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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.)
Because only a small amount of bone marrow is removed, donating usually does not pose any significant problems for the donor. The most serious risk associated with donating bone marrow involves the use of anesthesia during the procedure.
There is a high likelihood that immediate biological family members could benefit from the baby’s cord tissue stem cells, with parents having a 100% likelihood of being compatible, siblings having a 75% likelihood of being compatible, and grandparents having a 25% likelihood of being compatible.16,50 Another reason why parents today are choosing to bank their baby’s cord tissue for the future.
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].
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.
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.
At present, the odds of undergoing any stem cell transplant by age 70 stands at one in 217, but with the continued advancement of cord blood and related stem and immune cell research, the likelihood of utilizing the preserved cord blood for disease treatment will continue to grow. Read more about cord blood as a regenerative medicine here.
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.
NCI’s Cancer Information Service (CIS) can provide patients and their families with additional information about sources of financial assistance at 1–800–422–6237 (1–800–4–CANCER). NCI is part of the National Institutes of Health.
The Cord Blood Registry (CBR) is unique, because it is currently the world’s largest cord blood bank, with over a half-million cord blood and cord tissue units stored to date. This is substantially more than its nearest competitor, ViaCord, which has 350,000 units stored. It was recently acquired by pharmaceutical giant, AMAG Pharmaceuticals, for $700 million in June 2015.
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.
Are public banks and family banks the same, except for who may use the cord blood and the cost to the parents? No. Public banks are subject to much higher regulatory requirements, and compliance with regulations carries costs. At a family bank you pay the bank enough to cover the cost of storing your baby’s cord blood, plus they make a profit. When you donate to a public bank, it costs you nothing, but the bank pays more on processing each blood collection than at a family bank. Let’s look at the steps that take place in the laboratory.
Florida Hospital for Children is conducting an FDA-regulated phase I clinical trial to investigate the use of a child’s stem cells derived from their own cord blood as a treatment for acquired sensorineural hearing loss.
^ 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.
Another type of cell that can also be collected from umbilical cord blood are mesenchymal stromal cells. These cells can grown into bone, cartilage and other types of tissues and are being used in many research studies to see if patients could benefit from these cells too.
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.
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 some types of leukemia, the graft-versus-tumor (GVT) effect that occurs after allogeneic BMT and PBSCT is crucial to the effectiveness of the treatment. GVT occurs when white blood cells from the donor (the graft) identify the cancer cells that remain in the patient’s body after the chemotherapy and/or radiation therapy (the tumor) as foreign and attack them.
To minimize potential side effects, doctors most often use transplanted stem cells that match the patient’s own stem cells as closely as possible. People have different sets of proteins, called human leukocyte-associated (HLA) antigens, on the surface of their cells. The set of proteins, called the HLA type, is identified by a special blood test.
Clinical trials that include BMT and PBSCT are a treatment option for some patients. Information about ongoing clinical trials is available from NCI’s CIS at 1–800–422–6237 (1–800–4–CANCER) or on NCI’s website.
Sometimes, not enough cord blood can be collected. This problem can occur if the baby is preterm or if it is decided to delay clamping of the umbilical cord. It also can happen for no apparent reason. If an emergency occurs during delivery, priority is given to caring for you and your baby over collecting cord blood.
Close relatives, especially brothers and sisters, are more likely than unrelated people to be HLA-matched. However, only 25 to 35 percent of patients have an HLA-matched sibling. The chances of obtaining HLA-matched stem cells from an unrelated donor are slightly better, approximately 50 percent. Among unrelated donors, HLA-matching is greatly improved when the donor and recipient have the same ethnic and racial background. Although the number of donors is increasing overall, individuals from certain ethnic and racial groups still have a lower chance of finding a matching donor. Large volunteer donor registries can assist in finding an appropriate unrelated donor.
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.
