Stem cell transplants from a related family member are less likely to be rejected, therefore having your baby’s stem cells available makes it less likely you would have to search for an unrelated donor who is a match
Carolinas Cord Blood Bank at Duke (CCBB) is headed by Dr. Joanne Kurtzberg. Expectant parents who have a child in need of therapy with cord blood, especially the new therapies in clinical trials at Duke, may be eligible for directed donation through CCBB.
The Medical Letter On Drugs and Therapeutics also recently addressed aspects of public and private cord blood banks, asking the question: “Does Private Banking Make Sense?” After citing various statistics on the actual uses of privately stored cord blood, they concluded that: “At the present time, private storage of umbilical cord blood is unlikely to be worthwhile. Parents should be encouraged to contribute, when they can, to public cord blood banks instead.” [Access The Medical Letter at www.medicalletter.org].
 American Academy of Pediatrics Section on Hematology/Oncology, American Academy of Pediatrics Section on Allergy/Immunology, Bertram H. Lubin, and William T. Shearer, “Cord Blood Banking for Potential Future Transplantation,” Pediatrics 119 (2007): 165-170.
Private companies offer to store cord blood for anyone who wants it done, whether or not there is any medical reason known to do so at the time. The fee for private storage varies, but averages about $1,500 up front and $100 per year for storage. When there is no one in the family who needs a transplant, private storage of a newborn’s cord blood is done for a purely speculative purpose that some companies have termed “biological insurance.”
The first cord blood banks were private cord blood banks. In fact, Cryo-Cell is the world’s first private cord blood bank. It wasn’t until later that the government realized the need to preserve cord blood for research and public welfare. As a result, 31 states have adopted a law or have a piece of pending legislation that requires or encourages OBGYNs to educate expectant parents about cord blood banking and many states now have publicly held cord blood banks. As a result, parents have the option of banking their baby’s cord blood privately for the exclusive use of the child and the rest of the family or donating the cord blood to a public bank so that it can be used in research or by any patient who is a match and in need.
There are no hard numbers on a child’s risk of needing a stem-cell transplant: It’s anywhere between one in 1,000 and one in 200,000, according to studies cited by ACOG and the AAP. But private banks’ marketing materials often place the odds at one in 2,700 and note that these numbers don’t factor in its potential future use for diabetes, Alzheimer’s, Parkinson’s disease, and spinal-cord injuries in adults. “Researchers are constantly discovering new treatments using stem cells,” says Gerald Maass, executive vice president of corporate development for Cryo-Cell, a private bank in Clearwater, Florida. Another major bank’s Web site claims incredible odds: “Should cord blood prove successful in treating heart disease, the lifetime probability of being diagnosed with a disease treatable by cord blood will increase from one in 100 to one in two.”
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 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.
Stem cells are amazingly powerful. They have the ability to divide and renew themselves and are capable turning into specific types of specialized cells – like blood or nerve. After all, these are the cells responsible for the development of your baby’s organs, tissue and immune system
The next step at either a public or family bank is to process the cord blood to separate the blood component holding stem cells. The final product has a volume of 25 milliliters and includes a cryoprotectant which prevents the cells from bursting when frozen. Typical cost, $250 to $300 per unit.
If siblings are a genetic match, a cord blood transplant is a simple procedure that is FDA approved to treat over 80 diseases. However, there are a few considerations you should make before deciding to only bank one of your children’s blood:
Use for Donor Clients can rest assured knowing their cord blood is available if needed. Always available if needed. Donors may never find the stem cells donated if ever needed because of the following:
Blood from the umbilical cord and placenta is put into a sterile bag. (The blood is put into the bag either before or after the placenta is delivered, depending upon the procedure of the cord blood bank.)
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.
Collection hospitals for the NY Blood Center do NOT require advance registration: mothers can give a partial consent to collect the cord blood during labor, and only if the collected cord blood is suitable for transplantation will the mothers will be given additional education and asked for a final banking consent post-delivery.
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.
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).
Why should you consider donating the cord blood to a public bank? Simply because, besides bringing a new life into the world, you could be saving an individual whose best chance at life is a stem cell transplant with your baby’s donated cord blood. This can only happen if you donate and if your baby is a close enough match for a patient in need. If you chose to reserve the cord blood for your family, then siblings who have the same parents have a 25% chance of being an exact match.
Since 1989, umbilical cord blood has been used successfully to treat children with leukaemia, anaemias and other blood diseases. Researchers are now looking at ways of increasing the number of haematopoietic stem cells that can be obtained from cord blood, so that they can be used to treat adults routinely too.
Banking a baby’s blood and stem cells in a cord blood bank is a type of insurance. Ideally, you would not need to access your baby’s stem cells in order to address a medical concern. However, using a cord blood bank can provide peace of mind in knowing that you have a valuable resource if you need it.
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.
In the United States, the Food and Drug Administration regulates any facility that stores cord blood; cord blood intended for use in the person from whom it came is not regulated, but cord blood for use in others is regulated as a drug and as a biologic. Several states also have regulations for cord blood banks.
