The AMA also suggests considering private cord blood banking if there is a family history of malignant or genetic conditions that might benefit from cord blood stem cells. Keep in mind, however, that to find a suitable match for any type of transplant, 70% must look outside their family.
A cord blood bank may be private (i.e. the blood is stored for and the costs paid by donor families) or public (i.e. stored and made available for use by unrelated donors). While public cord blood banking is widely supported, private cord banking is controversial in both the medical and parenting community. Although umbilical cord blood is well-recognized to be useful for treating hematopoietic and genetic disorders, some controversy surrounds the collection and storage of umbilical cord blood by private banks for the baby’s use. Only a small percentage of babies (estimated at between 1 in 1,000 to 1 in 200,000) ever use the umbilical cord blood that is stored. The American Academy of Pediatrics 2007 Policy Statement on Cord Blood Banking stated: “Physicians should be aware of the unsubstantiated claims of private cord blood banks made to future parents that promise to insure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood.” and “private storage of cord blood as ‘biological insurance’ is unwise” unless there is a family member with a current or potential need to undergo a stem cell transplantation. The American Academy of Pediatrics also notes that the odds of using a person’s own cord blood is 1 in 200,000 while the Institute of Medicine says that only 14 such procedures have ever been performed.
As the research into umbilical cord blood and it’s therapeutic use for blood diseases has grown, so has the question as to whether people should privately store the cord blood of their offspring for future use. A recent paper on this issue by Mahendra Rao and colleagues advocates the practice of cord blood banking (for treatment of blood diseases) but in the context of public cord blood banks rather than a private cord blood banks. Any adult needing treated would need at least two cord blood samples that are immune compatible. So one sample will not be sufficient. A child might only need one cord blood sample but in the case of childhood leukaemia there is a risk that pre-leukemic cells are present in cord blood sample – and so the child could not use their own cells for therapy.
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When you consider that public banks can only expect to ship 1-2% of their inventory for transplant, you can quickly understand why most public banks are struggling to make ends meet. That struggle means that fewer collection programs are staffed, and there are fewer opportunities for parents to donate to the public good. We said earlier that public banks only keep cord blood donations over a minimum of 900 million cells, but today most public banks have raised that threshold to 1.5 billion cells. The reason is that the largest units are the ones most likely to be used for transplants that bring income to the bank. Family cord blood banks do not need to impose volume thresholds because they have a profit margin on every unit banked.
When a child develops a condition that can be treated with stem cells, they undergo transplant. A doctor infuses stem cells from cord blood or bone marrow into the patient’s bloodstream, where they will turn into cells that fight the disease and repair damaged cells—essentially, they replace and rejuvenate the existing immune system.
In the rare event of a processed sample not adhering to quality standards, CBR’s certified genetic counselors will work with potential clients to help them understand their options. Under this scenario, clients will have the option to discontinue storage and receive a refund.
Cord Blood banking is a confusing topic. Many parents get bombarded with information when searching to see if cord blood banking is right for them. There is information that private cord blood banking companies, like Viacord and Cord Blood Registry, will not tell you, until now.
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).
‡ 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.
While donating cord blood is honorable, there is a lot people do not know about the public option. Most public cord blood banks have a limited number of collection sites, and they only retain a small number of collections because of volume and other criteria that must be met. Once cord blood is donated, it is highly unlikely that the donation can ever be attained by the donor or his or her family if the need arises. In addition, it may be hard to find another viable match from what is publically available. While donating is free, retreiving a cord blood sample from a public cord blood bank is not and pales in comparison to the overall cost of privately banking cord blood. These are just some of the reasons why privately banking cord blood may be a better option for some families.
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.
Luckily for expectant parents, cord blood can be easily collected at the baby’s birth via the umbilical cord with no harm to the mother or baby. This is why pregnancy is a great time to plan to collect and bank a baby’s cord blood.
Fortunately, those odds should improve soon. In 2005, Congress passed the Stem Cell Therapeutic and Research Act, which provides $79 million in federal funding to create a centralized cord-blood registry much like the one that exists for bone marrow. The goal is to expand the existing inventory of 45,000 donated cord-blood units to 150,000.
Dennis Michael Todd, PhD, joined Community Blood Services as its President and CEO in 2000. Community Blood Services operates the NJ Cord Blood Bank and The HLA Registry bone marrow donor center, both of which are affiliated with the National Marrow Donor Program (NMDP). In 2012, the blood center expects to distribute over 85,000 units of red cells and 20,000 platelets to hospitals and medical centers throughout northern NJ and Orange County, NY. Dr. Todd is presently a member of the NMDP Executive Committee and Chairman of the Finance Committee. He is a member of the International Society for Cellular Therapy (ISCT), the International Society for Stem Cell Research (ISSCR), the AABB, the American Association of Bioanalysts, and the New Jersey Society of Blood Bank Professionals.
In New Zealand, a hopeful couple are participating in a study that will use one of their son’s cord blood stem cells to research treatment for another son’s cystic fibrosis. In Chicago, people are using their sibling’s stem cells to successfully treat sickle cell disease. And countless other families have banked their second child’s cord blood after their first child was diagnosed with leukemia. Many of those children are alive and well today thanks to their sibling’s stem cells. Since the first successful cord blood stem cell transplant on a sibling in 1988, over 30,000 cord blood transplants have been performed worldwide.
^ 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.
The first cord blood transplant was performed in Paris on October 6, 1988. Since that time, over 1 million cord blood units have been collected and stored in public and family banks all over the world.
Cord tissue is rich in another type of stem cell. Although there are no current uses, researchers are excited about the benefits cord tissue stem cells may offer in potential future users, such as regenerative medicine. By storing both, you’ll have potential access to more possibilities
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).
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.
At present, the odds of undergoing any stem cell transplant by age 70 stands at one in 217, but with the continued advancement of cord blood and related stem and immune cell research, the likelihood of utilizing the preserved cord blood for disease treatment will continue to grow. Read more about cord blood as a regenerative medicine here.
The umbilical cord blood contains haematopoietic stem cells – similar to those found in the bone marrow – and which can be used to generate red blood cells and cells of the immune system. Cord blood stem cells are currently used to treat a range of blood disorders and immune system conditions such as leukaemia, anaemia and autoimmune diseases. These stem cells are used largely in the treatment of children but have also started being used in adults following chemotherapy treatment.
With the consent of the parents, blood can be collected from the umbilical cord of a newborn baby shortly after birth. This does not hurt the baby or the mother in any way, and it is blood that would otherwise be discarded as biological waste along with the placenta (another rich source of stem cells) after the birth.