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In the last 10 yr, umbilical cord blood has been shown to be therapeutically useful for rescuing patients with bone marrow-related deficits and inborn errors of metabolism. Umbilical cord blood offers advantages over bone marrow because cord blood does not require perfect human leukocyte antigen (HLA) tissue matching, has less incidence of graft vs host disease, and may be used allogenically (11,12). In addition, cord blood may be banked, and thus is available for use “off-the-shelf.” Last year, a federally supported program was established to expand the national umbilical cord blood banks to include a wide sample of HLA types. By 2004, there were more than 6000 cord blood stem cell units banked. As of January 2006, it is estimated that there are about 300,000 units in public and private banks in the United States.
The Celebration Stem Cell Centre (CSCC), offers both public donation and private “family banking” of umbilical cord blood. All cord blood collections are processed according to the highest standards in the industry in a new, state-of-the art facility located in Gilbert, Arizona. The public cord blood donation program is funded by the private “family banking” program and private philanthropy.
A large challenge facing many areas of medical research and treatments is correcting misinformation. Some companies advertise services to parents suggesting they should pay to freeze their child’s cord blood in a blood bank in case it’s needed later in life. Studies show it is highly unlikely that the cord blood will ever be used for their child. However, clinicians strongly support donating cord blood to public blood banks. This greatly helps increase the supply of cord blood to people who need it.
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.
As shown in Table 1, at least five different laboratories have extracted MSC-like cells from umbilical cord tissues. Some differences in the ease with which MSC-like cells are isolated from the various tissues are reported. Importantly, the methods for isolating MSC-like cells are robust, i.e., labs throughout the world independently isolate MSC-like cells from these tissues. This opens the door for independent verification, scalable production, and a large-team approach.
For these and other reasons, the American Academy of Pediatrics (AAP) and many physicians do not recommend private cord blood banking except as “directed donations” in cases where a family member already has a current need or a very high potential risk of needing a bone marrow transplant. In all other cases, the AAP has declared the use of cord blood as “biological insurance” to be “unwise.” [Read the AAP’s news release at http://www.aap.org/advocacy/archives/julcord.htm ]
One part of the Program, the Cord Blood Coordinating Center, has a network of cord blood banks, including some banks that get Federal support to build the NCBI. The Cord Blood Coordinating Center works with its network of cord blood banks to recruit expectant parents for umbilical cord blood donations and to distribute cord blood units listed on the registry of the C.W. Bill Young Cell Transplantation Program, also called the Be The Match Registry®. The registry is a listing of potential marrow donors and donated cord blood units.
* Disclaimer: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used. Cord tissue stem cells are not approved for use in treatment, but research is ongoing.
If you go to the hospital to deliver your baby before you are able to complete the form, inform the hospital staff that you would like to donate your baby’s cord blood and they will provide a form to be completed at that time.
There is indirect support for an immune-suppressive effect of the MSC-like cells derived from umbilical cord: two labs have transplanted UCM cells xenogenically in nonimmune-suppressed hosts without observation of frank immune rejection (25,27,28,31). In preliminary work, we have found that human UCM cells suppress the proliferation of rat splenocytes exposed to the mitogen ConA, and that a diffusible factor is likely involved (Anderson, Medicetty, and Weiss, unpublished observations). These data would support the hypothesis that UCM cells, like MSCs, may have immunosuppressive effects. We speculate that these effects may facilitate the engraftment of other therapeutic cells, that has been reported recently for co-grafts of MSC with hematopoietic cells (43).
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.
Sign a consent form. While there is a chance of the donor family using their child’s cord blood, by signing the consent form, you’re giving the public bank rights to your child’s blood. They can use it as a treatment for any patient, unless your family needs the stem cells first.
Luckily for expectant parents, cord blood can be easily collected at the baby’s birth via the umbilical cord with no harm to the mother or baby. This is why pregnancy is a great time to plan to collect and bank a baby’s cord blood.
 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.
In addition to the benefits related to transplanting HSCs derived from cord blood, HSCs are relatively easy to isolate, giving them an advantage over other adult stem cell types. Cord blood HSCs are also believed to have greater plasticity than HSCs found in bone marrow or the blood stream. The limits and possibilities of using HSCs to repair tissues and treat non-blood related disorders are currently being studied.
You and your baby’s personal information are always kept private by the public cord blood bank. The cord blood unit is given a number at the hospital, and this is how it is listed on the registry and at the public cord blood bank.
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.