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.
Lead image of baby’s umbilical cord from Wikimedia Commons. Possible human blood stem cell image by Rajeev Gupta and George Chennell. Remaining images of blood sample bags and red blood cells from Wellcome Images.
Medical staff at the public cord blood bank will check to see if you can donate. If you have had a disease that can be given to another person through blood-forming cells, such as hepatitis B, hepatitis C, or HIV (the AIDS virus), you will likely not be able to donate. However, other medical reasons may still allow you to donate, for example, hepatitis A or diabetes only during your pregnancy (gestational diabetes). The staff at the public cord blood bank will tell you.
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?
Donating your baby’s umbilical cord blood may offer a precious resource to a patient in need of a life-saving stem cell transplant. Umbilical cord blood is rich in blood-forming stem cells, which can renew themselves and grow into mature blood cells. After your baby is born, these cord blood cells can be collected, preserved and later used as a source of stem cells for transplantation for patients with leukemia, lymphoma, and other life-threatening blood diseases.
Graft-versus-host disease (GVHD) is a common complication after an allogeneic transplant (from a source other than the patient) where the patient’s immune system recognizes the cells as “foreign” and attacks the newly transplanted cells. This can be a potentially life threatening complication. The risk for developing GVHD is lower with cord blood transplants than with marrow or peripheral blood transplants. Patients who do develop GVHD after a cord blood transplant typically do not develop as severe of a case of GVHD. Cord blood also is less likely to transmit certain viruses such as cytomegalovirus (CMV), which poses serious risks for transplant patients with compromised immune systems.
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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.
Unlike other banks, CBR uses a seamless cryobag for storage. The seamless construction decreases the potential for breakage that can occur in traditional, seamed-plastic storage bags. Prior to storage, each cryobag is placed in a second overwrap layer of plastic, which is hermetically sealed as an extra precaution against possible cross contamination by current and yet unidentified pathogens that may be discovered in the future. CBR stores the stem cells in vaults, called dewars, specially designed for long-term cryostorage. The cord blood units are suspended above a pool of liquid nitrogen that creates a vapor-phase environment kept at minus 196 degrees Celsius. This keeps the units as cold as liquid nitrogen without immersing them in liquid, which can enable cross-contamination. Cryopreserved cord blood stem cells have proven viable after more than 20 years of storage, and research suggests they should remain viable indefinitely.
This is only the beginning. Newborn stem cell research is advancing, and may yield discoveries that could have important benefits for families. CBR’s mission is to support the advancement of newborn stem cell research, with the hope that the investment you are making now will be valuable to your family in the future. CBR offers a high quality newborn stem cell preservation system to protect these precious resources for future possible benefits for your family.
Editor’s Note: This article originally appeared in the Volume 16, Number 1, Spring 2009 issue of Dignitas, the Center’s quarterly publication. Subscriptions to Dignitas are available to CBHD Members. To learn more about the benefits of becoming a member click here.
Congratulations to the Marepalli family, this week’s winners of a free year of storage! CBR Clients: Enter for a chance to win by tagging a family photo with #CBRFamilyContest! #MyStemCellsLiveAtCBR pic.twitter.com/RLIx54bLqS
Stem cells from cord blood can be used for the newborn, their siblings, and potetinally other relatives. Patients with genetic disorders like cystic fibrosis, cannot use their own cord blood and will need stem cells from a sibling’s cord blood. In the case of leukemia or other blood disorders, a child can use either their own cord blood or their sibling’s for treatment.
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.
‡ 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.
Expecting and want to help push the science of cord blood forward? Enroll now and we’ll make a donation toward cord blood education and research for #CordBloodAwarenessMonth! bit.ly/2mpcB1b pic.twitter.com/6WJYDaAgdu
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.
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.
According to Cord Blood Registry, cord blood is defined as “the blood that remains in your baby’s umbilical cord after the cord has been cut, is a rich source of unique stem cells that can be used in medical treatments.” Cord blood has been shown to help treat over 80 diseases, such as leukemia, other cancers, and blood disorders. This cord blood, which can be safely removed from your newborn’s already-cut umbilical cord, can be privately stored for the purpose of possible use in the future for your child or family member. (It can also be donated to a public bank, but this is not widely available)
While banking cord blood is a new experience for many parents, it is a simple one. After all, most mothers are worried about how the delivery will go and don’t want to also be worried about the details of collecting, processing and cryo-preserving their babies’s cord blood. Thankfully, the healthcare provider and the cord blood bank do most of the work. Here are the steps found in cord blood banking:
Bone marrow and similar sources often requires an invasive, surgical procedure and one’s own stem cells may already have become diseased, which means the patient will have to find matching stem cells from another family member or unrelated donor. This will increase the risk of GvHD. In addition, finding an unrelated matched donor can be difficult, and once a match is ascertained, it may take valuable weeks, even months, to retrieve. Learn more about why cord blood is preferred to the next best source, bone marrow.