And as Victor and Tracey Dones learned, a child’s own cord blood can’t always be used to treat him, even when he’s young. “Childhood leukemia is one of the diseases private banks like to play up, but most kids with leukemia are cured with chemotherapy alone. If a transplant is needed, we wouldn’t use a child’s tainted cord blood,” Dr. Kurtzberg says.
As cord blood is inter-related to cord blood banking, it is often a catch-all term used for the various cells that are stored. It may be surprising for some parents to learn that stored cord blood contains little of what people think of as “blood,” as the red blood cells (RBCs) can actually be detrimental to a cord blood treatment. (As we’ll discuss later, one of the chief goals of cord blood processing is to greatly reduce the volume of red blood cells in any cord blood collection.)
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.
Once a cord blood donation has been saved, it may be listed on a national registry that can be searched to find a match for a transplant patient. The donation could be released to any recipient who is compatible.
The American College of Obstetricians and Gynecologists (ACOG) neither recommends nor advises against cord blood banking. But along with the AAP and AMA, it cautions parents about private cord blood banking. Here’s why:
Upon arrival at CBR’s laboratory, the kit is immediately checked in and inspected. Next, the cord blood unit is tested for sterility, viability, and cell count. In addition, the cord tissue is tested for sterility. CBR processes cord blood using the AutoXpress® Platform* (AXP®) – a fully automated, functionally closed stem cell processing technology. The AXP platform is an integral component of CBR’s proprietary CellAdvantage® system. CBR has the industry’s highest published average cell recovery rate of 99%.
For example, in the UK the NHS Cord Blood Bank has been collecting and banking altruistically donated umbilical cord blood since 1996. The cord blood in public banks like this is stored indefinitely for possible transplant, and is available for any patient that needs this special tissue type. There is no charge to the donor but the blood is not stored specifically for that person or their family.
Gift of Life is a non-profit charity that seeks to help Jewish patients find a transplant match. They recruit both bone marrow donors and cord blood donations from the Jewish community. Gift of Life operates their own accredited cord blood laboratory that participates in the national NMDP network.
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As most parents would like to bank their babies’ cord blood to help safeguard their families, it is often the cost of cord blood banking that is the one reason why they do not. Most cord blood banks have an upfront fee for collecting, processing and cryo-preserving the cord blood that runs between $1,000 and $2,000. This upfront fee often also includes the price of the kit provided to collect and safely transport the cord blood, the medical courier service used to expedite the kit’s safe shipment, the testing of the mother’s blood for any infectious diseases, the testing of the baby’s blood for any contamination, and the cost of the first full year of storage. There is then often a yearly fee on the baby’s birthday for continued storage that runs around $100 to $200 a year.
There is no significant opposition in the medical community to the public banking of cord blood. The donation of cord blood to public banks has generally been encouraged by the medical profession. The American Academy of Pediatrics encourages the public donation of cord blood with appropriate genetic and infectious disease testing, although they caution that parents should be notified that they will receive the results of this testing. They also recommend that parents be informed that publicly banked cord blood may not be available for future private use.
Taking time to consider helping another person when you are already busy planning for the birth of your child is greatly appreciated. A gift of cord blood may someday give someone a second chance at life.
^ 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.
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.
There are usually two fees involved in cord blood banking. The first is the initial fee that covers enrollment, collection, and storage for at least the first year. The second is an annual storage fee. Some facilities vary the initial fee based upon the length of a predetermined period of storage.
Part of the reason for the dominance of these three companies in terms of the total number of units stored is that they are three of the oldest cord blood banks within the U.S., founded in 1992, 1993, and 1989, respectively. All three of these cord blood banks also support cord blood research and clinical trials.
When Tracey and Victor Dones’s 4-month-old son was diagnosed with osteopetrosis, a potentially fatal disorder that affects bone formation, the panic-stricken couple was relieved to hear that a stem-cell transplant could save his life. “We’d paid to store Anthony’s umbilical-cord blood in a private bank in case he ever needed it — and I thought we were so smart for having had the foresight to do that,” says Tracey.
Generally not. The reason siblings are more likely to match is because they get half of their HLA markers from each parent. Based on the way parents pass on genes, there is a 25 percent chance that two siblings will be a whole match, a 50 percent chance they will be a half match, and a 25 percent chance that they will not be a match at all. It is very rare for a parent to be a match with their own child, and even more rare for a grandparent to be a match.
The standard used to identify these cord blood banks was the number of cord blood and cord tissue units stored by each company. The purpose of this analysis is to compare pricing and services among the largest cord blood banks within the U.S., the most mature cord blood banking market in the world. These three industry giants also represent several of the largest cord blood banks worldwide.
Banked cord blood is most abundant in white blood cells and stem cells. While a lot of attention is paid to the stem cells, there are approximately 10 times more total nucleated cells (TNCs) than stem cells in any cord blood collection. TNCs are basically white blood cells, or leukocytes; they are the cells of the immune system that protect the body. Despite stem cells comprising one-tenth of most collections, cord blood is still considered a rich source of hematopoietic (he-mah-toe-po-ee-tic) stem cells (HSCs). HSCs are often designated by the marker CD34+. Hematopoietic stem cells can become two categories of cells: myeloid and lymphoid cells. Myeloid cells go on to form your red blood cells, platelets, and other cells of the blood. Lymphoid cells go on to become the B cells and T cells and are the basis for the immune system. Cord blood also contains mesenchymal (meh-sen-ki-mal) stem cells (MSCs), but they are much more abundant in cord tissue, which we will discuss in a minute.
If you feel that the procedure is too expensive for your child, check with the hospital to see if there are any programs and/or grants available that can assist with the procedure. Some companies do offer financial aid.
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.
Life Line Stem Cell asks mothers arriving for delivery to donate all perinatal tissue: cord blood, cord tissue, and the placenta. Cord blood donations that are eligible for transplant are sent to a public cord blood bank; the tissue collections go towards research programs.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
* Disclaimer: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used. Cord tissue stem cells are not approved for use in treatment, but research is ongoing.
^ 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.
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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.
There has been considerable debate about the ethical and practical implications of commercial versus public banking. The main arguments against commercial banking have to do with questions about how likely it is that the cord blood will be used by an individual child, a sibling or a family member; the existence of several well-established alternatives to cord blood transplantation and the lack of scientific evidence that cord blood may be used to treat non-blood diseases (such as diabetes and Parkinson’s disease). In some cases patients may not be able to receive their own cord blood, as the cells may already contain the genetic changes that predispose them to disease.
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.
The cord blood of your baby is an abundant source of stem cells that are genetically related to your baby and your family. Stem cells are dominant cells in the way they contribute to the development of all tissues, organs, and systems in the body.
There was a time before the 1990s when the umbilical cord and its blood were considered medical waste. Today, parents bank or store their baby’s umbilical cord blood because the stem cells it contains are currently utilized or show promise in the treatment of life-threatening and debilitating diseases.
CBR collection kits have been designed to shield the samples from extreme temperatures (shielding for more than 1 hour at extreme hot and cold). Samples remain at room temperature and are shipped directly to the CBR lab for processing.
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.
Experts believe that umbilical cord blood is an important source of blood stem cells and expect that its full potential for treatment of blood disorders is yet to be revealed. Other types of stem cell such as induced pluripotent stem cells may prove to be better suited to treating non-blood-related diseases, but this question can only be answered by further research.
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.
Yes, stem cells can be used on the donor following chemo and radiation to repair the bone marrow. For a full list of treatments, please visit : http://cellsforlife.com/cord-blood-basics/diseases-treated-with-cord-blood-stem-cells/