While cord-blood companies herald the possible future treatments of many adult diseases with stem cells, they rarely mention a key issue. Researchers have greater hopes for the potential of embryonic stem cells, which are thought to have the ability to develop into many different types of cells. It is not known whether the stem cells in cord blood have that ability; until recently, it was thought that they (like those in bone marrow) could only regenerate blood and immune cells.
There is often confusion over who can use cord blood stem cells in treatment — the baby they were collected from or a sibling? The short answer is both, but it very much depends on the condition being treated. And it’s ultimately the treating physician’s decision.
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 $150.
Pro: It gives you that peace of mind that if anything did happen to your child, the doctors would have access to their blood. This could potentially be a great benefit, and you would have no idea what would have happened if it weren’t for this blood.
Public cord blood banking supports the health of the community. Public banks collect qualifying cord blood donations from healthy pregnancies and save them in case one of them will be the match to save the life of a patient who needs a stem cell transplant. In the United States our registry of donors is called Be The Match. Patients who have a rare genetic type are more likely to receive cord blood transplants. In order for parents to donate cord blood to a public bank, their baby must be born at a hospital that accepts donations. Public cord blood banking is highly recommended by both the American Academy of Pediatrics (AAP) and American Medical Association (AMA).
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Most stored cord blood is discarded. At public cord blood banks, a unit of stored cord blood has a greater chance of being used to help a sick child or used toward stem cell research. Private cord blood banks, on the other hand, eventually throw away blood that a family no longer wants to store or use.
Choosing a bank (specifically a private bank) for her daughter’s cord blood made perfect sense to Julie Lehrman, a mom based in Chicago. “We wanted the extra assurance that we were doing everything we could to keep Lexi healthy,” Lehrman says. “I was older when Lexi was born, and there’s a lot we didn’t know about my mom’s health history, so we felt that we were making a smart decision.” Fortunately, Lexi was born healthy, and neither she nor anyone else in the family has needed the cord blood since it was stored seven years ago. But Lehrman has no regrets; she still feels the family made a wise investment. “Lexi or her brother or even one of us could still need that blood in the future, so I’m thankful that we have it.” But banking your child’s cord blood may not be the right decision for you. Read on to see if you should opt for private cord blood banking.
Use for Family Siblings gain access to the stem cells, too. They have a one-in-four chance of being a perfect match amd a 39% chance of being a transplant-acceptable match. Parents have a 100 pecent chance of being a partial match. The chances of recovering the donated stem cells for a family memeber is also diminished greatly as described above. Siblings = 75% chance of acceptable match
Haematopoietic stem cells (HSCs) can make every type of cell in the blood – red cells, white cells and platelets. They are responsible for maintaining blood production throughout our lives. They have been used for many years in bone marrow transplants to treat blood diseases.
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.
Though uses of cord blood beyond blood and immunological disorders is speculative, some research has been done in other areas. Any such potential beyond blood and immunological uses is limited by the fact that cord cells are hematopoietic stem cells (which can differentiate only into blood cells), and not pluripotent stem cells (such as embryonic stem cells, which can differentiate into any type of tissue). Cord blood has been studied as a treatment for diabetes. However, apart from blood disorders, the use of cord blood for other diseases is not in routine clinical use and remains a major challenge for the stem cell community.
Like most transplants, the stem cells must be a genetic match with the patients to be accepted by the body’s immune system. It goes without saying that a patient’s own cord blood will be a 100% match. The second highest chance of a genetic match comes from siblings.
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).
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.
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In 2007, the AAP issued a revised cord-blood-banking policy, that discourages private banks for families who aren’t already facing a health crisis. “These banks prey on parents’ fears of the unknown, and there’s no scientific basis for a number of medical claims they make,” says Bertram Lubin, MD, president and director of medical research for Children’s Hospital Oakland Research Institute, and coauthor for the AAP’s 2006 cord-blood-banking committee.
The Cord Blood Registry (CBR) is unique, because it is currently the world’s largest cord blood bank, with over a half-million cord blood and cord tissue units stored to date. This is substantially more than its nearest competitor, ViaCord, which has 350,000 units stored. It was recently acquired by pharmaceutical giant, AMAG Pharmaceuticals, for $700 million in June 2015.
The American Pediatric Association in 2008 recommended that physicians recommend that cord blood be donated instead of saved privately for family families. One of the major proponents for this was Joanne Kurtzberg, who profited from this by getting funding for her public cord blood bank at Duke University. She has since started her own private cord blood bank after doing more research on Cerebral Palsy. Interesting.
Both public and family cord blood banks must register with the US Food and Drug Administration (FDA), and since Oct. 2011 public banks also need to apply for an FDA license. All cord blood banks are required by federal law to test the blood of the mother for infectious diseases. At public banks the screening is usually more extensive, similar to the tests performed when you donate blood. The typical expense to a public bank is $150 per unit.
In addition, CBR offers Genetic Counselors on staff to help families make informed decisions about newborn stem cell banking. Phone 1-888-CORDBLOOD1-888-CORDBLOOD to speak with a CBR Genetic Counselor.
In fact, the AAP does encourage parents to keep their child’s cord blood if a family member has already been diagnosed with a stem-cell-treatable disease. But a family won’t have to foot the bill: The Children’s Hospital Oakland Research Institute, in California, will bank a baby’s cord blood for free if a family member needs it at the time of the baby’s birth. Some private banks, such as Cord Blood Registry, Cryo-Cell, and ViaCord, have similar programs.
Stem cell transplant using an individual’s own cord blood (called an autologous transplant) cannot be used for genetic disorders such as sickle cell disease and thalassemia, because the genetic mutations which cause these disorders are present in the baby’s cord blood. Other diseases that are treated with stem cell transplant, such as leukemia, may also already be present in a baby’s cord blood.
Much research is focused on trying to increase the number of HSCs that can be obtained from one cord blood sample by growing and multiplying the cells in the laboratory. This is known as “ex vivo expansion”. Several preliminary clinical trials using this technique are underway. The results so far are mixed: some results suggest that ex vivo expansion reduces the time taken for new blood cells to appear in the body after transplantation; however, adult patients still appear to need blood from two umbilical cords. More research is needed to understand whether there is a real benefit for patients, and this approach has yet to be approved for routine clinical use.
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.
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.
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The syringe or bag should be pre-labeled with a unique number that identifies your baby. Cord blood may only be collected during the first 15 minutes following the birth and should be processed by the laboratory within 48 hours of collection.
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.
Are public banks and family banks the same, except for who may use the cord blood and the cost to the parents? No. Public banks are subject to much higher regulatory requirements, and compliance with regulations carries costs. At a family bank you pay the bank enough to cover the cost of storing your baby’s cord blood, plus they make a profit. When you donate to a public bank, it costs you nothing, but the bank pays more on processing each blood collection than at a family bank. Let’s look at the steps that take place in the laboratory.
In the public arena there has been much discussion on the benefits of for-profit private cord blood banking over public banking. Numerous for-profit companies offer new parents the option of collecting and storing cord blood for future use by the donor infant, siblings, or other family members. Parents may choose to bank cord blood if they have a family history of a particular disease or disorder, or as a means of “biological insurance” in case their child or family member develops a medical condition or becomes injured requiring a transplant.
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.
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.
If you do decide to bank your baby’s cord blood, there’s one more thing to keep in mind: It’s best not to make it a last-minute decision. You should coordinate with the bank before your baby is born so nothing is left to chance.