Umbilical cord blood was once discarded as waste material but is now known to be a useful source of blood stem cells. Cord blood has been used to treat children with certain blood diseases since 1989 and research on using it to treat adults is making progress. So what are the current challenges for cord blood research and how may it be used – now and in the future?
StemCyte is a global cord blood therapeutics company. StemCyte participates in the US network of public cord blood banks operated by Be The Match. In addition, StemCyte operates the National Cord Blood Bank of Taiwan, whose units are also listed with Be The Match.
^ a b c American Academy of Pediatrics Section on Hematology/Oncology; American Academy of Pediatrics Section on Allergy/Immunology; Lubin, BH; Shearer, WT (January 2007). “Cord blood banking for potential future transplantation”. Pediatrics. 119 (1): 165–70. doi:10.1542/peds.2006-2901. PMID 17200285.
Another type of cell that can also be collected from umbilical cord blood are mesenchymal stromal cells. These cells can grown into bone, cartilage and other types of tissues and are being used in many research studies to see if patients could benefit from these cells too.
As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
Therapies with cord blood have gotten more successful. “The outcomes of cord blood transplants have improved over the past 10 years because researchers and clinicians have learned more about dosing cord blood, picking better matches, and giving the patient better supportive care as they go through the transplant,” says Joanne Kurtzberg, M.D., director of the pediatric bone marrow and stem cell transplant program at Duke University.
Cord blood banking is not always cheap. It’s completely free to donate blood to a public cord blood bank, but private banks charge $1,400 to $2,300 for collecting, testing, and registering, plus an annual $95 to $125 storing fee.
Phone 1-888-932-6568 to connect with a CBR Cord Blood Education Specialist or submit an online request. International callers should phone 650-635-1420 to connect with a CBR Cord Blood Education Specialist.
Umbilical cord blood contains haematopoietic (blood) stem cells. These cells are able to make the different types of cell in the blood – red blood cells, white blood cells and platelets. Haematopoietic stem cells, purified from bone marrow or blood, have long been used in stem cell treatments for leukaemia, blood and bone marrow disorders, cancer (when chemotherapy is used) and immune deficiencies.
Because the body’s immune system is designed to find and get rid of what it believes to be outside contaminants, stem cells and other cells of the immune system cannot be transfused into just anyone. For stem cell transfusions of any type, the body’s immune system can mistakenly start attacking the patient’s own body. This is known as graft-versus-host disease (GvHD) and is a big problem post-transplant. GvHD can be isolated and minimal, but it can also be acute, chronic and even deadly.
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.
Even if a sick child has a sibling donor, there’s only a 25 percent chance that cord blood will be a perfect match — and an equal chance it won’t match at all. That’s why public donations are so important. So far, many more stem-cell transplants have been done using cord blood stored in public banks. From 2000 to 2004, more than 2,200 unrelated transplants were done nationwide.
Beyond these blood-related disorders, the therapeutic potential of umbilical cord blood stem cells is unclear. No therapies for non-blood-related diseases have yet been developed using HSCs from either cord blood or adult bone marrow. There have been several reports suggesting that umbilical cord blood contains other types of stem cells that are able to produce cells from other tissues, such as nerve cells. Some other reports claim that umbilical cord blood contains embryonic stem cell-like cells. However, these findings are highly controversial among scientists and are not widely accepted.
No one knows how stem cells will be used in the future, but researchers hope that they may be used to treat many conditions, like Alzheimer’s, diabetes, heart failure, spinal cord damage, and other conditions.
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.
Remaining in the umbilical cord and placenta is approx. 40–120 milliliters of cord blood. The healthcare provider will extract the cord blood from the umbilical cord at no risk or harm to the baby or mother.
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.
Preserving stem cells does not guarantee that the saved stem cells will be applicable for every situation. Ultimate use will be determined by a physician. Please note: Americord Registry’s activities are limited to collection of umbilical cord tissue from autologous donors. Americord Registry’s possession of a New York State license for such collection does not indicate approval or endorsement of possible future uses or future suitability of cells derived from umbilical cord tissue.
The majority of programs that accept cord blood donations require the mother to sign up in advance. In the united States, the current requirement is to sign up by the 34th week of pregnancy. This cannot be over-stressed; time and time again, mothers who want to donate are turned away because they did not inquire about donation until it was too late.
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.
After birth, your baby no longer needs the umbilical cord or placenta. But the blood that remains could be a lifesaver for a patient who needs it, including a member of your own family. That’s because this blood is rich with blood-forming stem cells. As with bone marrow transplants, these cells can be transplanted and help save the lives of patients with leukemia or other life-threatening diseases.
If you want the blood stored, after the birth, the doctor clamps the umbilical cord in two places, about 10 inches apart, and cuts the cord, separating mother from baby. Then she inserts a needle and collects at least 40 milliliters of blood from the cord. The blood is sealed in a bag and sent to a lab or cord blood bank for testing and storage. The process only takes a few minutes and is painless for mother and baby.
Prices subject to change until they are paid. Fees apply to single-birth, U.S. customers only. Cancellation fees may apply. All major credit cards accepted. Payment plans cover first-year fees only; future annual storage fees are not included. If not paying by credit/debit card, total first year fees are due at the time of enrollment.
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.
It would be possible for a healthy child’s cord blood to be used to treat a sibling with leukemia, but the banks’ literature doesn’t spell out that distinction. In the last 10 years, almost all of the approximately 70 cord-blood transplants that have used privately stored blood were given to relatives with preexisting conditions, not to the donors themselves.
Access Immediately available once a match is confirmed. Search and match process may take weeks or months; ultimately, a match may not be located. Immediately available upon HLA match May take weeks or months; no match may be found
Cord tissue use is still in early research stages, and there is no guarantee that treatments using cord tissue will be available in the future. Cord tissue is stored whole. Additional processing prior to use will be required to extract and prepare any of the multiple cell types from cryopreserved cord tissue. Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue and long-term storage of umbilical cord–derived stem cells. Cbr Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
*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.
Banking of stem cells from cord blood began in 1994 with the foundation of the New York Blood Centre Cord Blood Bank. The field of umbilical cord blood storage has matured considerably over the last two decades. We continue to learn more about the long-term effects of cryo-preservation on the cells, which has resulted in increased storage times.
Companies throughout Europe also offer commercial (private) banking of umbilical cord blood. A baby’s cord blood is stored in case they or a family member develop a condition that could be treated by a cord blood transplant. Typically, companies charge an upfront collection fee plus an annual storage fee.
Because of the invasive procedure required to obtain the bone marrow, scientist continued to look for a better source, which eventually lead to the discovery of similar stem cells in cord blood in 1978. Cord blood was used in its first transplant in 1988, and cord blood has since been shown to be more advantageous than other means of acquiring similar stem cells and immune system cells. This is because umbilical cord blood can be considered naïve and immature compared to other sources. Cord blood has not been exposed to disease or environmental pollutants, and it is more accepting of foreign cells. In this case, inexperience makes it stronger.
To save money, public banks will not even process a cord blood donation unless they know in advance that they are going to keep it. When the collection first arrives at the lab, it is passed through a cell counting machine. Only collections that have at least 900 million nucleated cells are kept. As a result, over 60%-80% of cord blood donations are discarded. The public bank must absorb the expense of the collection kit and delivery charges for discarded blood; typically $100 per unit.