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.
* 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.
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.
However, parents should know that a child’s own cord blood (stored at birth), would rarely be suitable for a transplant today. It could not be used at present to treat genetic diseases, for example, because the cord blood stem cells carry the same affected genes and. if transplanted, would confer the same condition to the recipient. (See the story of Anthony Dones.) In addition, most transplant physicians would not use a child’s own cord blood to treat leukemia. There are two reasons why the child’s own cord blood is not safe as a transplant source. First, in most cases of childhood leukemia, cells carrying the leukemic mutation are already present at birth and can be demonstrated in the cord blood. Thus, pre-leukemic cells may be given back with the transplant, since there is no effective way to remove them (purge) today. Second, in a child with leukemia, the immune system has already failed to prevent leukemia. Since cord blood from the same child re-establishes the child’s own immune system, doctors fear it would have a poor anti-leukemia effect.
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.
So what are your options? You have three choices. One is to store the cord blood with a private company at a cost to you ranging from $1,500 to $2,500 and an annual storage fee in the ballpark of $125. Secondly, you can donate the cord blood to a public bank, if there is one working with your hospital, and your doctor is on board with the idea. There are also public banks that accept mail-in donations, if you register during your second trimester and your doctor is willing to take a short training class on-line. Zero cost to you. The third option is to do nothing and have the cord blood, umbilical cord, and placenta destroyed as medical waste.
People who are in need of a transplant are more likely to find a match from a donor of the same ethnic descent. There are fewer racial minorities in the national registries, so finding a match can be more difficult.5
An additional cost that is borne only by public banks is the “HLA typing” that is used to match donors and patients for transplants. This is an expensive test, running about $75 to $125 per unit. Family banks always defer this test until it is known whether a family member might use the cord blood for therapy.
Umbilical cords have traditionally been viewed as disposable biological by-product. Cord blood, however, is rich in multi-potent hematopoietic stem cells (HSCs). Recent medical advances have indicated that these stem cells found in cord blood can be used to treat the same disorders as the hematopoietic stem cells found in bone marrow and in the bloodstream but without some of the disadvantages of these types of transplants. Cord blood is currently used to treat approximately 70 diseases including leukemias, lymphomas, anemias, and Severe Combined Immunodeficiency (SCID). Six thousand patients worldwide have been treated with cord blood stem cell transplants, although the FDA considers the procedure to be experimental. These multipotent stem cells also show promise for the treatment of a variety of diseases and disorders other than those affecting the blood.
Your own cord blood will always be accessible. This applies only if you pay to store your cord blood at a private bank. The blood is reserved for your own family; nobody else can access or use it, and it will never be allotted to another family or be donated to research. If you donate your cord blood to a public bank, on the other hand, anyone who needs compatible cord blood can have it; there’s no guarantee that it will be available if and when your family needs it.
Another way scientists are working with stem cells is through expansion technologies that spur replication of the cord blood stem cells. If proven effective and approved by the U.S. Food and Drug Administration, these expansion technologies will allow scientists to culture many stem cells from a small sample. This could provide doctors and researchers with enough stem cells to treat multiple family members with one cord blood collection or provide the baby with multiple treatments over time. To better prepare for the day when these expansion technologies are more easily accessible, some cord blood banks have begun to separate their cord blood collections into separate compartments, which can easily be detached from the rest of the collection and used independently. You can learn more about Cryo-Cell’s five-chambered storage bag here.
Once it arrives at the storage facility, the cord blood will be processed and placed in storage. The cord blood will either be completely immersed in liquid nitrogen or it will be stored in nitrogen vapor.
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.
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)
Chloe Savannah Metz’ mother donated her baby girl’s cord blood to the NCBP in December 2000. “Many thanks to the New York Blood Center for giving us the opportunity to donate our cord — we hope to give someone a second chance!” – Christine Metz
Cord blood stem cells are classified as adult (or non-embryonic) stem cells. Embryonic stem cells (ESC) are believed to be more advantageous for the treatment of disease or injury due to their pluripotent nature; that is, they have the ability to differentiate into all the cells present in the human body derived from the three germ layers (endoderm, mesoderm, and ectoderm). Adult stem cells are multipotent, implying that they can only differentiate into a limited number of cells typically within the same “family” (e.g., hematopoietic stem cells give rise to red blood cells, white blood cells, and platelets).
Because of these limitations and the uncommon occurrence of the diseases treatable with stem cell transplant, there have been just more than 400 autologous cord blood transplants in United States in the last two decades. In contrast, more than 60,000 unrelated donor cord blood transplants have been performed worldwide.
^ 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.
^ Reddi, AS; Kuppasani, K; Ende, N (December 2010). “Human umbilical cord blood as an emerging stem cell therapy for diabetes mellitus”. Current stem cell research & therapy. 5 (4): 356–61. doi:10.2174/157488810793351668. PMID 20528762.
It depends on who you ask. Although commercial cord blood banks often bill their services as “biological insurance” against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
The Doneses were shocked, however, when doctors told them that Anthony’s cord blood couldn’t be used because the cells contained the same genetic defect that caused his condition. “The materials provided by the bank said this was Anthony’s life insurance and could save him if he needed it. They never mentioned that the cells could be diseased. We felt duped,” Tracey says. The Long Island, New York, couple has since filed a lawsuit against the bank alleging false advertising and consumer fraud.
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.
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.
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.