As noted earlier, with better matching, there is a greater chance of success and less risk of graft-versus-host disease (GvHD) in any stem cell transplant. With cord blood, the baby’s own cells are always a perfect match and share little risk. When using cord blood across identical twins, there is also a very low chance of GvHD although mutations and biological changes caused by epigenetic factors can occur. Other blood-related family members have a 35%–45% chance of GvHD, and unrelated persons have a 60%–80% chance of suffering from GvHD.
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.
After all is said and done, the cost to collect, test, process and store a donated cord blood collection at a public bank is estimated to be $1,200 to $1,500 dollars for each unit banked. That does not include the expense for the regulatory and quality systems needed to maintain licensure, or the cost of collecting units that are discarded because they don’t meet standards.
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.
As most parents would like to bank their babies’ cord blood to help safeguard their families, it is often the cost of cord blood banking that is the one reason why they do not. Most cord blood banks have an upfront fee for collecting, processing and cryo-preserving the cord blood that runs between $1,000 and $2,000. This upfront fee often also includes the price of the kit provided to collect and safely transport the cord blood, the medical courier service used to expedite the kit’s safe shipment, the testing of the mother’s blood for any infectious diseases, the testing of the baby’s blood for any contamination, and the cost of the first full year of storage. There is then often a yearly fee on the baby’s birthday for continued storage that runs around $100 to $200 a year.
Private storage of one’s own cord blood is unlawful in Italy and France, and it is also discouraged in some other European countries. The American Medical Association states “Private banking should be considered in the unusual circumstance when there exists a family predisposition to a condition in which umbilical cord stem cells are therapeutically indicated. However, because of its cost, limited likelihood of use, and inaccessibility to others, private banking should not be recommended to low-risk families.” The American Society for Blood and Marrow Transplantation and the American Congress of Obstetricians and Gynecologists also encourage public cord banking and discourage private cord blood banking. Nearly all cord blood transplantations come from public banks, rather than private banks, partly because most treatable conditions can’t use a person’s own cord blood. The World Marrow Donor Association and European Group on Ethics in Science and New Technologies states “The possibility of using one’s own cord blood stem cells for regenerative medicine is currently purely hypothetical….It is therefore highly hypothetical that cord blood cells kept for autologous use will be of any value in the future” and “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.”
In March 2004, the European Union Group on Ethics (EGE) has issued Opinion No.19 titled Ethical Aspects of Umbilical Cord Blood Banking. The EGE concluded that “[t]he 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. Thus they promise more than they can deliver. The activities of such banks raise serious ethical criticisms.”
Banked cord blood is most abundant in white blood cells and stem cells. While a lot of attention is paid to the stem cells, there are approximately 10 times more total nucleated cells (TNCs) than stem cells in any cord blood collection. TNCs are basically white blood cells, or leukocytes; they are the cells of the immune system that protect the body. Despite stem cells comprising one-tenth of most collections, cord blood is still considered a rich source of hematopoietic (he-mah-toe-po-ee-tic) stem cells (HSCs). HSCs are often designated by the marker CD34+. Hematopoietic stem cells can become two categories of cells: myeloid and lymphoid cells. Myeloid cells go on to form your red blood cells, platelets, and other cells of the blood. Lymphoid cells go on to become the B cells and T cells and are the basis for the immune system. Cord blood also contains mesenchymal (meh-sen-ki-mal) stem cells (MSCs), but they are much more abundant in cord tissue, which we will discuss in a minute.
You certainly should, especially if you have a family history of any diseases or conditions that could be treated with cord blood stem cells. Since there is only a 25% chance of a match, you should bank the cord blood of each individual child if you have the means.
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.
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
On average, the transport time for stem cells from the hospital to CBR’s lab is 19 hours. CBR partners with Quick International, a private medical courier service with 30 years of experience in the transportation of blood and tissue for transplant and research.
Your baby isn’t the only one who may benefit from having access to preserved newborn stem cells. The cells can potentially be used by siblings and parents, too. In many cord blood treatments, stem cells from a matched family member are preferred.
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.