It’s the First Annual #WorldCordBloodDay. Take the time today to spread awareness and learn about current cord blood applications and ground-breaking research: bit.ly/wordlcordblood… twitter.com/CordBloodDay/s…
In the body, stem cells live in specialized “niches,” microenvironments included stem cell support cells and extracellular matrix. The niche microenvironment regulates the growth and differentiation of stem cells (4–6). Understanding the role of the various “support” cells and the environment of the niche is helpful for in vitro manipulation and maintenance of stem cell populations. For example, a normal atmospheric oxygen concentration of 21% is relatively toxic to stem cells, and growth in “hyoxic” conditions of 2–3% oxygen is preferred (7). Other components of the niche, such as the extracellular matrix and growth and angiogenic factors, play a role in stem cell regulation. Understanding the stem cell microenviornment is rapidly unfolding and is an important topic which, however, is beyond the scope of this article.
For families who wish to donate cord blood to a public bank, the biggest hurdle may be finding a nearby hospital that collects cord blood for donation. Most public banks only work with select hospitals in their community. In the U.S., there are only about 200 hospitals that collect cord blood donations. Find out if there is a donation hospital near you.
Within 24 hours of giving birth, your doctor will take a small blood sample. In most cases, the blood sample is sent to the bank along with your child’s cord blood. This helps the storage facility staff when checking the blood for diseases and contamination. Some hospitals may decide to test the mother’s blood for diseases themselves.
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
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.
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.
Several groups have isolated MSC-like cells from the umbilical cord tissues or blood and have reported that those cells may express neural markers when differentiated (26,32), and differentiate into neural cells upon transplantation into rat brain. This is not too surprising, because adult bone marrow-derived MSCs injected into fetal rat brain engrafted, differentiated along neural-like lineages, and survived into the postnatal period (34). Similarly, Jiang et al. (19) demonstrated convincingly that bone marrow-derived MAPCs could be differentiated in vitro to become cells with electrophysiological properties of neurons. Increasingly, reports are indicating that bone marrow-derived cells may differentiate, first to neurospheres and then to neurons with proper neuronal electrophysiological characteristics (35,36).
Importantly, ESCs are the de facto pluripotent cells for biomedical research. Proponents state that ESCs will enable cell-based therapeutics and biopharmaceutical testing/manufacturing. In contrast, biomedical research conducted using postnatally collected tissues and stem cells has generated less controversy and enjoyed more therapeutic applications to date. This is likely owing to the fact that blood and bone marrow stem cells were found to rescue patients with bone marrow deficiencies about 40 yr ago (8,9). The result of this work produced the national bone marrow registry, which was established in the United States in 1986.
^ Jump up to: 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.
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.
Hematopoietic stem cells can be used to treat more than 70 types of diseases, including diseases of the immune system, genetic disorders, neurologic disorders, and some forms of cancer, including leukemia and lymphoma. For some of these diseases, stem cells are the primary treatment. For others, treatment with stem cells may be used when other treatments have not worked or in experimental research programs.
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.
The United States Congress saw the need to help more patients who need a bone marrow or cord blood transplant and passed the Stem Cell Therapeutic and Research Act of 2005, Public Law 109-129 (Stem Cell Act 2005) and the Stem Cell Therapeutic and Research Reauthorization Act of 2010, Public Law 111-264 (Stem Cell Act 2010). These acts include support for umbilical cord blood transplant and research.
When Tracey and Victor Dones’s 4-month-old son was diagnosed with osteopetrosis, a potentially fatal disorder that affects bone formation, the panic-stricken couple was relieved to hear that a stem-cell transplant could save his life. “We’d paid to store Anthony’s umbilical-cord blood in a private bank in case he ever needed it — and I thought we were so smart for having had the foresight to do that,” says Tracey.
Find a public bank that participates with your hospital. Public banks usually partner with specific hospitals, so you will usually only have one choice. If your hospital doesn’t partner with a public bank, or if you don’t like the facility they work with, several private banks offer a donation option, which means public banking may still be possible.
Even if you don’t want to store the cord blood, highly consider donating the cord blood to local public banks. This cord blood can help patients that are on waiting lists with diseases such as leukemia.
Tissue is typed and listed on the registry of the C.W. Bill Young Cell Transplantation Program, also called the Be The Match Registry®. (The registry is a listing of potential marrow donors and donated cord blood units. When a patient needs a transplant, the registry is searched to find a matching marrow donor or cord blood unit.) It’s frozen in a liquid nitrogen freezer and stored, so if the unit is selected as a match for a patient needing a transplant, it will be available.
A literature review revealed a question about the stability of umbilical cord cells in culture. Two groups found that the cell surface marker expression shifted over passage (28,29). Sarugaser’s (29) work indicated that HLA-1 was lost as a result of cryopreservation. Whereas, umbilical cord perivascular cells lost cell surface staining for HLA-1 with freeze–thaw, HLA-1 surface staining was consistent out to passage 5 for cells maintained in culture. In contrast, Weiss et al. (28) reported a decrease in the percentage of cells expressing CD49e and CD105 when human UCM cells were maintained in culture for passage 4–8 and no significant changes in HLA-1 expression. This question about the stability of surface marker expression may indicate that epigenetic phenomena associated with cell culture are influencing the cord MSC-like cells. Further characterization of the cord MSC-like cells is needed to understand the mechanisms of these changes.
