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Recently the minimal defining characteristics of MSCs was the subject of a blue ribbon panel of scientists (24). This panel ascribed three defining characteristics to MSCs. First, MSCs are plastic-adherent when maintained in standard culture conditions. Second, MSCs express the cell surface markers CD105, CD73, and CD90 and lack expression of CD45, CD34, CD14 or CD11b, CD79 or CD19, and HLA-DR. Third, MSCs differentiate to osteoblasts, adipocytes, and chondroblasts in vitro. As shown in Table 1, mesenchymal-like cells collected from the umbilical cord, placenta, and from umbilical cord blood, perivascular space, and placenta all share a relatively consistent set of surface markers, which is apparently consistent with the hypothesis that they are MSC-like.
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.
Cord blood is used the same way that hematopoietic stem cell transplantation is used to reconstitute bone marrow following radiation treatment for various blood cancers, and for various forms of anemia. Its efficacy is similar as well.
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.
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.
Donating cord blood to a public bank adds to the supply and can potentially help others. Donating to a public bank is especially important for ethnic minorities, who are not well represented in cord blood banks. Public cord blood donation increases the chance of all groups finding a match.
‡ 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.
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.
In the event your child becomes seriously ill, develops a genetic disorder, illness affecting the immune system or blood-related disease, we ask that you notify the cord blood bank as this could impact the patient receiving your cord blood donation. Contact us for information »
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.
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.
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 fixed upon enrollment for 18 years and will not increase during that span of time. If the stem cells are preserved after the 18th year, preservation may then fall under the new pricing structure.
CORD:USE is directed by leading doctors in cord blood transplantation. Public donations collected by CORD:USE are sent to the Carolinas Cord Blood Bank, a FACT-accredited laboratory under the direction of Dr. Joanne Kurtzberg.
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.
Most cells can make copies only of themselves. For example, a skin cell only can make another skin cell. Hematopoietic stem cells, however, can mature into different types of blood cells in the body. Hematopoietic stem cells also are found in blood and bone marrow in adults and children.
Along with cord blood, Wharton’s jelly and the cord lining have been explored as sources for mesenchymal stem cells (MSC), and as of 2015 had been studied in vitro, in animal models, and in early stage clinical trials for cardiovascular diseases, as well as neurological deficits, liver diseases, immune system diseases, diabetes, lung injury, kidney injury, and leukemia.
We have 12- and 24-month in-house payment plans to spread the initial cost out over time. They require no credit check and begin with little money down. Starting at approximately $2.50 a day, you can help safeguard your baby’s future. After the term of the payment plan, you are then only responsible for the annual storage fee, which begins at approximately $12 a month depending on which services you have chosen.
You can check the status of your child’s cord blood unit any time by contacting the public bank. In most cases, the parents won’t have much control over any donated stem cells, so you probably won’t hear much from the storage facility. They may keep you updated if your cells are being used in a patient or clinical trial, but this is up to the bank. By signing the consent form, you are giving the bank full rights to use your child’s cord blood in any patient or clinical trial available.
When a donor signs up with a public bank, the mother must pass a health screening and sign a consent form. After that, the bank processes the application, which makes last-minute donations impossible. However, there are a small number of banks that accept late donor requests.
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.
Cord blood in public banks is available to unrelated patients who need haematopoietic stem cell transplants. Some banks, such as the NHS bank in the UK, also collect and store umbilical cord blood from children born into families affected by or at risk of a disease for which haematopoietic stem cell transplants may be necessary – either for the child, a sibling or a family member. It is also possible to pay to store cord blood in a private bank for use by your own family only.
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.
The use of cord blood is determined by the treating physician and is influenced by many factors, including the patient’s medical condition, the characteristics of the sample, and whether the cord blood should come from the patient or an appropriately matched donor. Cord blood has established uses in transplant medicine; however, its use in regenerative medicine is still being researched. There is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.
Banking cord blood is a new type of medical protection, and there are a lot of questions that parents may want to ask. The Parent’s Guide to Cord Blood organization even has questions it believes all parents should ask their cord blood banks. We have answers to these and other frequently asked cord blood questions in our FAQs. If you can’t find the answer for which you are looking, please feel free to engage one of our cord blood educators through the website’s chat interface.
Clearly, it is advantageous to save cord blood stem cells, but it can be confusing to decide where to store them. There are currently two options: public cord blood banks and private cord blood banks. Public and private banks serve very different purposes, and it is important to know which type of bank would be more beneficial to you and your family.
