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Certainly, there are plenty of doctors who have high hopes for stem-cell advances and advise patients to consider cord-blood banking. When private banks first started sending him informational packets, Jordan Perlow, MD, a maternal-fetal specialist in Phoenix, assumed they were just trying to profit from parents’ anxieties. But after attending medical conferences and scrutinizing studies about developments in stem-cell therapies, Dr. Perlow now encourages his patients to privately bank if they can afford it because he’s convinced that it might save their child’s life or the life of another family member. “If private banking had been available when my children were born, I would have done it,” he says.
If you’re looking to attain cord blood from a public bank, be aware that matched cord blood, as with bone marrow, can be difficult to obtain through a public cord blood bank. Once a match is ascertained, it may take valuable weeks, even months, to retrieve the match, and the cost of acquiring the cord blood from a public bank can be upwards of $40,000. When the newborn’s umbilical cord blood is banked privately, they can be retrieved quickly, and since the parents own the cord blood, banks can perform the retrieval free of charge. Learn more about public versus private cord blood banking here.
There is now compelling evidence that MSCs, guided by chemokines and other cues emanating from areas of pathology such as tumors, will “home” specifically to those areas. The supporting connective tissue stroma of a tumor is formed in a manner similar to wound healing and scar formation (64), and tumors generate signals to recruit stromal cells from contiguous regions as well as from bone marrow to sustain themselves (65,66). Because UCM stem cells are very closely related to MSCs (28), it would not be surprising to find that they also will home to tumors, and in fact such a phenomenon has been observed in preliminary experiments in our laboratory (unpublished observations). The exact signals that recruit transplanted or endogenous cells to regions of inflammation or neoplasia remain obscure. However, stromal cell-derived factor-1α plays a crucial role in recruitment of bone marrow-derived cells to the heart after myocardial infarction (67). Matrigel invasion assays have implicated such molecules as platelet-derived growth factor-BB, epidermal growth factor, and stromal cell-derived factor-1α as chemokines for MSCs; however, neither basic FGF (bFGF) nor vascular endothelial growth factor (VEGF) had an affect (68). In any event, the directed trafficking of umbilical and other mesenchymal stem cells to tumors opens the enticing prospect that they may be a platform for targeted delivery of high local levels of protein. Often, such proteins have a short half-life and/or cause major side effects when given systematically.
Private cord blood banking can benefit those with a strong family history of certain diseases that harm the blood and immune system, such as leukemia and some cancers, sickle-cell anemia, and some metabolic disorders. Parents who already have a child (in a household with biological siblings) who is sick with one of these diseases have the greatest chance of finding a match with their baby’s cord blood. Parents who have a family history of autism, Alzheimer’s, and type 1 diabetes can benefit from cord blood. Although these diseases aren’t currently treated with umbilical cord steam cells, researchers are exploring ways to treat them (and many more) with cord blood.
There are usually two fees involved in cord blood banking. The first is the initial fee that covers enrollment, collection, and storage for at least the first year. The second is an annual storage fee. Some facilities vary the initial fee based upon the length of a predetermined period of storage.
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.”
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).
Mesenchymal cells have been reported to act as supporting cells that promote the expansion of other stem cell types. For example, MSCs and MSC-like cells support ex vivo expansion of hematopoietic stem cells (28,69–71). When co-grafted, MSCs and MSC-like cells support in vivo engraftment of hematopoietic stem cells, too (23,43,72). This work suggests that MSCs from a variety of sources, including umbilical cord, may facilitate engraftment of hematopoietic stem cells. This addresses two significant problems found in umbilical cord blood transplantation: (1) getting enough cells to engraft an adult and (2) increasing the speed of engraftment (12,73). Theoretically, cografting or ex vivo expansion may enable transplantation of cord blood units into larger patients and speed the engraftment in other patients.
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.
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.
^ a b c American Academy of Pediatrics Section on Hematology/Oncology; American Academy of Pediatrics Section on Allergy/Immunology; Lubin, BH; Shearer, WT (January 2007). “Cord blood banking for potential future transplantation”. Pediatrics. 119 (1): 165–70. doi:10.1542/peds.2006-2901. PMID 17200285.
Private cord blood banks allow families to store cord blood stem cells for themselves and their loved ones. They are privately funded, and typically charge a first-year processing fee that ranges from about $1,400 to $2,300, plus annual storage costs of about $115 to $175. (Americord offers cord blood banking for a one-time fee of $3,499, which includes 20 years of storage). The pros and cons of private cord blood banking are listed below.
