American Academy of Pediatrics Section on Hematology/Oncology, American Academy of Pediatrics Section on Allergy/Immunology, Bertram H. Lubin, and William T. Shearer, “Cord Blood Banking for Potential Future Transplantation,” Pediatrics 119 (2007): 165-170.
There are over 130 public cord blood banks in 35 countries. They are regulated by Governments and adhere to internationally agreed standards regarding safety, sample quality and ethical issues. In the UK, several NHS facilities within the National Blood Service harvest and store altruistically donated umbilical cord blood. Trained staff, working separately from those providing care to the mother and newborn child, collect the cord blood. The mother may consent to donate the blood for research and/or clinical use and the cord blood bank will make the blood available for use as appropriate.
Today, cord blood stem cells have been used in more than 35,000 transplants worldwide to regenerate healthy blood and immune systems, like in a bone marrow transplant. 1* Find out which conditions have been treated here.
They aren’t the only ones questioning the business practices of private cord-blood banks. Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) issued statements in the late 1990s opposing the use of for-profit banks — and criticizing their marketing tactics. Instead, they recommended that parents donate cord blood to public banks, which make it available for free to anyone who needs it. Globally, other organizations have done the same. Italy and France have banned private cord-blood banking altogether.
Most of the diseases on the proven treatment list are inherited genetic diseases. Typically, a child with a genetic disease would require cord blood unit from a sibling or an unrelated donor. Having a sibling cord blood unit can be a great advantage as 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
If you are interested in donating cord blood to a public bank and do not have access to a hospital that accepts cord blood donations, you can contact a lab that offers a mail-in program. After you’ve passed the lab’s eligibility screening process, they’ll send you a kit that you can use to package and mail in your cord blood.2
CBR Clients: Did you know that when you refer a friend, and they preserve their baby’s stem cells with us, you receive a free year of cord blood storage? After your first referral, you start earning even more rewards. (Exclusions apply)
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.
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.
The parents who make the decision to store their baby’s cord blood and cord tissue are thinking ahead, wanting to do right from the start (even before the start), and taking steps to do whatever they can to protect their baby down the road. Today, many conscientious parents are also considering delayed cord clamping (DCC), a practice in which the umbilical cord is not clamped immediately but rather after it continues to pulse for an average of 30 seconds to 180 seconds. Many parents don’t realize that they can delay the clamping of the cord and still bank their baby’s cord blood. As noted early, our premium processing method, PrepaCyte-CB, is able to capture more immune system cells and reduce the greatest number of red blood cell contaminants. This makes it go hand in hand with delayed cord clamping because it is not as affected by volume, effectively making up for the smaller quantity with a superior quality. You can read more about delayed cord clamping vs. cord blood banking here.
Your baby’s cord blood could be a valuable resource for another family. From foundations to non-profit blood banks and medical facilities, there are numerous locations that will collect, process, and use the stem cells from your baby’s cord blood to treat other people.
Because the body’s immune system is designed to find and get rid of what it believes to be outside contaminants, stem cells and other cells of the immune system cannot be transfused into just anyone. For stem cell transfusions of any type, the body’s immune system can mistakenly start attacking the patient’s own body. This is known as graft-versus-host disease (GvHD) and is a big problem post-transplant. GvHD can be isolated and minimal, but it can also be acute, chronic and even deadly.
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.
After your baby is born, the umbilical cord and placenta are usually thrown away. Because you are choosing to donate, the blood left in the umbilical cord and placenta will be collected and tested. Cord blood that meets standards for transplant will be stored at the public cord blood bank until needed by a patient. (It is not saved for your family.)
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.
Though uses of cord blood beyond blood and immunological disorders is speculative, some research has been done in other areas. Any such potential beyond blood and immunological uses is limited by the fact that cord cells are hematopoietic stem cells (which can differentiate only into blood cells), and not pluripotent stem cells (such as embryonic stem cells, which can differentiate into any type of tissue). Cord blood has been studied as a treatment for diabetes. However, apart from blood disorders, the use of cord blood for other diseases is not in routine clinical use and remains a major challenge for the stem cell community.
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.
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.
Cord blood holds promise for future medical procedures. Scientists are still studying more ways to treat more diseases with cord blood. At Duke University, for example, researchers are using patients’ own cord blood in trials for cerebral palsy and Hypoxic ischemic encephalopathy (a condition in which the brain does not receive enough oxygen). Trials are also under way for the treatment of autism at the Sutter Neuroscience Institute in Sacramento, California.
Umbilical cord blood can save lives. Cord blood is rich in stem cells that can morph into all sorts of blood cells, which can be used to treat diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. There are a few ways for transplant patients to get blood cells (umbilical and placenta, bone marrow, peripheral/circulation), but cord blood is easier to match with patients, and because it is gathered during birth from the umbilical cord, it’s a painless procedure.
Companies throughout Europe also offer commercial (private) banking of umbilical cord blood. A baby’s cord blood is stored in case they or a family member develop a condition that could be treated by a cord blood transplant. Typically, companies charge an upfront collection fee plus an annual storage fee.