^ Reddi, AS; Kuppasani, K; Ende, N (December 2010). “Human umbilical cord blood as an emerging stem cell therapy for diabetes mellitus”. Current stem cell research & therapy. 5 (4): 356–61. doi:10.2174/157488810793351668. PMID 20528762.
In Europe, Canada, and Australia use of cord blood is regulated as well. In the United Kingdom the NHS Cord Blood Bank was set up in 1996 to collect, process, store and supply cord blood; it is a public cord blood bank and part of the NHS.
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.
Only 25-50% of donations to public cord blood banks end up being stored.4 Typically, public cord blood banks only store donations that meet the size threshold for transplant use. That means most public cord blood banks will only keep cord blood collections that are at least 3 ounces.2
The longest study to date, published in 2011 by Broxmeyer at al found that stem cells cyro-preserved for 22.5 years engrafted as expected. There was no significant loss of stem cell recovery or proliferation.
Our work has focused on human umbilical cord matrix (UCM) cells. There are cells isolated in large numbers from the Wharton’s jelly of human cords (25–28). Two other research labs have published on the isolation and characterization of cells from the Wharton’s jelly: Dr. Davies’ lab at the University of Toronto (29) and Dr. Y. S. Fu at the National Yang-Ming University, Taipei (30–32). All three groups reported that UCM cells are MSC-like cells and are robust. These cells can be isolated easily, frozen/thawed, clonally expanded, engineered to express exogenous proteins, and extensively expanded in culture. Human UCM cells express a marker of neural precursors, nestin, without exposure to differentiation signals (26,28,30). In response to differentiation signals, human UCM cells can differentiate to catecholaminergic neurons, expressing tyrosine hydroxylase TH (28,30,31). Human UCM cells meet the basic criteria established for MSCs described previously (29,32). Similarly, MSC-like cells are derived from other umbilical cord tissues, e.g., umbilical vein sub-endothelium, umbilical cord blood, amnion, placenta, and amniotic fluid (Table 1).
FACS Antibody reference 1 reference 2 reference 3 reference 4 reference 5 reference 6 reference 7 reference 8 reference 9 reference 10 reference 11 reference 12 reference 13 reference 14,15 reference 16 reference 17
^ 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.
This is great news for families who have chosen to bank their newborn’s blood because someone in the family, typically a sibling, is suffering from a genetic disease or disorder, that cord blood is currently being used to treat.
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.
Cord blood banking means preserving the newborn stem cells found in the blood of the umbilical cord and the placenta. After a baby is born, and even after delayed cord clamping, there is blood remaining in the umbilical cord and placenta that holds valuable newborn stem cells. Parents have a choice between donating cord blood to a public bank for free, or paying to store it for their family in a private bank. Cord blood banking includes the whole process from collection through storage of newborn stem cells for future medical purposes.
For these and other reasons, the American Academy of Pediatrics (AAP) and many physicians do not recommend private cord blood banking except as “directed donations” in cases where a family member already has a current need or a very high potential risk of needing a bone marrow transplant. In all other cases, the AAP has declared the use of cord blood as “biological insurance” to be “unwise.” [Read the AAP’s news release at http://www.aap.org/advocacy/archives/julcord.htm ]
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.
With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.
^ Jump up to: 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.
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.
“Raising a family is expensive enough,” says Jeffrey Ecker, MD, director of obstetrical clinical research at Massachusetts General Hospital, in Boston, and a member of ACOG’s ethics committee. “There’s no reason for parents to take on this additional financial burden when there’s little chance of a child ever using his own cord blood.”
* Annual storage fees will be charged automatically to the credit/debit card on file, on or around your baby’s birthday, unless you’ve chosen a prepay option and are subject to change until they are paid.
We believe that every family should have the opportunity to preserve their baby’s newborn stem cells. That’s why CBR offers transparent costs of cord blood banking, and various payment options to fit this important step into almost every family budget.
Private cord blood banking costs $2,000 to $3,000 for the initial fee, and around another $100 per year for storage. While that may seem like a hefty price tag, many expectant parents may see it as an investment in their child’s long-term health.
2 – Cbr, cord blood registry, Cbr families’ stem cell units used to date. [Available at http://www.cordblood.com/best-cord-blood-bank/stem-cell-therapy/advancing-stem-cell-therapies (accessed Oct 13, 2015)].