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CBR created the world’s only collection device designed specifically for cord blood stem cells. CBR has the highest average published cell recovery rate in the industry – 99% – resulting in the capture of 20% more of the most important cells than other common processing methods.
Once considered medical waste, the blood left in the umbilical cord after a baby’s delivery is now known to be a rich source of stem cells similar to those in bone marrow. It’s been used in transplants to treat more than 70 different diseases including leukemia, lymphoma, sickle-cell disease, and some metabolic disorders. Unlike with marrow, which is obtained through a painful medical procedure and replenished by the body, there’s only one chance to collect this seemingly magical elixir: immediately after a baby’s birth.
There are so many things to think about when you have a child. One of them is the blood from your baby’s umbilical cord (which connects the baby to the mother while in the womb). It used to be thrown away at birth, but now, many parents store the blood for the future health of their child. Should you do it?
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.
Of course, this means that expectant parents will have one more choice to make about their child’s health and future. “I certainly don’t think parents should feel guilty if they don’t privately bank their child’s blood,” Dr. Kurtzberg says. The best choice is the one that works for your family.
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.
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.
After your unit arrives at ViaCord’s Processing Lab, specialists will process your baby’s stem cells to maximize cell yield. They are then transferred to a transplant-ready cryobag for storage at or below ≤ -170º C (brrr).
Osteopetrosis is a genetic disease, so this means that doctors could use a sibling’s cord blood cells to treat Anthony, but they cannot use his own cells because the disease is in every cell in his body. In fact, a majority of the diseases listed in private banking firms’ marketing material as treatable with stem cells are genetic diseases.
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.
Haematopoietic stem cells (HSCs) can make every type of cell in the blood – red cells, white cells and platelets. They are responsible for maintaining blood production throughout our lives. They have been used for many years in bone marrow transplants to treat blood diseases.
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.
Until now, however, it hasn’t always been easy for couples to donate their baby’s cord blood to a public bank. The 28 public banks currently in operation work with only about 100 hospitals in the U.S. (find the list at parentsguidetocordblood.com). If you don’t deliver at one of these hospitals, you can contact either Cryobanks International or LifebankUSA, commercial organizations that store both private and public units. These banks pick up the tab for your donation (minus the physician’s collection fee).
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 (short for umbilical cord blood) is the blood that remains in the umbilical cord and placenta post-delivery. At or near term, there is a maternal–fetal transfer of cells to boost the immune systems of both the mother and baby in preparation for labor. This makes cord blood at the time of delivery a rich source of stem cells and other cells of the immune system. Cord blood banking is the process of collecting the cord blood and extracting and cryogenically freezing its stem cells and other cells of the immune system for potential future medical use.
*Fee schedule subject to change without notice. If a client has received a kit and discontinues services prior to collection, there is no cancelation fee if the kit is returned unused within two weeks from cancelation notice; otherwise, a $150 kit replacement fee will be assessed. †Additional courier service fee applies for Alaska, Hawai’i and Puerto Rico. ††Applies to one-year plan and promotional plan only. After the first year, an annual storage fee will apply. Cryo-Cell guarantees to match any written offer for product determined to be similar at Cryo-Cell’s sole discretion. ** Promotional Plan cannot be combined with any other promotional offers, coupons or financing.
Experts believe that umbilical cord blood is an important source of blood stem cells and expect that its full potential for treatment of blood disorders is yet to be revealed. Other types of stem cell such as induced pluripotent stem cells may prove to be better suited to treating non-blood-related diseases, but this question can only be answered by further research.
Cord blood donation doesn’t cost anything for parents. Public cord blood banks pay for everything which includes the collection, testing, and storing of umbilical cord blood. This means that cord blood donation is not possible in every hospital.
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).
Participating mothers will give a sample of blood (about four teaspoons), which will be tested for certain infections, including hepatitis and HIV. This is done to reduce the chances of passing on an infectious disease through the transplantation of the cord blood unit. This blood sample can be obtained at the hospital when the nurse is starting your IV or collecting routine blood samples for your physician.
Donors to public banks must be screened for blood or immune system disorders or other problems. With a cord blood donation, the mother’s blood is tested for genetic disorders and infections, and the cord blood also is tested after it is collected. Once it arrives at the blood bank, the cord blood is “typed.” It is tracked by a computer so that it can be found quickly for any person who matches when needed.
