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Mothers and families can donate blood from their child’s umbilical cord, which contains valuable stem cells used in the treatment of over 80 diseases. There are over half a million donated cord blood units around the world, with thousands more added every year.
But considering the average cost of a new car or top-of-the-line stroller these days, many expectant parents feel it’s not an unreasonable price to pay to give their child the best chance in life. “Ultimately, my conscience wouldn’t let me not do it,” says Merilee Kern, of San Diego. “We could afford it, and the blood could someday save my daughter.”
During the harvesting procedure, doctors use a catheter to draw out blood. The blood moves through a machine, which separates stem cells and allows these cells to be put into storage. This process takes a few hours, and may be repeated over several days in order for doctors to get enough stem cells.
Checked to make sure it has enough blood-forming cells for a transplant. (If there are too few cells, the cord blood unit may be used for research to improve the transplant process for future patients or to investigate new therapies using cord blood, or discarded.)
AutoXpress™ Platform (AXP) cord blood processing results in a red-cell reduced stem cell product. Each sample is stored in a cryobag consisting of two compartments (one major and one minor) and two integrally attached segments used for unit testing.
There are also hundreds of human clinical trials being performed using cord blood to treat conditions and diseases that affect millions of people in the U.S. alone. These trials involve regenerative medicine and other applications for the treatment of Diabetes, Cerebral Palsy, Autism, Strokes, Neonatal & Pediatric Brain Injury, Alzheimer’s & Spinal Cord Injury to name a few (see www.clinicaltrials.gov). The existence of clinical trials does not guarantee that cord blood will be successful in the treatment of those diseases in the future. While you can’t plan on health issues your child may face, you can have possible treatment options.
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.
Each year, thousands of people are diagnosed with leukemia, lymphoma, or certain immune system or genetic metabolic disorder. Many of these patients need an umbilical cord blood or bone marrow transplant (also called a BMT). Because the qualities that make a suitable match for bone marrow or umbilical cord blood are inherited, a match from a sibling or other family member is often checked first. However, 70 percent of patients will not find a matching donor in their family. For these patients, a transplant of bone marrow or cord blood from an unrelated donor may be their only transplant option.
I am currently 38 years old and I would like to have my blood and it’s stem cells harvested via peripheral blood draw to be stored in definitely. Do you offer this service? If so, how can I arrange for my family?
Meet Dylan. Diagnosed with leukemia at just 8 weeks old, he received a life-saving cord blood transplant at 6 months old. Today, Dylan is growing up strong, going to school, travelling with his family and just having fun being a kid!
The Doneses were shocked, however, when doctors told them that Anthony’s cord blood couldn’t be used because the cells contained the same genetic defect that caused his condition. “The materials provided by the bank said this was Anthony’s life insurance and could save him if he needed it. They never mentioned that the cells could be diseased. We felt duped,” Tracey says. The Long Island, New York, couple has since filed a lawsuit against the bank alleging false advertising and consumer fraud.
In addition to the use of cord blood stem cells for transplantation, cord blood stem cells are currently being investigated for use in stem cell therapy. Cord blood stem cells are multipotent and are believed to have greater plasticity (the ability to form into different stem cell types) than adult hematopoietic stem cells found in bone marrow. HSCs are being investigated for use in autoimmune diseases such as diabetes, rheumatoid arthritis, and systemic lupus erythermatosis (SLE) in order to reprogram or reconstitute the immune system. Additionally, research is being conducted on differentiating HSCs into other tissue types such as skeletal and cardiac muscle, liver cells (hepatocytes), and neurons. HSCs are currently being used in gene therapy, due to their self-renewing properties, as a means of delivering genes to repair damaged cells. HSCs are the only cells currently being used in this manner in clinical gene therapy trials.
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.
LifebankUSA seeks mothers in NEW YORK & NEW JERSEY ONLY who will donate both their cord blood and their placenta. The donations support an international registry, clinical trials and research. Donations can be taken from any hospital, but mothers must register at least 8 weeks prior to delivery and pass a health screening.
Operating both a family and public bank, CORD:USE cord blood units have been used in more transplants in the past 9 years than the two largest family cord blood banks have been involved in over their combined past 43 years of business2,3.
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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.
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.
This is only the beginning. Newborn stem cell research is advancing, and may yield discoveries that could have important benefits for families. CBR’s mission is to support the advancement of newborn stem cell research, with the hope that the investment you are making now will be valuable to your family in the future. CBR offers a high quality newborn stem cell preservation system to protect these precious resources for future possible benefits for your family.
