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Editor’s Note: This article originally appeared in the Volume 16, Number 1, Spring 2009 issue of Dignitas, the Center’s quarterly publication. Subscriptions to Dignitas are available to CBHD Members. To learn more about the benefits of becoming a member click here.
There are no hard numbers on a child’s risk of needing a stem-cell transplant: It’s anywhere between one in 1,000 and one in 200,000, according to studies cited by ACOG and the AAP. But private banks’ marketing materials often place the odds at one in 2,700 and note that these numbers don’t factor in its potential future use for diabetes, Alzheimer’s, Parkinson’s disease, and spinal-cord injuries in adults. “Researchers are constantly discovering new treatments using stem cells,” says Gerald Maass, executive vice president of corporate development for Cryo-Cell, a private bank in Clearwater, Florida. Another major bank’s Web site claims incredible odds: “Should cord blood prove successful in treating heart disease, the lifetime probability of being diagnosed with a disease treatable by cord blood will increase from one in 100 to one in two.”
The second question concerns “storing” the newborn’s cord blood for the child’s future use or a family member’s future use. The American Academy of Pediatrics has issued a policy statement saying that, “Cord blood donation should be discouraged when cord blood stored in a bank is to be directed for later personal or family use.” They state: “No accurate estimates exist of the likelihood of children to need their own stored cord blood stem cells in the future. The range of available estimates is from 1 in 1000 to more than 1 in 200000.51 The potential for children needing their own cord blood stem cells for future autologous use is controversial presently.” Read the complete statement here.
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.
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?
Tissue typed and listed on the registry of the C.W. Bill Young Cell Transplantation Program, also called the Be The Match Registry®. (The registry is a listing of potential marrow donors and donated cord blood units. When a patient needs a transplant, the registry is searched to find a matching marrow donor or cord blood unit.)
Started the National Cord Blood Inventory (NCBI). The goal of the NCBI is to collect and store at least 150,000 new cord blood units. These cord blood units are used for patients who need a transplant but do not have a matching donor within their family. To continue to help the success of transplants, the NCBI banks will provide additional cord blood units for research.
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 ]
Jump up ^ Roura, S; Pujal, JM; Gálvez-Montón, C; Bayes-Genis, A (2 July 2015). “The role and potential of umbilical cord blood in an era of new therapies: a review”. Stem cell research & therapy. 6: 123. doi:10.1186/s13287-015-0113-2. PMC 4489204 . PMID 26133757.
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.
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.
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.
The American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics don’t recommend routine cord blood storage. The groups say private banks should only be used when there’s a sibling with a medical condition who could benefit from the stem cells. Families are encouraged to donate stem cells to a public bank to help others.
As shown in Table 1, at least five different laboratories have extracted MSC-like cells from umbilical cord tissues. Some differences in the ease with which MSC-like cells are isolated from the various tissues are reported. Importantly, the methods for isolating MSC-like cells are robust, i.e., labs throughout the world independently isolate MSC-like cells from these tissues. This opens the door for independent verification, scalable production, and a large-team approach.
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.”
Disclaimer: 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, there is 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.
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.
Once it arrives at the storage facility, the cord blood will be processed and placed in storage. The cord blood will either be completely immersed in liquid nitrogen or it will be stored in nitrogen vapor.
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 »
The University of Texas Health Science Center at Houston is conducting a pioneering FDA-regulated phase I/II clinical trial to compare the safety and effectiveness of two forms of stem cell therapy in children diagnosed with cerebral palsy. The randomized, double-blinded, placebo-controlled study aims to compare the safety and efficacy of an intravenous infusion of autologous cord blood stem cells to bone marrow stem cells.
The stored blood can’t always be used, even if the person develops a disease later on, because if the disease was caused by a genetic mutation, it would also be in the stem cells. Current research says the stored blood may only be useful for 15 years.
Be the Match is a nonprofit organization that supports public cord blood banks’ efforts to encourage donations. It maintains the largest public listing of donated cord blood available for transplantation in the United States. The organization has facilitated more than 7,000 unrelated cord blood transplants since the year 2000.
Jump up ^ Li, T; Xia, M; Gao, Y; Chen, Y; Xu, Y (2015). “Human umbilical cord mesenchymal stem cells: an overview of their potential in cell-based therapy”. Expert Opinion on Biological Therapy. 15 (9): 1293–306. doi:10.1517/14712598.2015.1051528. PMID 26067213.
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).
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.
Throughout pregnancy your baby’s umbilical nurtures life. It’s carries oxygen rich cells and nutrients from your placenta to your baby, and then allows your baby to pump deoxygenated and nutrient depleted blood back to your placenta. This constant exchange is protected by a special type of tissue that acts like a cushion, preventing twisting and compression to ensure that the cord blood flow remains steady and constant.
In a report to the HRSA Advisory Council, scientists estimated that the chances of a pediatric patient finding a cord blood donor in the existing Be the Match registry are over 90 percent for almost all ethnic groups.
Several research teams have reported studies in animals suggesting that cord blood can repair tissues other than blood, in diseases ranging from heart attacks to strokes. These findings are controversial: scientists often cannot reproduce such results and it is not clear HOW cord blood may be having such effects. When beneficial effects are observed they may be very slight and not significant enough to be useful for developing treatments. If there are positive effects, they might be explained not by cord blood cells making nerve or heart cells, but by the cells in the cord blood releasing substances that help the body repair damage.
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.
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.
Families have the additional option of storing a section of the umbilical cord, which is rich in unique and powerful stem cells that may help repair and heal the body in different ways than stem cells derived from cord blood.
CBR is committed to advancing the science of newborn stem cells. We’ve awarded a grant to the Cord Blood Association, to help fund a multi-center clinical trial researching the use of cord blood for children with autism and cerebral palsy.
