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Mother’s Day is just around the corner and we are celebrating by sharing one of our employee’s journey as a new mom. Tiffany shares 5 things she’s learned being a new parent to a 6 month old. Can you relate?
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.
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Once donated cord blood is listed on the Be the Match registry, doctors can access it to treat patients who need stem cell transplants. Public cord blood banks keep the names of both mothers and babies confidential to protect the privacy of families.
This is the time of year when many employers and insurance companies hold open enrollment for insurance plans, for the upcoming year. Along with the usual medical, dental, and life insurance plans, many families also opt to enroll in a Medical Flexible Spending Account (or FSA). This type of account offers tax advantages for eligible healthcare costs throughout the year for you and all your dependents. Your Medical FSA is funded by pre-taxed payroll deductions in the amount you choose and covers a wide range of eligible medical expenses including those that result from the diagnosis, care, treatment, or prevention of disease or illness.
A bone marrow or cord blood transplant replaces diseased blood-forming cells with healthy cells. Cells for a transplant can come from the marrow of a donor or from the blood of the umbilical cord collected after a baby is born. Sometimes special qualities of umbilical cord blood make it a better choice of blood-forming cells for transplant.
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.
Dr. C. L. Cetrulo is thanked for critically reviewing the manuscript. Thanks to Dr. M. S. Rao and the members of the stem cell laboratory at NIA for their hospitality during my sabbatical leave and their continued assistance with this work. Thanks to my wife, Betti, and my children, Rita, Jonathan, Ellen, and James, for their patience and understanding. Dr. S. Bennet is thanked for assisting with umbilical cord collection. The anonymous donors are thanked for donating their umbilical cords. The Midwest Institute for Comparative Stem Cell Biology members who contributed to this work: M. Pyle, J. Hix, R. Rakasheklar, D. Davis, R. Carlin, D. Davis, S. Medicety, K. Seshareddy, C. Anderson, and M. Burton are thanked for their assistance. Thanks to our collaborators at ViaCell, Inc. (E. Abraham and A. Krivtsov, M. Kraus, S. Wnendt, and J. Visser) and at Athersys, Inc. (R. Deans and A. Ting) for their assistance and support. Drs. H. Klingemann (Tufts) and F. Marini (MD Anderson) are thanked for sharing the results of their ongoing work. This work was supported by National Institutes of Health (NIH) (salary support during sabbatical leave), Department of Anatomy and Physiology, College of Veterinary Medicine Dean’s office, Terry C. Johnson center for Basic Cancer Research and NIH NS034160. MLW is a paid consultant for RMI (Las Vegas, NV).
The syringe or bag should be pre-labeled with a unique number that identifies your baby. Cord blood may only be collected during the first 15 minutes following the birth and should be processed by the laboratory within 48 hours of collection.
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.
Cord Blood Registry is headquartered in South San Francisco, California. CBR owns their 80,000 square foot laboratory located in Tucson, Arizona. CBR’s laboratory processes cord blood collections seven days a week, 365 days a year. The state-of-the-art facility has the capacity to store the stem cell samples of five million newborns.
Public cord blood banking supports the health of the community. Public banks collect qualifying cord blood donations from healthy pregnancies and save them in case one of them will be the match to save the life of a patient who needs a stem cell transplant. In the United States our registry of donors is called Be The Match. Patients who have a rare genetic type are more likely to receive cord blood transplants. In order for parents to donate cord blood to a public bank, their baby must be born at a hospital that accepts donations. Public cord blood banking is highly recommended by both the American Academy of Pediatrics (AAP) and American Medical Association (AMA).
Up to 180 mL of blood can be taken from an umbilical cord for use in stem cell transplants. Due to the experimental nature of cord blood transplants, such transplants are considered on a case-by-case basis. This blood is collected from the umbilical cord, processed, and cryogenically preserved shortly after the umbilical cord is clamped. This blood can be cryogenically preserved for public or private (family) use. Public registries store cord blood donated for availability to the general public for transplantation. Private registries store cord blood on behalf of families who wish to use this blood for the donor infant, siblings, or other family members. Private cord blood banks charge a collection fee (ranging from $1,000-2,000) and an annual storage fee (approximately $150 per year).
Since most banks require mothers to sign up for donation between the 28th and 34th week of pregnancy, families must decide to donate ahead of time. If you are considering a public bank for your child’s cord blood, contact the bank and make sure you still have time.
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!
There are a number of different processing methods out there for a cord blood bank to use, and the processing method can ultimately affect the purity of the final product, which we’ll explain in a minute. Once the stem and immune system cells have been isolated and extracted from the plasma and red blood cell, they are mixed with a cryo-protectant and stored in a cryo-bag. We overwrap our bags for added protection and use a technique called “controlled-rate freezing” to prepare the cells for long-term storage. The overwrapped cryo-bag is housed in a protective metal cassette and placed in vapor-phase liquid nitrogen freezer for long-term preservation.
Cord Blood Registry is a registered trademark of CBR® Systems, Inc. Annual grant support for Parent’s Guide to Cord Blood Foundation is made possible by CBR® through the Newborn Possibilities Fund administered by Tides Foundation.
Some controversial studies suggest that cord blood can help treat diseases other than blood diseases, but often these results cannot be reproduced. Researchers are actively investigating if cord blood might be used to treat various other diseases.
Private companies offer to store cord blood for anyone who wants it done, whether or not there is any medical reason known to do so at the time. The fee for private storage varies, but averages about $1,500 up front and $100 per year for storage. When there is no one in the family who needs a transplant, private storage of a newborn’s cord blood is done for a purely speculative purpose that some companies have termed “biological insurance.”
/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.
A limitation of cord blood is that it contains fewer HSCs than a bone marrow donation does, meaning adult patients often require two volumes of cord blood for treatments. Researchers are studying ways to expand the number of HSCs from cord blood in labs so that a single cord blood donation could supply enough cells for one or more HSC transplants.
Banking your child’s cord blood really comes down your personal choice. Some people may seem the potential benefits, while others can’t justify the costs. No one debates cord blood cells being a lifesaver, and in recent years, more than 20,000 lives have been saved because of it; however, experts, such as The American Academy of Pediatrics, note that your odds of using this blood is about one in 200,000. Instead of buying into a company’s advertising scheme, be sure to do your own research and deem what’s best for your child’s future.
If you want the blood stored, after the birth, the doctor clamps the umbilical cord in two places, about 10 inches apart, and cuts the cord, separating mother from baby. Then she inserts a needle and collects at least 40 milliliters of blood from the cord. The blood is sealed in a bag and sent to a lab or cord blood bank for testing and storage. The process only takes a few minutes and is painless for mother and baby.
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.
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.
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.