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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.
Tracey Dones of Hicksville, N.Y., paid to bank her son Anthony’s cord blood. But four months after he was born, Anthony was diagnosed with osteopetrosis, a rare disease that causes the body to produce excess bone, leads to blindness, and can be fatal if left untreated.
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.
Stem cell transplants from a related family member are less likely to be rejected, therefore having your baby’s stem cells available makes it less likely you would have to search for an unrelated donor who is a match
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.
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.
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.
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.
One potentially eligible expense with your Medical FSA that many families are not aware of is umbilical cord blood and tissue banking! Fees for storing umbilical cord blood and tissue to be used for surgery of the child or a family member in the near future (generally within one year) are an eligible medical expense.
CBR is committed to advancing the science of newborn stem cells. We’ve awarded a grant to the Cord Blood Association, to help fund a multi-center clinical trial researching the use of cord blood for children with autism and cerebral palsy.
As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
There’s a network of public cord blood banks in the United States that can take your donation. Most public banks are nonprofit organizations, and all public cord blood banks must meet stringent quality standards.
Since 1988, cord blood transplants have been used to treat over 80 diseases in hospitals around the world. Inherited blood disorders such as sickle cell disease and thalassemia can be cured by cord blood transplant. Over the past decade, clinical trials have been developing cord blood therapies for conditions that affect brain development in early childhood, such as cerebral palsy and autism.
We have shown that porcine UCM stem cells can be xeno-transplanted into nonimmune-suppressed rats, where they engrafted, proliferated in a controlled fashion, and exhibited TH expression in some cells (27). Most recently, our lab (28), and others (31) have reported that UCM cells ameliorate behavioral deficits in the hemi-parkinsonian rat, and UCM cell transplantation resulted in significantly more dopaminergic neurons in the substantia nigra compared with lesioned, nontransplanted rats that responded to the transplant (28). In contrast with our work, in which UCM cells were transplanted without prior differentiation, Fu et al. (31) subjected UCM cells to an in vitro induction protocol utilizing neuronconditioned media, sonic hedgehog, and fibroblast growth factor (FGF)-8 to increase the number of tyrosine hydroxylasepositive cells. After transplantation of these predifferentiated human UCMS cells into hemi-parkinsonian rats, Dr. Fu’s lab reported that they prevented the progressive degeneration/ deterioration in their Parkinson’s disease model.
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.
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.
HSCs can become any type of blood cell or cellular blood component inside the body, including white blood cells and red blood cells. These cells are found in umbilical cord blood and are multipotent, which means they can develop into more than one cell type.
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.
Then, the cord blood is listed on a national registry. Be The Match is the name of the U.S. registry. This organization also partners with international programs, which means your child’s stem cells could be used to treat a patient on the other side of the world.
Cord blood, which is harvested from the umbilical cord right after a baby is born, is marketed as a treatment for diseases such as leukemia and sickle cell disease, and as a potential source of cells for regenerative medicine – a cutting-edge field of medicine studying how to repair tissues damaged by everything from heart disease to cerebral palsy.
Collection hospitals for the NY Blood Center do NOT require advance registration: mothers can give a partial consent to collect the cord blood during labor, and only if the collected cord blood is suitable for transplantation will the mothers will be given additional education and asked for a final banking consent post-delivery.
Private cord blood banking costs $2,000 to $3,000 for the initial fee, and around another $100 per year for storage. While that may seem like a hefty price tag, many expectant parents may see it as an investment in their child’s long-term health.
You must complete the medical health questionnaire regarding your pregnancy and the medical history of your family, preferably before your deliver. This form asks for information about your health, your pregnancy, and the medical history of your family. These questions are similar to the questions asked of volunteer blood donors, and some are of a personal nature. This information will be kept strictly confidential. Get a medical history questionnaire prior to delivery.
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.
Cancellations prior to CBR’s storage of the samples(s) are subject to an administrative fee of $150. If you terminate your agreement with CBR after storage of the sample(s), you will not receive a refund.
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.
Throughout pregnancy your baby’s umbilical nurtures life. It’s carries oxygen rich cells and nutrients from your placenta to your baby, and then allows your baby to pump deoxygenated and nutrient depleted blood back to your placenta. This constant exchange is protected by a special type of tissue that acts like a cushion, preventing twisting and compression to ensure that the cord blood flow remains steady and constant.
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
The umbilical cord blood contains haematopoietic stem cells – similar to those found in the bone marrow – and which can be used to generate red blood cells and cells of the immune system. Cord blood stem cells are currently used to treat a range of blood disorders and immune system conditions such as leukaemia, anaemia and autoimmune diseases. These stem cells are used largely in the treatment of children but have also started being used in adults following chemotherapy treatment.
In 2003, we reported that UCM cells can be induced in vitro to become cells with morphological and biochemical characteristics of neurons (26). These findings have been extended by others, for example, neurons (30–32), cardiac muscle, bone, and cartilage (29,32). Using two in vitro differentiation methods, Wang et al. (32) found that umbilical cord matrix stem (UCMS) cells could be induced to exhibit cardiomyocyte morphology and synthesize cardiac muscle proteins such as N-cadherin and cardiac troponin I. The cells responded to five azacytidine or culture in cardiomyocyte-conditioned media. Fu et al. (30) used media conditioned by primary rat brain neurons to induce human UCMS cells to synthesize NeuN neurofilament. Furthermore, they could invoke an inward current in UCM cells with glutamate. In that report, exposure to neural-conditioned media also increased the proportion of cells synthesizing the astroglial protein glial fibrillary acidic protein (GFAP) from 94% initially to 5% after 9 d, although the percentage had declined to about 2% by day 12. The multilineage potential of UCMS cells was also verified by Wang and colleagues (32), who showed that they could be induced in vitro into chondrogenic, osteogenic, and adipogenic lineages.
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
Your baby’s newborn stem cells are transported to our banking facilities by our medical courier partner, and you can receive tracking updates. Each sample is processed and stored with great care at our laboratory in Tucson, Arizona. CBR’s Quality Standard means we test every cord blood sample for specific quality metrics.
The European Group on Ethics in Science and New Technologies (EGE) has also adopted a position on the ethical aspects of umbilical cord blood banking. The EGE is of the opinion that “support for public cord blood banks for allogeneic transplantations should be increased and long term functioning should be assured.” They further stated that “the legitimacy of commercial cord blood banks for autologous use should be questioned as they sell a service which has presently no real use regarding therapeutic options.”
Clinical Trials More likely to be used in clinical trials to potentially treat strokes, heart attacks, diabetes, cerebral palsy, autism and a range of other serious medical conditions Less likely to be available to the donor or family members for use in clinical trials More likely to be used in clinical trials for range of other serious medical conditions Less likely to be available for use in clinical trials
Cord blood is used the same way that hematopoietic stem cell transplantation is used to reconstitute bone marrow following radiation treatment for various blood cancers, and for various forms of anemia. Its efficacy is similar as well.