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The Medical Letter On Drugs and Therapeutics also recently addressed aspects of public and private cord blood banks, asking the question: “Does Private Banking Make Sense?” After citing various statistics on the actual uses of privately stored cord blood, they concluded that: “At the present time, private storage of umbilical cord blood is unlikely to be worthwhile. Parents should be encouraged to contribute, when they can, to public cord blood banks instead.” [Access The Medical Letter at www.medicalletter.org].
Beyond these blood-related disorders, the therapeutic potential of umbilical cord blood stem cells is unclear. No therapies for non-blood-related diseases have yet been developed using HSCs from either cord blood or adult bone marrow. There have been several reports suggesting that umbilical cord blood contains other types of stem cells that are able to produce cells from other tissues, such as nerve cells. Some other reports claim that umbilical cord blood contains embryonic stem cell-like cells. However, these findings are highly controversial among scientists and are not widely accepted.
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?
There has been considerable debate about the ethical and practical implications of commercial versus public banking. The main arguments against commercial banking have to do with questions about how likely it is that the cord blood will be used by an individual child, a sibling or a family member; the existence of several well-established alternatives to cord blood transplantation and the lack of scientific evidence that cord blood may be used to treat non-blood diseases (such as diabetes and Parkinson’s disease). In some cases patients may not be able to receive their own cord blood, as the cells may already contain the genetic changes that predispose them to disease.
Lack of awareness is the #1 reason why cord blood is most often thrown away. For most pregnant mothers, their doctor does not even mention the topic. If a parent wants to save cord blood, they must be pro-active.
Marketing materials by Viacord and Cord Blood Registry, the two largest companies, do not mention that cord blood stem cells cannot be used by the child for genetic diseases, although the fine print does state that cord blood may not be effective for all of the listed conditions.
In the United States, the Food and Drug Administration regulates any facility that stores cord blood; cord blood intended for use in the person from whom it came is not regulated, but cord blood for use in others is regulated as a drug and as a biologic. Several states also have regulations for cord blood banks.
Unlike some other cord blood banks, Cryo-Cell does not charge any upfront enrollment fees. You’ll be charged only after your baby’s cord blood and cord tissue have been processed and we’ve confirmed that the collection meets our high standards for viability and the number of stem cells. If for any reason your collection falls below our standards, we will notify you promptly and let you make a decision whether to continue to cryo-preserve your baby’s stem cells. Our processing fees include the first year of storage. After the first year, you can continue to pay for the storage annually or pre-pay for storage at a significantly discounted price and for added convenience. Our annual storage fees are fixed for the life of your contract.
In terms of performance, our PrepaCyte-CB processing method has taken the lead. PrepaCyte-CB greatly improves on parents’ returns on investment because it yields the highest number of stem cells while showing the greatest reduction in red blood cells.1–4 Clinical transplant data show that cord blood processed with PrepaCyte-CB engrafts more quickly than other processing methods.7 This means patients may start feeling better more quickly, may spend less time in the hospital and are less likely to suffer from an infection. The ability to get better more quickly and a reduced chance of infection can prove vital in certain cases. Learn more about PrepaCyte®-CB here.
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.
Most of the diseases on the proven treatment list are inherited genetic diseases. Typically, these treatments require a donor transplant, as from a sibling. In fact, research shows that treatments using cord blood from a family member are about twice as successful as treatments using cord blood from a non-relative.9a, 17 To date, over 400 ViaCord families have used their cord blood 56% were for transplant.1
A limitation of cord blood is that it contains fewer HSCs than a bone marrow donation does, meaning adult patients often require two volumes of cord blood for treatments. Researchers are studying ways to expand the number of HSCs from cord blood in labs so that a single cord blood donation could supply enough cells for one or more HSC transplants.
Most public banks only work with selected hospitals in their community. They do this because they need to train the staff who will collect the cord blood, and they want the blood to be transported to their laboratory as quickly as possible. A parent who wants to donate should start by finding public banks in your country.
This and all other stem cell therapies since involve introducing new stem cells into the area to encourage the healing process. Often, the stem cell will create a particular type of cell simply because it is in proximity to other cells of that type. Unfortunately, researchers still had a ways to go before they could use stem cells from unrelated persons.
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.
Sign a consent form to donate. This consent form says that the donated cord blood may be used by any patient needing a transplant. If the cord blood cannot be used for transplantation, it may be used in research studies or thrown away. These studies help future patients have a more successful transplant.
The therapeutic potential of stem cells from the umbilical cord is vast. Cord blood is already being used in the treatment of nearly 80 life-threatening diseases,2 and researchers continue to explore it’s potential. Duke University Medical Center is currently using cord blood stem cells in a Phase II clinical trial to see if it benefits kids with Autism. The number of clinical trials using cord tissue stem cells in human patients has increased to approximately 150 since the first clinical trial in 2007. Cord tissue stem cells are also being studied for the potential use in kids with Autism – a Phase I Clinical Trial is underway.
The procedure for peripheral blood harvesting is easier on the patient than a bone marrow transplant, and stem cell transplants are faster. However, the chances for graft-versus-host disease, where donated cells attack the patient’s body, are much higher after a peripheral blood transplant.