CBR Cord Blood Education Specialists are available 7 days a week (Monday – Friday 6 AM – 9 PM PST and Saturday – Sunday 6 AM – 4 PM PST) to respond to consumer inquiries. In addition, consumers may request to schedule a call with a CBR Cord Blood Education Specialist at a specific date and time.
Cord tissue use is still in early research stages, and there is no guarantee that treatments using cord tissue will be available in the future. Cord tissue is stored whole. Additional processing prior to use will be required to extract and prepare any of the multiple cell types from cryopreserved cord tissue. Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue and long-term storage of umbilical cord–derived stem cells. Cbr Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
Carolinas Cord Blood Bank at Duke (CCBB) is headed by Dr. Joanne Kurtzberg. Expectant parents who have a child in need of therapy with cord blood, especially the new therapies in clinical trials at Duke, may be eligible for directed donation through CCBB.
Unlike other banks, CBR uses a seamless cryobag for storage. The seamless construction decreases the potential for breakage that can occur in traditional, seamed-plastic storage bags. Prior to storage, each cryobag is placed in a second overwrap layer of plastic, which is hermetically sealed as an extra precaution against possible cross contamination by current and yet unidentified pathogens that may be discovered in the future. CBR stores the stem cells in vaults, called dewars, specially designed for long-term cryostorage. The cord blood units are suspended above a pool of liquid nitrogen that creates a vapor-phase environment kept at minus 196 degrees Celsius. This keeps the units as cold as liquid nitrogen without immersing them in liquid, which can enable cross-contamination. Cryopreserved cord blood stem cells have proven viable after more than 20 years of storage, and research suggests they should remain viable indefinitely.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
Umbilical cord blood contains a large amount of stem cells. If parents sign up for personalized storage or donation, medical staff will remove stem cells from the umbilical cord and placenta. The blood is then cryogenically frozen, and put into long-term storage.
The first cord blood banks were private cord blood banks. In fact, Cryo-Cell is the world’s first private cord blood bank. It wasn’t until later that the government realized the need to preserve cord blood for research and public welfare. As a result, 31 states have adopted a law or have a piece of pending legislation that requires or encourages OBGYNs to educate expectant parents about cord blood banking and many states now have publicly held cord blood banks. As a result, parents have the option of banking their baby’s cord blood privately for the exclusive use of the child and the rest of the family or donating the cord blood to a public bank so that it can be used in research or by any patient who is a match and in need.
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.
In addition to cord blood banking as an eligible FSA expense, you can also benefit from certain tax advantages to store your baby’s cord blood. As of 2013, if your child or a family member has a medical condition that might be expected to improve (through the use of cord blood), you can deduct your out-of-pocket expenses from your income taxes!
Use for Family Siblings gain access to the stem cells, too. They have a one-in-four chance of being a perfect match amd a 39% chance of being a transplant-acceptable match. Parents have a 100 pecent chance of being a partial match. The chances of recovering the donated stem cells for a family memeber is also diminished greatly as described above. Siblings = 75% chance of acceptable match
In addition to hematopoietic cells, Mesenchymal cells derived from Wharton’s jelly are useful as feeder layers for the propagation of other stem cell types. For example, equine embryonic stem cell-like cells derived from the inner cell mass were propagated successfully for more than 350 divisions on a feeder layer derived from stem cells isolated from Wharton’s jelly of equine umbilical cords (74). The equine ES-like cells could be maintained without leukemia inhibitory factor (LIF) as long as they were on the cord matrix 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.)
Disclaimer: Any and all uses of stem cells must be at the direction of a treating physician, who will determine if they are applicable and suitable, for treatment of the condition. Additionally, there is no guarantee that any treatments being used in research, clinical trials, or any experimental procedures or treatments, for cellular therapy or regenerative medicine, will be available or approved in the future.
The University of Texas Health Science Center at Houston is conducting a pioneering FDA-regulated phase I/II clinical trial to compare the safety and effectiveness of two forms of stem cell therapy in children diagnosed with cerebral palsy. The randomized, double-blinded, placebo-controlled study aims to compare the safety and efficacy of an intravenous infusion of autologous cord blood stem cells to bone marrow stem cells.
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.
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.)
However, cord blood transplants also have limitations. Treatment of adults with cord blood typically requires two units of cord blood to treat one adult. Clinical trials using “double cord blood transplantation” for adults have demonstrated outcomes similar to use of other sources of HSCs, such as bone marrow or mobilized peripheral blood. Current studies are being done to expand a single cord blood unit for use in adults. Cord blood can also only be used to treat blood diseases. No therapies for non-blood-related diseases have yet been developed using HSCs from either cord blood or adult bone marrow.