In order to preserve more types and quantity of umbilical cord stem cells and to maximize possible future health options, Cryo-Cell’s umbilical cord tissue service provides expectant families with the opportunity to cryogenically store their newborn’s umbilical cord tissue cells contained within substantially intact cord tissue. Should umbilical cord tissue cells be considered for potential utilization in a future therapeutic application, further laboratory processing may be necessary. Regarding umbilical cord tissue, all private blood banks’ activities for New York State residents are limited to collection, processing, and long-term storage of umbilical cord tissue stem cells. The possession of a New York State license for such collection, processing and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
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.
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.
As most parents would like to bank their babies’ cord blood to help safeguard their families, it is often the cost of cord blood banking that is the one reason why they do not. Most cord blood banks have an upfront fee for collecting, processing and cryo-preserving the cord blood that runs between $1,000 and $2,000. This upfront fee often also includes the price of the kit provided to collect and safely transport the cord blood, the medical courier service used to expedite the kit’s safe shipment, the testing of the mother’s blood for any infectious diseases, the testing of the baby’s blood for any contamination, and the cost of the first full year of storage. There is then often a yearly fee on the baby’s birthday for continued storage that runs around $100 to $200 a year.
CBR created the world’s only collection device designed specifically for cord blood stem cells. CBR has the highest average published cell recovery rate in the industry – 99% – resulting in the capture of 20% more of the most important cells than other common processing methods.
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.
The other way the body creates more cells is through its stem cells, and stem cells do things a little differently. They undergo what is called asymmetric division, forming not one but two daughter cells: one cell often an exact replica of itself, a new stem cell with a relatively clean slate, and another stem cell that is ready to turn into a specific type of cell. This trait is known as self-renewal and allows stem cells to proliferate, or reproduce rapidly.
Some financial aid is available for families that opt for private cord blood banking. If you have a sick child who could benefit from umbilical cord blood, some cord blood banks offer programs in which the bank will cover free cord blood processing and storage if the baby has a biological sibling with certain diseases. Certain insurance companies may pitch in if that sibling needs to be treated with the cord blood in the near future, Dr. Verter says.
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?
^ a b c d e f Juric, MK; et al. (9 November 2016). “Milestones of Hematopoietic Stem Cell Transplantation – From First Human Studies to Current Developments”. Frontiers in Immunology. 7: 470. doi:10.3389/fimmu.2016.00470. PMC 5101209 . PMID 27881982.
As the research into umbilical cord blood and it’s therapeutic use for blood diseases has grown, so has the question as to whether people should privately store the cord blood of their offspring for future use. A recent paper on this issue by Mahendra Rao and colleagues advocates the practice of cord blood banking (for treatment of blood diseases) but in the context of public cord blood banks rather than a private cord blood banks. Any adult needing treated would need at least two cord blood samples that are immune compatible. So one sample will not be sufficient. A child might only need one cord blood sample but in the case of childhood leukaemia there is a risk that pre-leukemic cells are present in cord blood sample – and so the child could not use their own cells for therapy.
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.
After the baby is born and the umbilical cord has been cut, blood is retrieved from the umbilical cord and placenta. This process poses minimal health risk to the mother or the child. If the mother agrees, the umbilical cord blood is processed and frozen for storage by the cord blood bank. Only a small amount of blood can be retrieved from the umbilical cord and placenta, so the collected stem cells are typically used for children or small adults.
There have been several reports suggesting that cord blood may contain other types of stem cells which can produce specialised cells that do not belong to the blood, such as nerve cells. These findings are highly controversial among scientists and are not widely accepted.
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.
Umbilical cord blood stem cells have the unique ability to help rebuild a healthy immune system damaged by disease. Cord blood has been used in transplant medicine for nearly 30 years and can be used in the treatment of nearly 80 different diseases today.1 Over the last few years, cord blood use has expanded beyond transplant medicine into clinical research trials for conditions like autism and brain injuries.
Cord blood is collected by your obstetrician or the staff at the hospital where you give birth. Not all hospitals offer this service. Some charge a separate fee that may or may not be covered by insurance.
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.
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.