The blood that remains in the umbilical cord and the placenta after birth is called “cord blood”. Umbilical cord blood, umbilical cord tissue, and the placenta are all very rich sources of newborn stem cells. The stem cells in the after birth are not embryonic. Most of the stem cells in cord blood are blood-forming or hematopoietic stem cells. Most of the stem cells in cord tissue and the placenta are mesenchymal stem cells.
Women thinking about donating their child’s cord blood to a public bank must pass certain eligibility requirements. While these vary from bank to bank, the following list shows general health guidelines for mothers wanting to donate.
We offer standard and premium processing options for our cord blood service. The standard cord blood processing method has been in place since 1988 and thousands of transplants using this method have been successful. Our premium service uses a superior new type of processing, which greatly enhances your return on investment and captures more stem cells (what you want) while reducing the number of red blood cells and other contaminants (what you don’t want). Please visit our processing technology page to learn about our standard and premium processing methods.
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.
While most people have a small amount of stem cells in their bloodstream, donors produce more stem cells after taking growth factor hormones. Doctors give these medications a few days before stem cell harvesting, which makes the bone marrow push more cells into the bloodstream.
When the medical courier delivers the cord blood collection kit to the cord blood bank, it is quickly processed to ensure the continued viability of the stem cells and immune system cells found in the cord blood. Firstly, a sample of the cord blood is tested for microbiological contamination, and the mother’s blood is tested for infectious diseases. As these tests are being conducted, the cord blood is processed to reduce the number of red blood cells and its total volume and isolate the stem cells and immune cells.
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.
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.
To explain why cord blood banking is so expensive in the United States, we wrote an article with the CEO of a public cord blood bank that lists the steps in cord blood banking and itemizes the cost of each one.
iPS cells are artificially-made pluripotent stem cells. This technique allows medical staff to create additional pluripotent cells, which will increase treatment options for patients using stem cell therapy in the near future.
Lead image of baby’s umbilical cord from Wikimedia Commons. Possible human blood stem cell image by Rajeev Gupta and George Chennell. Remaining images of blood sample bags and red blood cells from Wellcome Images.
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.
Several research teams have reported studies in animals suggesting that cord blood can repair tissues other than blood, in diseases ranging from heart attacks to strokes. These findings are controversial: scientists often cannot reproduce such results and it is not clear HOW cord blood may be having such effects. When beneficial effects are observed they may be very slight and not significant enough to be useful for developing treatments. If there are positive effects, they might be explained not by cord blood cells making nerve or heart cells, but by the cells in the cord blood releasing substances that help the body repair damage.
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.
MSCs can turn into bone, cartilage, fat tissue, and more. Although they are associated with bone marrow, these cells are also found in umbilical cord blood. These cells can function as connective tissue, which connects vital organs inside the body. Like HSCs, MSCs are multipotent.
Depending on the predetermined period of storage, the initial fee can range from $900 to $2100. Annual storage fees after the initial storage fee are approximately $100. It is common for storage facilities to offer prepaid plans at a discount and payment plans to help make the initial storage a more attractive option for you and your family.
The mother signs an informed consent which gives a “public” cord blood bank permission to collect the cord blood after birth and to list it on a database that can be searched by doctors on behalf of patients. The cord blood is listed purely by its genetic type, with no information about the identity of the donor. In the United States, Be The Match maintains a national network of public cord blood banks and registered cord blood donations. However, all the donation registries around the world cooperate with each other, so that a patient who one day benefits from your child’s cord blood may come from anywhere. It is truly a gift to the benefit of humankind.
Cord blood donation doesn’t cost anything for parents. Public cord blood banks pay for everything which includes the collection, testing, and storing of umbilical cord blood. This means that cord blood donation is not possible in every hospital.
The range of diseases that doctors can treat with cord blood is vast. More than 80 diseases are currently known to respond to cord blood stem cells transplants and, as more are studied and tested, that number is sure to grow.
We have 12- and 24-month in-house payment plans to spread the initial cost out over time. They require no credit check and begin with little money down. Starting at approximately $2.50 a day, you can help safeguard your baby’s future. After the term of the payment plan, you are then only responsible for the annual storage fee, which begins at approximately $12 a month depending on which services you have chosen.
The process is safe, painless, easy and FREE. Your physician or midwife collects the cord blood after your baby has delivered, so it does not interfere with the birthing process. The collection will not take place if there is an concern for your safety or that of your baby.
Cord blood in public banks is available to unrelated patients who need haematopoietic stem cell transplants. Some banks, such as the NHS bank in the UK, also collect and store umbilical cord blood from children born into families affected by or at risk of a disease for which haematopoietic stem cell transplants may be necessary – either for the child, a sibling or a family member. It is also possible to pay to store cord blood in a private bank for use by your own family only.
This is only the beginning. Newborn stem cell research is advancing, and may yield discoveries that could have important benefits for families. CBR’s mission is to support the advancement of newborn stem cell research, with the hope that the investment you are making now will be valuable to your family in the future. CBR offers a high quality newborn stem cell preservation system to protect these precious resources for future possible benefits for your family.