Use of adult bone marrow-derived stem cells brought to the forefront, the limitations that these types of cells are thought to have. Specifically, scientific dogma states that adult-type stem cells have limited capacity to expand in vitro. Initial work indicated that bone marrow-derived mesenchymal stem cells (bmMSCs) become senescent (cease to divide in vitro) by passage 6–10. Furthermore, bone marrow-derived stem cells are reported to be more difficult to extract from the marrow cavity in normal aging because the red marrow space changes to a yellow marrow (fat-filled) as a consequence of aging. Optimal stem cell aspirates from the marrow are found in young donors (e.g., 18–19 yr of age; 9a). One would think that the fat-derived MSCs would be a useful alternative to the marrow-derived MSCs for autologous grafting in aged individuals. We do not know whether this will be the case. It is known that fat-derived MSCs are more rare than bmMSCs. Therefore, extraction and expansion may be required prior to therapeutic use. It is generally thought that stem cells derived from “younger” tissues, for example, tissues derived from the early embryo or fetus, would have longer telomeres and have the capacity for extended expansion in culture prior to becoming senescent. There are some data to support this contention (10).
MSCs and MSC-like cells are useful multipotent stem cells that are found in many tissues. While MSCs can be isolated from adults via peripheral blood, adipose tissue, or bone marrow apiration, MSCs derived from the discarded umbilical cord offer a low-cost, pain-free collection method of MSCs that may be cryogenically stored (banked) along with the umbilical cord blood sample. From the umbilical cord, isolation of cells from the Wharton’s jelly has the greatest potential for banking, presently, because the most cells can be isolated consistently. The challenge for the future is to define industrial-grade procedures for isolation and cryopreservation of umbilical cord-derived MSCs and to generate Food and Drug Administration (FDA)-approved standard operating procedures (SOPs) to enable translation of laboratory protocols into clinical trials. This represents a paradigm shift from what has been done with umbilical cord blood banking because the cord blood cells do not require much in the way of processing for cryopreservation or for transplantation (relatively). For such a challenge to be met, researchers in the field of umbilical cord-derived MSC need to organize and reach consensus on the characterization, freezing/thawing, and expansion of clinical-grade cells for therapies and tissue engineering. Thus, more and more umbilical cord stem cells can be diverted from the biohazardous waste bag and into the clinic, where their lifesaving potential can be realized.
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 umbilical cord is a rich source of two main types of stem cells: cord blood stem cells and cord tissue stem cells. Through the science of cord blood and cord tissue banking, these stem cells can help nurture life, long after your baby’s birth.
Similar to transplantation, the main disadvantage is the limited number of cells that can be procured from a single umbilical cord. Different ways of growing and multiplying HSCs in culture are currently being investigated. Once this barrier is overcome, HSCs could be used to create “universal donor” stem cells as well as specific types of red or white blood cells. Immunologic rejection is a possibility, as with any stem cell transplant. HSCs that are genetically modified are susceptible to cancerous formation and may not migrate (home) to the appropriate tissue and actively divide. The longevity of cord blood HSCs is also unknown.
Research is being conducted using cord blood cells to analyze immune response and other factors that may eventually shed light on causes and treatment of MS. However, at present there is no treatment available involving cord blood cells. Nor do we know of any sites that are looking for cord blood specifically for MS research.
The stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling. Cord blood stem cells have similar ability to treat disease as bone marrow but with significantly less rejection.
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.
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There is no significant opposition in the medical community to the public banking of cord blood. The donation of cord blood to public banks has generally been encouraged by the medical profession. The American Academy of Pediatrics encourages the public donation of cord blood with appropriate genetic and infectious disease testing, although they caution that parents should be notified that they will receive the results of this testing. They also recommend that parents be informed that publicly banked cord blood may not be available for future private use.
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 cord blood banking (also known as family banking), is preferred for families in a situation, where they currently have a family member suffering from a genetic disorder or have a family history of this type of disorder. By using a private cord blood bank, such as CariCord, your baby’s cord blood and tissue are stored for exclusive use by your family. It will always be there and readily available if it is ever needed. If it is donated to a public bank it can be accessed by anyone who is a match to it and there are no guarantees that it would be available, should your family ever need it later.
People who are in need of a transplant are more likely to find a match from a donor of the same ethnic descent. There are fewer racial minorities in the national registries, so finding a match can be more difficult.5
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.
In addition to their immune-suppressive properties, MSCs appear to exhibit a tropism for damaged or rapidly growing tissues. For example, following injection into the brain, MSCs migrate along known pathways when injected into the corpus striatum (44). MSCs migrated throughout forebrain and cerebellum, integrated into central nervous system cytoarchitecture, and expressed markers typical of mature astrocytes and neurons after injection into the lateral ventricle of neonatal mice (45). MSCs injected into injured spinal cord were found to form guiding “cord,” ushering in regenerating fibers (46). MSCs may assist with regeneration in stroke (47–51) or myocardial ischemia (52–55) by release of trophic factors such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, or angiogenic factors (56–61).
Pro: It gives you that peace of mind that if anything did happen to your child, the doctors would have access to their blood. This could potentially be a great benefit, and you would have no idea what would have happened if it weren’t for this blood.
Public cord blood banks store cord blood for allogenic transplants. They do not charge to store cord blood. The stem cells in the donated cord blood can be used by anyone who matches. Some public banks will store cord blood for directed donation if you have a family member who has a disease that could potentially be treated with stem cells.