^ a b Ballen, KK; Gluckman, E; Broxmeyer, HE (25 July 2013). “Umbilical cord blood transplantation: the first 25 years and beyond”. Blood. 122 (4): 491–8. doi:10.1182/blood-2013-02-453175. PMC 3952633 . PMID 23673863.
^ Roura S, Pujal JM, Gálvez-Montón C, Bayes-Genis A (2015). “Impact of umbilical cord blood-derived mesenchymal stem cells on cardiovascular research”. BioMed Research International. 2015: 975302. doi:10.1155/2015/975302. PMC 4377460 . PMID 25861654.
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.)
They aren’t the only ones questioning the business practices of private cord-blood banks. Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) issued statements in the late 1990s opposing the use of for-profit banks — and criticizing their marketing tactics. Instead, they recommended that parents donate cord blood to public banks, which make it available for free to anyone who needs it. Globally, other organizations have done the same. Italy and France have banned private cord-blood banking altogether.
^ 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.
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.
Cord blood banking is the process of collecting and storing your baby’s umbilical cord blood stem cells for potential medical use. ViaCord also offers parents the option to collect and store stem cells found in the tissue of the umbilical cord. This is known as cord tissue banking. Our approach to cord blood and cord tissue banking is simple: Apply the most advanced science to deliver the highest-quality stem cell collection and storage process in order to achieve the best results for families. That approach has guided our growth and success for nearly twenty-five years.
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 diseases,2 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.
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.
The baby’s cord blood will be processed and stored in a laboratory facility, often referred to as a blood bank. The cord blood should be processed and stored in a facility that is accredited by the American Association of Blood Banks (AABB) for the purpose of handling stem cells.
‡ 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.
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, CariCord makes 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.
There is little doubt that scientists believe umbilical cord blood stem cells hold promise for the future. Cord blood stem cells are already used to treat blood disorders such as aplastic anemia, and research is underway to determine if they can treat other more common conditions like type 1 diabetes. But many experts question whether many companies’s marketing materials confuse or even mislead parents about the usefulness of private banking.
However, parents should know that a child’s own cord blood (stored at birth), would rarely be suitable for a transplant today. It could not be used at present to treat genetic diseases, for example, because the cord blood stem cells carry the same affected genes and. if transplanted, would confer the same condition to the recipient. (See the story of Anthony Dones.) In addition, most transplant physicians would not use a child’s own cord blood to treat leukemia. There are two reasons why the child’s own cord blood is not safe as a transplant source. First, in most cases of childhood leukemia, cells carrying the leukemic mutation are already present at birth and can be demonstrated in the cord blood. Thus, pre-leukemic cells may be given back with the transplant, since there is no effective way to remove them (purge) today. Second, in a child with leukemia, the immune system has already failed to prevent leukemia. Since cord blood from the same child re-establishes the child’s own immune system, doctors fear it would have a poor anti-leukemia effect.
MSCs are reported to have immune-suppressive effects. To comment human fetal and adult MSCs are not inherently immunostimulatory in vitro and fail to induce proliferation of allogeneic lymphocytes (37–39; for review, see ref. 40). In one human case, fully mismatched allogeneic fetal liver-derived MSCs were transplanted into an immunocompetent fetus with osteogenesis imperfecta in the third trimester of gestation (41). No immunoreactivity was observed when patient lymphocytes were re-exposed to the graft in vitro, indicating that MSCs can be tolerated when transplanted across MHC barriers in humans. Similarly, after intrauterine transplantation of human MSCs into sheep, the cells persisted long-term and differentiated along multiple mesenchymal lineages (42). Instead, the cells are immunosuppressive and reduce lymphocyte proliferation and the formation of cytotoxic T-cells and natural killer cells when present in mixed lymphocyte cultures. The mechanism whereby MSCs suppress lymphocyte proliferation is still largely unknown but appears to, at least in part, be mediated by a soluble factor. Several factors, including MSC-produced prostaglandin E2, indoleamine 2,3-dioxygenase-mediated tryptophan depletion, transforming growth factor-β1, and hepatocyte growth factor have been proposed to mediate the suppression, but the data remain controversial.
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.
We offer standard and premium processing options for our cord blood service. The standard cord blood processing method has been in place since 1988 and thousands of transplants using this method have been successful. Our premium service uses a superior new type of processing, which greatly enhances your return on investment and captures more stem cells (what you want) while reducing the number of red blood cells and other contaminants (what you don’t want). Please visit our processing technology page to learn about our standard and premium processing methods.