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.
Graft-versus-host disease (GVHD) is a common complication after an allogeneic transplant (from a source other than the patient) where the patient’s immune system recognizes the cells as “foreign” and attacks the newly transplanted cells. This can be a potentially life threatening complication. The risk for developing GVHD is lower with cord blood transplants than with marrow or peripheral blood transplants. Patients who do develop GVHD after a cord blood transplant typically do not develop as severe of a case of GVHD. Cord blood also is less likely to transmit certain viruses such as cytomegalovirus (CMV), which poses serious risks for transplant patients with compromised immune systems.
There are a few simple things that you need to do in order to donate cord blood. These include a medical history questionnaire, a consent form, a blood sample and maybe a follow up phone call. If you’re considering donating your baby’s umbilical cord blood, call the St. Louis Cord Blood Bank at 314-268-2787 or 888-453-2673 to register and download the required forms here. This can be done anytime before you deliver.
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.
Cord blood is one of three sources of blood-regenerating cells used in stem cell transplantation; the other two sources are bone marrow and peripheral blood stem cells. Stem cells have ability to transform themselves into different types of cells that help replace or heal impaired cells such as bone, nerve and blood cells.
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.
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.
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.
If everyone donated cord blood to public registries for the ‘common good’ this would increase the chances of someone benefiting from a double cord blood transplant. This far outweights the actual probability of the person who donated the sample being able to usefully use it for themself.
Bone marrow transplantation, also called hemopoietic stem cell transplantation, is under investigation for the treatment of severe forms of multiple sclerosis. The long-term benefits of this experimental procedure have not yet been established. In this procedure, the individual receives grafts of his or her own blood stem cells, and thus donor stem cells are not used or needed.
To learn more about umbilical cord blood and banking please watch Banking on cord blood, Cord blood – banking and uses, Cord blood transplantation – how stem cells can assist in the treatment of cancer in our video library.
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.
Students who register to donate blood three or more times during their high school career earn a Red Cord to wear during graduation events. Seniors must complete the requirement by May 15 (or by the date of their school’s final blood drive of the year, whichever is later).
From these findings, it is suggested that UCM cells offer advantages over stem cells as a source of therapeutic cells. First, UCM cells are derived from a noncontroversial, inexhaustible source, and can be harvested noninvasively at low cost. Second, unlike human ESCs, UCM cells did not induce teratomas or death after 1 × 106 to 6 × 106 human UCM cells were transplanted either intravenously or subcutaneously into severe combined immunodeficient beige mice (Rachakatla, Medicetty, Burton, Troyer, and Weiss, unpublished observations). Third, UCM cells are easy to start and do not require feeder layers or medium containing high serum concentrations to be maintained. Fourth, they are not acutely rejected when transplanted as xenografts in nonimmune-suppressed rats. For example, we demonstrated that pig UCM cells undergo a moderated expansion following transplantation into rat brain without obvious untoward behavioral effects or host immune response (25).
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.
If clients need to use the cord blood stem cells stored with CBR for transplantation and the cells fail to engraft, clients receive a full refund of all fees paid to CBR for cord blood services plus an additional $50,000.
Umbilical cords have traditionally been viewed as disposable biological by-product. Cord blood, however, is rich in multi-potent hematopoietic stem cells (HSCs). Recent medical advances have indicated that these stem cells found in cord blood can be used to treat the same disorders as the hematopoietic stem cells found in bone marrow and in the bloodstream but without some of the disadvantages of these types of transplants. Cord blood is currently used to treat approximately 70 diseases including leukemias, lymphomas, anemias, and Severe Combined Immunodeficiency (SCID). Six thousand patients worldwide have been treated with cord blood stem cell transplants, although the FDA considers the procedure to be experimental. These multipotent stem cells also show promise for the treatment of a variety of diseases and disorders other than those affecting the blood.
The main reason for this requirement is to give the cord blood bank enough time to complete the enrollment process. For the safety of any person who might receive the cord blood donation, the mother must pass a health history screening. And for ethical reasons, the mother must give informed consent.
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.
A nurse from the St. Louis Cord Blood Bank may contact you several weeks after your delivery to check on the health of you and your baby. If your child’s cord blood is identified as a potential match for a patient anytime in the future, an additional phone call will be made to check on the health of your child and family. This call is to obtain and update medical information only. At no time will you or your child be asked for additional blood samples.
In the United States, the Food and Drug Administration regulates any facility that stores cord blood; cord blood intended for use in the person from whom it came is not regulated, but cord blood for use in others is regulated as a drug and as a biologic. Several states also have regulations for cord blood banks.
Cord blood is also being studied as a substitute for normal blood transfusions in the developing world. More research is necessary prior to the generalized utilization of cord blood transfusion.
“This reanalysis supports several previously expressed opinions that autologous [to use one’s OWN cells] banking of cord blood privately as a biological insurance for the treatment of life-threatening diseases in children and young adults is not clinically justified because the chances of ever using it are remote. The absence of published peer-reviewed evidence raises the serious ethical concern of a failure to inform prospective parents about the lack of future benefit for autologous cord banking … Attempts to justify this [commercial cord blood banking] are based on the success of unrelated public domain cord banking and allogeneic [using someone ELSE’S cells] cord blood transplantation, and not on the use of autologous [the person’s OWN cells] cord transplantation, the efficacy of which remains unproven”.
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.
Why Do Pregnant Women Crave Pickles and Ice Cream? There’s a Science to It MSCs: Characteristics, Advatages Over Other Stem Cells & Applications Human Leukocyte Antigen (HLA) Matching And Stem Cell Transplants Top Questions to Ask Your Cord Blood Bank Before Making a Decision
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.