in 1996 to collect, process, store and supply cord blood; it is a public cord blood bank and part of the NHS.
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.
Cord blood contains mesenchymal stem cells but is much more abundant in hematopoietic stem cells. Cord tissue, on the other hand, contains some hematopoietic stem cells but is much richer in mesenchymal stem cells. Cord tissue, or Wharton’s jelly, is the protective layer that covers the umbilical cord’s vein and other vessels. Its MSCs can become a host of cells including those found in the nervous system, sensory organs, circulatory tissues, skin, bone, cartilage, and more. MSCs are currently undergoing clinical trials for sports injuries, heart and kidney disease, ALS, wound healing and autoimmune disease. As with cord blood, cord tissue is easily collected at the type of birth and holds great potential in regenerative medicine. Learn more about cord tissue banking here.
Pregnant women sometimes have questions or concerns regarding umbilical cord blood donation. Two common questions are: Can their infant’s cord blood be used to benefit MS research? Another question: Is it worthwhile to “bank” their infant’s umbilical cord blood for the benefit of a family member who might need the umbilical stem cells for future treatment of their MS?
Public cord blood banks store cord blood for allogenic transplants. They do not charge to store cord blood. The stem cells in the donated cord blood can be used by anyone who matches. Some public banks will store cord blood for directed donation if you have a family member who has a disease that could potentially be treated with stem cells.
Because of the invasive procedure required to obtain the bone marrow, scientist continued to look for a better source, which eventually lead to the discovery of similar stem cells in cord blood in 1978. Cord blood was used in its first transplant in 1988, and cord blood has since been shown to be more advantageous than other means of acquiring similar stem cells and immune system cells. This is because umbilical cord blood can be considered naïve and immature compared to other sources. Cord blood has not been exposed to disease or environmental pollutants, and it is more accepting of foreign cells. In this case, inexperience makes it stronger.
An HLA match helps ensure the body accepts the new cell and the transplant is successful. It also reduces the risk of graft-versus-host disease (GVHD), which is when the transplanted cells attack the recipient’s body. GVHD occurs in 30%–40% of recipients when they aren’t a perfect match but the donor is still related. If the donor and recipient are not related, it increases to a 60%–80% risk. The better the match, the more likely any GVHD symptoms will be mild, if they suffer from GVHD at all. Unfortunately, GVHD can also be deadly.
After being treated with high-dose anticancer drugs and/or radiation, the patient receives the stem cells through an intravenous (IV) line just like a blood transfusion. This part of the transplant takes 1 to 5 hours.
Pro: It gives you that peace of mind that if anything did happen to your child, the doctors would have access to their blood. This could potentially be a great benefit, and you would have no idea what would have happened if it weren’t for this blood.
The cord blood of your baby is an abundant source of stem cells that are genetically related to your baby and your family. Stem cells are dominant cells in the way they contribute to the development of all tissues, organs, and systems in the body.
The American Pediatric Association in 2008 recommended that physicians recommend that cord blood be donated instead of saved privately for family families. One of the major proponents for this was Joanne Kurtzberg, who profited from this by getting funding for her public cord blood bank at Duke University. She has since started her own private cord blood bank after doing more research on Cerebral Palsy. Interesting.
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.
Since 1989, umbilical cord blood has been used successfully to treat children with leukaemia, anaemias and other blood diseases. Researchers are now looking at ways of increasing the number of haematopoietic stem cells that can be obtained from cord blood, so that they can be used to treat adults routinely too.
There are several cord blood banks that are accredited by the American Association of Blood Banks. Most offer information on cord blood banking and provide private cord blood banking services. With a little research, you should be able to locate a credible cord blood bank online.
Families have the additional option of storing a section of the umbilical cord, which is rich in unique and powerful stem cells that may help repair and heal the body in different ways than stem cells derived from cord blood.
It’s hard to ignore the ads for cord blood banks, offering a lifetime of protection for your children. If you’re an expectant mom, there’s information coming at you constantly from your doctor’s office, magazines, online, and perhaps even your yoga class.
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.
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 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.
With allogeneic transplants, GVHD sometimes develops when white blood cells from the donor (the graft) identify cells in the patient’s body (the host) as foreign and attack them. The most commonly damaged organs are the skin, liver, and intestines. This complication can develop within a few weeks of the transplant (acute GVHD) or much later (chronic GVHD). To prevent this complication, the patient may receive medications that suppress the immune system. Additionally, the donated stem cells can be treated to remove the white blood cells that cause GVHD in a process called “T-cell depletion.” If GVHD develops, it can be very serious and is treated with steroids or other immunosuppressive agents. GVHD can be difficult to treat, but some studies suggest that patients with leukemia who develop GVHD are less likely to have the cancer come back. Clinical trials are being conducted to find ways to prevent and treat GVHD.
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.
Banking cord blood is a new type of medical protection, and there are a lot of questions that parents may want to ask. The Parent’s Guide to Cord Blood organization even has questions it believes all parents should ask their cord blood banks. We have answers to these and other frequently asked cord blood questions in our FAQs. If you can’t find the answer for which you are looking, please feel free to engage one of our cord blood educators through the website’s chat interface.
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