While many diseases can be treated with a cord blood transplant, most require stem cells from another donor (allogeneic). Cord blood cells taken from the patient (autologous) typically contain the same defect or precancerous cells that caused the patient to need the transplant in the first place. Most medical professionals believe the chance that cord blood banking will be utilized by the patient or a close relative is relatively low. Estimates range from 1 out of 1,000 to 1 out of 200,000. From these estimates, privately stored cord blood is not likely to be utilized by the average family. The American Academy of Pediatrics has discouraged cord blood banking for self-use, since most diseases requiring stem cell transplants are already present in the cord blood stem cells. Additionally, a recent study published in Pediatrics indicates that few transplants have been performed using privately stored cord blood. From the responses of 93 transplant physicians, in only 50 cases was privately banked blood used. In 9 of these cases the cord blood was transplanted back into the donor patient (autologous transplant). One of the main selling points of private cord blood banks is the possibility of a future autologous transplant.
Becoming a parent is a life-changing moment full of promise, joy and a natural share of anxiety. For parents of a sick child, those worries are more intense – especially if that child needs a stem cell transplant to survive. You have the power to Give Life to patients in Canada and around the world.
Generally speaking, public cord blood banks collect, process and store your donated cord blood for free. The cord blood you donate to a public bank may be used for transplants or for research purposes, so you may not be able to access your own cord blood. View a list of public cord blood banks in North America.
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): bit.ly/2Lk9enq pic.twitter.com/6g7QrMiegc
Our annual storage fee is due every year on the birth date of the child and covers the cost of storage until the following birthday. The fee is the same $150 for both our standard and our premium cord blood services. The annual cord tissue storage fee is an additional $150.
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.
Donating cord blood to a public cord blood bank involves talking with your doctor or midwife about your decision to donate and then calling a cord blood bank (if donation can be done at your hospital). Upon arriving at the hospital, tell the labor and delivery nurse that you are donating umbilical cord blood.
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.
‡ Payment Plan Disclosures for in-house CBR 6-Month Plan (interest free) – No credit check required. The 6-month plan requires a $10/month administrative fee. The plans may be prepaid in full at any time.
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.
Like any insurance, cord-blood banking isn’t cheap. Banks initially charge from $1,000 to $2,000 to collect and process the stem-cell units, which are stored for a family’s exclusive use. When you factor in additional costs for shipping (about $150 for a medical courier), the doctor’s collection fee (prices can range from $150 to $500), and annual storage fees averaging $100 per year for 18 years, parents can expect to pay up to $4,000 in expenses not covered by insurance.
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
Founded in 1992, CBR has stored more than 600,000 cord blood and cord tissue collections from 3,500 hospitals in over 100 countries and partnered with institutions to establish multiple FDA-regulated clinical trials. CBR has helped more than 400 families use their cord blood stem cells for established and experimental medical treatments, more than any other family cord blood bank. CBR’s goal is to expand the potential scope of newborn stem cell therapies that may be available to patients and their families.
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.
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.
There is no cost associated with public cord blood banking, but you do give up your rights to your baby’s stem cells at the time of donation. The public cord blood bank owns the donation. If your child or another family member needs a transplant in the future, there is no guarantee you would have access to your baby’s cord blood.
In order to preserve more types and quantity of umbilical cord stem cells and to maximize possible future health options, Cryo-Cell’s umbilical cord tissue service provides expectant families with the opportunity to cryogenically store their newborn’s umbilical cord tissue cells contained within substantially intact cord tissue. Should umbilical cord tissue cells be considered for potential utilization in a future therapeutic application, further laboratory processing may be necessary. Regarding umbilical cord tissue, all private blood banks’ activities for New York State residents are limited to collection, processing, and long-term storage of umbilical cord tissue stem cells. The possession of a New York State license for such collection, processing and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these 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.)
Cord Blood Banking Cost and Fees Cord Blood Banks and Banking Cost in the United States of America ViaCord | Cord Blood Banking & Research®. Services Provided: Cord Blood Banking, Cord Tissue Banking, Newborn Genetic Screening Description: ViaCord, a PerkinElmer company, is an industry leading Cord…
As cord blood is inter-related to cord blood banking, it is often a catch-all term used for the various cells that are stored. It may be surprising for some parents to learn that stored cord blood contains little of what people think of as “blood,” as the red blood cells (RBCs) can actually be detrimental to a cord blood treatment. (As we’ll discuss later, one of the chief goals of cord blood processing is to greatly reduce the volume of red blood cells in any cord blood collection.)