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The members of the team at CORD:USE are credited for discovering the field of cord blood banking and transplantation. With more than 150 years of combined knowledge and experience, our team members are universally recognized as pioneers and leading experts in the field.
Stem cells are the next frontier in medicine. Stem cells are thought to have great therapeutic and biotechnological potential. This will not only to replace damaged or dysfunctional cells, but also rescue them and/or deliver therapeutic proteins after they have been engineered to do so. Currently, ethical and scientific issues surround both embryonic and fetal stem cells and hinder their widespread implementation. In contrast, stem cells recovered postnatally from the umbilical cord, including the umbilical cord blood cells, amnion/placenta, umbilical cord vein, or umbilical cord matrix cells, are a readily available and inexpensive source of cells that are capable of forming many different cell types (i.e., they are “multipotent”). This review will focus on the umbilical cord-derived stem cells and compare those cells with adult bone marrow-derived mesenchymal stem cells.
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.
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.
^ Jump up to: a b Haller M J; et al. (2008). “Autologous umbilical cord blood infusion for type 1 diabetes”. Exp. Hematol. 36 (6): 710–715. doi:10.1016/j.exphem.2008.01.009. PMC 2444031 . PMID 18358588.
The gene expression analysis and reverse-transcription polymerase chain reaction (RT-PCR) of MSCs from the umbilical cord was reported by one lab using the National Institutes on Aging (NIA) human 15k gene array (28). That work indicated that human UCM cells express genes found in cells derived from all three germ layers to some extent. At least one report indicates that UCM cells express the pluripotency gene markers Oct-4, nanog, and Sox-2 at low levels relative to ESCs (33). One interpretation of these findings is that cord matrix stem cells are pleiotropic and express a relatively large number of genes in relatively low abundance. On the other hand, it may serve as evidence that the cord matrix cell population has a subset of primitive stem cells. Because gene array is not a sensitive method by which to examine low copy number message, we suggest that massively parallel signature sequencing (MPSS) is a more appropriate method of assessing matrix cell gene expression. RT-PCR alone is not useful for characterizing cord matrix stem cells: quantitative RT-PCR is needed to make meaningful statements about gene expression and to compare gene expression between experimental conditions.
During the harvesting procedure, doctors use a catheter to draw out blood. The blood moves through a machine, which separates stem cells and allows these cells to be put into storage. This process takes a few hours, and may be repeated over several days in order for doctors to get enough stem cells.
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.
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).
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.
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.
The parents who make the decision to store their baby’s cord blood and cord tissue are thinking ahead, wanting to do right from the start (even before the start), and taking steps to do whatever they can to protect their baby down the road. Today, many conscientious parents are also considering delayed cord clamping (DCC), a practice in which the umbilical cord is not clamped immediately but rather after it continues to pulse for an average of 30 seconds to 180 seconds. Many parents don’t realize that they can delay the clamping of the cord and still bank their baby’s cord blood. As noted early, our premium processing method, PrepaCyte-CB, is able to capture more immune system cells and reduce the greatest number of red blood cell contaminants. This makes it go hand in hand with delayed cord clamping because it is not as affected by volume, effectively making up for the smaller quantity with a superior quality. You can read more about delayed cord clamping vs. cord blood banking here.
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.
If someone doesn’t have cord blood stored, they will have to rely on stem cells from another source. For that, we can go back to the history of cord blood, which really begins with bone marrow. Bone marrow contains similar although less effective and possibly tainted versions of the same stem cells abundant in cord blood. Scientists performed the first bone marrow stem cell transplant in 1956 between identical twins. It resulted in the complete remission of the one twin’s leukemia.
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
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.
Parents who wish to donate cord blood are limited by whether there is a public bank that collects donations from the hospital or clinic where their baby will be born. Search our list of public banks in your country. Parents who wish to store cord blood and/or cord tissue for their family can find and compare private banks in your country. Family banks usually offer payment plans or insurance policies to lower the cost of cord blood banking.
^ Jump up to: a b Walther, Mary Margaret (2009). “Chapter 39. Cord Blood Hematopoietic Cell Transplantation”. In Appelbaum, Frederick R.; Forman, Stephen J.; Negrin, Robert S.; Blume, Karl G. Thomas’ hematopoietic cell transplantation stem cell transplantation (4th ed.). Oxford: Wiley-Blackwell. ISBN 9781444303537.
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.
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.
Cord tissue is rich in a completely different type of stem cell. With over fifty clinical trials currently in progress, researchers agree that banking cord tissue is the future of stem cell banking. Learn more >
AutoXpress™ Platform (AXP) cord blood processing results in a red-cell reduced stem cell product. Each sample is stored in a cryobag consisting of two compartments (one major and one minor) and two integrally attached segments used for unit testing.
Cord Blood Registry offers two ways to save your newborn’s stem cells, and convenient payment options to fit your family’s needs. CBR recognizes that each family’s budget is unique. As a result, CBR does not take a one-size-fits-all approach to pricing and payments for cord blood and tissue banking. Calculate your stem cell banking costs and CBR will recommend payment plans that may fit your family’s budget.
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.
Cord Blood Registry is a registered trademark of CBR® Systems, Inc. Annual grant support for Parent’s Guide to Cord Blood Foundation is made possible by CBR® through the Newborn Possibilities Fund administered by Tides Foundation.
Some controversial studies suggest that cord blood can help treat diseases other than blood diseases, but often these results cannot be reproduced. Researchers are actively investigating if cord blood might be used to treat various other diseases.
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.
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 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.
After your baby is born, the umbilical cord and placenta are usually thrown away. Because you are choosing to donate, the blood left in the umbilical cord and placenta will be collected and tested. Cord blood that meets standards for transplant will be stored at the public cord blood bank until needed by a patient. (It is not saved for your family.)
Pregnant women sometimes have questions or concerns regarding umbilical cord blood donation. Two common questions are: Can their infant’s cord blood be used to benefit MS research? Another question: Is it worthwhile to “bank” their infant’s umbilical cord blood for the benefit of a family member who might need the umbilical stem cells for future treatment of their MS?
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.
CBR Cord Blood Education Specialists are available 7 days a week (Monday – Friday 6 AM – 9 PM PST and Saturday – Sunday 6 AM – 4 PM PST) to respond to consumer inquiries. In addition, consumers may request to schedule a call with a CBR Cord Blood Education Specialist at a specific date and time.
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 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.
“This is a medical service that has to be done when your baby’s cells arrive and you certainly want them to be handled by good equipment and good technicians,” says Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists. “It’s just not going to be cheap.” Although the American Academy of Pediatrics (AAP) states cord blood has been used to treat certain diseases successfully, there isn’t strong evidence to support cord blood banking. If a family does choose to bank cord blood, the AAP recommends public cord blood banking (instead of private) to reduce costs.
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.”
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).
The term “cord blood” is used for the blood remaining in the umbilical cord and the placenta after the birth of a baby. Cord Blood contains stem cells that can grow into blood and immune system cells, as well as other types of cells. Today cord blood is often used as a substitute for bone marrow in stem cell transplants. There are over 80 diseases treated this way, including cancers, blood disorders, genetic and metabolic diseases.
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.