Cord Blood Registry’s Newborn Possibilities Program® serves as a catalyst to advance newborn stem cell medicine and science for families that have been identified with a medical need to potentially use newborn stem cells now or in the near future. NPP offers free cord blood and cord tissue processing and five years of storage to qualifying families. To date, the Newborn Possibilities Program has processed and saved stem cells for nearly 6,000 families.
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.”
When it comes to cord blood banking, expectant parents have three options: (1) They can privately store their cord blood for their family, (2) They can take the public option and donate their cord blood for other families, or (3) They can do nothing, at which point the medical facility must dispose of the cord blood as medical waste. At Cryo-Cell International, we believe cord blood should not be discarded. Many states agree with our basic sentiment and have passed laws or guidelines for physicians to use when discussing private and public banking options with expectant parents.
In terms of performance, our PrepaCyte-CB processing method has taken the lead. PrepaCyte-CB greatly improves on parents’ returns on investment because it yields the highest number of stem cells while showing the greatest reduction in red blood cells.1–4 Clinical transplant data show that cord blood processed with PrepaCyte-CB engrafts more quickly than other processing methods.7 This means patients may start feeling better more quickly, may spend less time in the hospital and are less likely to suffer from an infection. The ability to get better more quickly and a reduced chance of infection can prove vital in certain cases. Learn more about PrepaCyte®-CB here.
Generalized stem cell lineage concept. The lineage is characterized by a self-maintaining “parent” true stem cell population that resides within a specialized niche microenvironment, which aids the regulation of stem cell division or quiescence (nondividing). Derivative cells (called progeny or daughter cells) are of two types: symmetric division produces two identical daughter cells to expand or maintain the stem cell population; asymmetric division produces an identical daughter and a specialized cell (a differentiated cell). The differentiated cell is an intermediate type of precursor cell, termed the transient dividing population. The number of divisions of the intermediate precursor is fairly tightly regulated by microenvironment and inborn regulation factors. The intermediate precursors are thought to have a limited proliferative capacity. Further tissue-specific specialization continues form the intermediate precursors, producing specialized populations with a commitment to a progressively more specialized (differentiated) fate. The end points are fully differentiated cells that are nondividing and that live for various, tissue-specific periods prior to senescence or damage that leads to cell death. In some tissues, the naturally occurring cell loss produces various feedback signals that trigger normal cell replacement via amplification/differentiation of either stem cells or the intermediate precursors.
However, the American Academy of Pediatrics strongly encourages umbilical cord donations for general research purposes. Donors are encouraged to contact a cord blood bank by the 35th week of pregnancy.
Some parents-to-be are sold on the advertising that banking their child’s cord blood could potentially treat an array of diseases the child, or his siblings, could encounter in their lives. Other parents-to-be may find all the promises too good to be true.
In addition to the benefits related to transplanting HSCs derived from cord blood, HSCs are relatively easy to isolate, giving them an advantage over other adult stem cell types. Cord blood HSCs are also believed to have greater plasticity than HSCs found in bone marrow or the blood stream. The limits and possibilities of using HSCs to repair tissues and treat non-blood related disorders are currently being studied.
Whole genome sequencing is the process of mapping out the entire DNA sequence of a person’s genome. This test can show what type of health concerns we might face and most importantly how we can improve our health and quality of life.
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.
When you bank your child’s cord blood with ViaCord, your child will have access to stem cells that are a perfect genetic match. Some cancers like neuroblastoma are autologous treatments. Ongoing regenerative medicine clinical trials are using a child’s own stem cells for conditions like autism and cerebral palsy. 104, 109 To date, of the 400+ families that have used their cord blood 44% were for regenerative medicine research.
In the procurement of embryonic stem cells for research, the embryo from which the cells are harvested is destroyed. For those who believe that human life begins at conception this research is obviously unethical. In contrast, adult stem cells can be isolated from tissue from a consenting patient. While cord blood stem cells are classified as adult stem cells, they appear to have greater potency (ability to differentiate into other cell types) than other adult stem cells, making them a potentially valuable option for use in a variety of treatments and therapies. Cord blood stem cells offer some of the advantages of ESCs without any of the ethical drawbacks. Research into the use of cord blood stem cells for the treatment of disease and disability is a promising and ethical avenue of stem cell research.
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.
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.