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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.
Private or family banks store cord blood for autologous use or directed donation for a family member. Private banks charge a yearly fee for storage. Blood stored in a private bank must meet the same standards as blood stored in a public bank. If you have a family member with a disorder that may potentially be treated with stem cells, some private banks will store the cord blood free of charge.
Patients with leukemia, lymphoma, or certain inherited metabolic or immune system disorders have diseased blood-forming cells. For some patients, an umbilical cord blood or bone marrow transplant (also called a BMT) may be their best treatment option.
We believe that every family should have the opportunity to preserve their baby’s newborn stem cells. That’s why CBR offers transparent costs of cord blood banking, and various payment options to fit this important step into almost every family budget.
If someone doesn’t have cord blood stored, they will have to rely on stem cells from another source. For that, we can go back to the history of cord blood, which really begins with bone marrow. Bone marrow contains similar although less effective and possibly tainted versions of the same stem cells abundant in cord blood. Scientists performed the first bone marrow stem cell transplant in 1956 between identical twins. It resulted in the complete remission of the one twin’s leukemia.
You’ve just visited the doctor and the good news is that you’re going to have a baby and everything looks good. Thirty years ago, your doctor may have given you a baby book and information about products that sponsors want you to buy for your new addition. Today, along with pretty much the same materials, you’ll be asked to consider saving the blood of your newborn that’s left over in the umbilical cord and placenta after the delivery. Another big decision, and possibly a costly one.
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.
There is little doubt that scientists believe umbilical cord blood stem cells hold promise for the future. Cord blood stem cells are already used to treat blood disorders such as aplastic anemia, and research is underway to determine if they can treat other more common conditions like type 1 diabetes. But many experts question whether many companies’s marketing materials confuse or even mislead parents about the usefulness of private banking.
If you feel that the procedure is too expensive for your child, check with the hospital to see if there are any programs and/or grants available that can assist with the procedure. Some companies do offer financial aid.
Your free donation will be part of a program that is saving lives and supporting research to discover new uses for cord blood stem cells. Units that meet criteria for storage are made available to anyone, anywhere in the world, who needs a stem cell transplant.
In Europe and other parts of the world, cord blood banking is more often referred to as stem cell banking. As banking cord blood is designed more to collect the blood-forming stem cells and not the actual blood cells themselves, this term may be more appropriate.
In the rare event of a processed sample not adhering to quality standards, CBR’s certified genetic counselors will work with potential clients to help them understand their options. Under this scenario, clients will have the option to discontinue storage and receive a refund.
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.
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].
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.
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.
The stem cells used for autologous transplantation must be relatively free of cancer cells. The harvested cells can sometimes be treated before transplantation in a process known as “purging” to get rid of cancer cells. This process can remove some cancer cells from the harvested cells and minimize the chance that cancer will come back. Because purging may damage some healthy stem cells, more cells are obtained from the patient before the transplant so that enough healthy stem cells will remain after purging.
Cord blood has an abundance of stem cells and immune system cells, and the medical uses of these cells has been expanding at a rapid pace. As these cells help the body re-generate tissues and systems, cord blood is often referred to as a regenerative medicine.
Excitement about cord tissue’s potential to help conditions affecting cartilage, muscle and nerve cells continues to grow.19 Researchers are focusing on a wide range of potential treatment areas, including Parkinson’s disease, Alzheimer’s, liver fibrosis, lung cancer, and sports injuries. Since 2007 there have been 150 clinical trials using cord tissue stem cells.
Therapies with cord blood have gotten more successful. “The outcomes of cord blood transplants have improved over the past 10 years because researchers and clinicians have learned more about dosing cord blood, picking better matches, and giving the patient better supportive care as they go through the transplant,” says Joanne Kurtzberg, M.D., director of the pediatric bone marrow and stem cell transplant program at Duke University.
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 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.
Umbilical cord blood is useful for research. For example, researchers are investigating ways to grow and multiply haematopoietic (blood) stem cells from cord blood so that they can be used in more types of treatments and for adult patients as well as children. Cord blood can also be donated altruistically for clinical use. Since 1989, umbilical cord blood transplants have been used to treat children who suffer from leukaemia, anaemias and other blood diseases.
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.
Current applications for newborn stem cells include treatments for certain cancers and blood, metabolic and immune disorders. Additionally, newborn stem cell preservation has a great potential to benefit the newborn’s immediate family members with stem cell samples preserved in their most pristine state.
As a mother-to-be, you can decide that your baby’s first act may be saving another person’s life. You can do this by choosing to donate your baby’s umbilical cord blood to the St. Louis Cord Blood Bank’s First Gift℠ Donation Program.
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.
Cord tissue is rich in another type of stem cell. Although there are no current uses, researchers are excited about the benefits cord tissue stem cells may offer in potential future users, such as regenerative medicine. By storing both, you’ll have potential access to more possibilities