In addition to the stem cells, researchers are discovering specific uses for the other types of cells in the treatment of certain conditions. Cord blood Treg cells hold potential for preventing graft-versus-host disease in stem cell transplantations and ameliorating the effects of autoimmune diseases such as diabetes, rheumatoid arthritis and multiple sclerosis. Cord blood natural killer cells also hold future potential. These cells have been programmed to target specific cancers and tumors in clinical trials. This could make them exceptionally strong candidates for chronic or treatment-resistant cases of cancer.
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 diseases2, 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 term “Cord Blood harvesting” has a slightly morbid sound, but in reality, it is a very worthwhile and potentially lifesaving field of medical science. Umbilical Cord blood is blood that remains in the umbilical cord after birth. This umbilical cord blood is full of…
While cord-blood companies herald the possible future treatments of many adult diseases with stem cells, they rarely mention a key issue. Researchers have greater hopes for the potential of embryonic stem cells, which are thought to have the ability to develop into many different types of cells. It is not known whether the stem cells in cord blood have that ability; until recently, it was thought that they (like those in bone marrow) could only regenerate blood and immune cells.
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.)
Preserving stem cells does not guarantee that the saved stem cells will be applicable for every situation. Ultimate use will be determined by a physician. Please note: Americord Registry’s activities are limited to collection of umbilical cord tissue from autologous donors. Americord Registry’s possession of a New York State license for such collection does not indicate approval or endorsement of possible future uses or future suitability of cells derived from umbilical cord tissue.
Brigham and Women’s Hospital and Dana-Farber Cancer Institute jointly oversee the Cord Blood Donation Program to provide hope to all patients in need of a life-saving stem cell transplant. For more information about the stem cell transplant program please visit The Stem Cell/Bone Marrow Transplant Program at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) web site.
While the transplantation of cord blood has its advantages, its main disadvantage is the limited amount of blood contained within a single umbilical cord. Because of this, cord blood is most often transplanted in children. Physicians are currently trying to determine ways that cord blood can be used in larger patients, such as transferring two cord blood units or increasing the number of cells in vitro before transplanting to the patient. It also takes longer for cord blood cells to engraft. This lengthier period means that the patient is at a higher risk for infection until the transplanted cells engraft. Patients also cannot get additional donations from the same donor if the cells do not engraft or if the patient relapses. If this is the case, an additional cord blood unit or an adult donor may be used. While cord blood is screened for a variety of common genetic diseases, rare genetic diseases that manifest after birth may be passed on. The National Cord Blood Program estimates that the risk of transmitting a rare genetic disorder is approximately 1 in 10,000.
Upon arrival at CBR’s laboratory, the kit is immediately checked in and inspected. Next, the cord blood unit is tested for sterility, viability, and cell count. In addition, the cord tissue is tested for sterility. CBR processes cord blood using the AutoXpress® Platform* (AXP®) – a fully automated, functionally closed stem cell processing technology. The AXP platform is an integral component of CBR’s proprietary CellAdvantage® system. CBR has the industry’s highest published average cell recovery rate of 99%.
There are some diseases on the list (like neuroblastoma cancer) where a child could use his or her own cord blood. However, most of the diseases on the proven treatment list are inherited genetic diseases. Typically, a child with a genetic disease would require a cord blood unit from a sibling or an unrelated donor.
The standard used to identify these cord blood banks was the number of cord blood and cord tissue units stored by each company. The purpose of this analysis is to compare pricing and services among the largest cord blood banks within the U.S., the most mature cord blood banking market in the world. These three industry giants also represent several of the largest cord blood banks worldwide.
Private cord blood banks allow families to store cord blood stem cells for themselves and their loved ones. They are privately funded, and typically charge a first-year processing fee that ranges from about $1,400 to $2,300, plus annual storage costs of about $115 to $175. (Americord offers cord blood banking for a one-time fee of $3,499, which includes 20 years of storage). The pros and cons of private cord blood banking are listed below.
To learn more about umbilical cord blood and banking please watch Banking on cord blood, Cord blood – banking and uses, Cord blood transplantation – how stem cells can assist in the treatment of cancer in our video library.
“One of the wonderful things about cord blood is that unlike bone marrow, you don’t always need a perfect match in order for it to work,” says Dr. Kurtzberg, who performed the first unrelated cord-blood transplant in the U.S. And it was a public donation that ultimately saved Anthony Dones. Within a week of starting a search, the National Cord Blood Program, a public bank operated by the New York Blood Center, found a “close enough” match. Had the now-3-year-old been forced to rely on a bone-marrow match, he might still be waiting.
/en/public-bankingM.D. Anderson hospital has the largest stem cell transplantation program in the world, and in April 2005 they established a public cord blood bank that is accredited under the international FACT/Netcord standards.
As your baby’s birth approaches, think about making a cord blood donation. You have the power to Give Life to patients like Jessica. Because two babies’ families gave life through cord blood donation, she can watch her own children grow up.