Umbilical Cord Cells Bank
on the Future

by Barbra Williams Cosentino

Blood. Thick, gelatinous, redder than a blushing bride, it’s filled with substances that move oxygen and nutrients to the cells of the body, defend the body against foreign invaders, and help us to clot if we nick ourselves dicing onions for dinner.
If you’re pregnant or have had a child in the past few years, you’ve probably heard about cord blood banking, which allows umbilical stem cells to be stored cryogenically, under liquid nitrogen.
Blood from the umbilical cord of a newborn baby is full of healthy, life-enhancing stem cells that are capable of turning into red blood cells, white blood cells or platelets. When the body’s own cells have been destroyed by disease, chemotherapy or radiation, stem cell transplants, injected into the patient’s bloodstream, can help to regenerate bone marrow and immune systems.
These stem cells are different from embryonic stem cells, which are harvested from human embryos and fetal tissue. Use of embryonic stem cells has been controversial because a potential life is ended to harvest them.
There has recently been a sharp increase in the number of parents saving the blood from their children’s umbilical cord, with at least 125,000 units of cord blood banked at storage facilities worldwide. “Even though it’s kind of expensive, it would be like buying an insurance policy for my baby’s future,” says one expectant mom who is considering having her as-yet unborn baby’s cord blood saved.
Harvested from the cord and placenta within 15 minutes after delivery and then frozen, stem cells are now often used in place of bone marrow transplants to
treat leukemia, aplastic anemia and more than 45 other serious or life-threatening disorders.
“There are 30,000 people who need a bone marrow transplant, and one half of these people die before they
get one,” points out Dr. Richard Schwarz, MD, a past president of the American College of Obstetricians and Gynecologists.

What’s Involved
Parents who are considering whether to save their children’s cord blood should decide at least two months before their due date, giving them time to discuss the option with their obstetrician or midwife, arrange the paperwork and receive the collection kit well in advance of delivery.
The expectant parents are responsible for bringing the blood collection kit to the hospital, informing the hospital staff that they will be banking the cord blood, (which does not need to be refrigerated) and arranging for an overnight delivery courier to pick up the kit at the hospital.
The process of obtaining cord blood is simple and generally takes less than ten minutes. The health care provider clamps and cuts the cord, then uses a needle to withdraw blood from the umbilical vein and transfer it into a syringe or collection bag. Doctors typically charge $100 to $300 to perform the service.
Kim Gede, office
nurse for Newark, DE obstetrician Tildon Burton, MD, provides cord blood counseling, even for moms-to-be who aren’t Dr. Burton’s patients on a consulting basis. “Not all doctors offer the service,” she explains. Her office works with Cord Blood Registry, a California-based private blood bank.

Public Donations
Some parents can donate their child’s cord blood to a nonprofit public blood bank. This blood is available to all matching patients needing a stem cell transplant. In some cases, the stem cells might be available for future use by the donor or his family, should they be needed, but that’s not guaranteed.
However, only four Delaware Valley hospitals, all in South Jersey, are linked to a public core cell bank. They are Burlington Memorial Virtual Hospital, Mt. Holly; Cooper Health Systems, Camden; Our Lady of Lourdes Hospital, Camden; and West Jersey Virtual Hospital, Voorhees. All are affiliated with the New Jersey Cord Blood Bank at the Coriell Institute for Medical Research in Camden.
Christiana Hospital in Wilmington, DE is conducting limited public donation research, also in conjunction with the Coriell Institute. No Pennsylvania hospitals are affiliated with a public umbilical core cell bank.
The New Jersey Blood Bank is part of the National Marrow Donor Program. So far, says program director Ellen Harris, Coriell has furnished about 10 units of umbilical blood to patients needing stem cells. “We’re a small bank, but we’re trying to grow,” says Harris. “The state has been very supportive.”

Private Banking
Private, for-profit companies such as Cord Blood Registry and CorCell encourage parents to store their child’s cord blood privately, to assure that those stem cells will be available should the child, a sibling or a parent need them.
The cord blood, sealed in a specially designed package, can be transported safely to whichever bank is chosen. Private cord banks generally charge between $1,000 and $1,800 in initial processing fees, with annual storage fees ranging from $50 to more than $125. The banks at least partially reimburse clients for their doctor’s core blood collection fee. Both CorCell and Cord Blood Registry reimburse $100. CorCell also gives discounts to clients insured by AmeriHealth and Independence Blue Cross
The banks describe their service as “biological insurance,” noting that cord blood can save a child’s life (or the life of a sibling) if the child later develops a disease that might otherwise require a bone marrow transplant or stem cells from an unrelated donor.
One study reported in the New England Journal of Medicine found that the one-year survival rate for youngsters who received cord blood stem cells from a sibling was 63 percent as opposed to only 29 percent for those who had transplants from an unrelated donor.
If stem cells are needed for a transplant, family-banked cells can allow for immediate administration. Because the cells are from the recipient or his sibling or child, they will be a perfect match, significantly increasing the odds of a favorable outcome.

The Odds
Research reported in the Journal of Pediatric Hematology/Oncology puts the odds of a child by age 21 needing to use her own stored blood at 1 in 2,700. The odds of a family member using the stem cells are about 1 in 1,400. However, private cord banking proponents point out that new therapies are being developed every day, and that autogenic (originating within the recipient’s own body) stem cells could be found to be useful in treating a variety of diseases and genetic disorders.
Should you choose to bank your child’s cord blood privately so it would be available in case of future need?
Expectant parents who have a family history of certain genetic diseases, such as severe anemias, (including sickle cell), metabolic storage disorders, immune disorders or some cancers, should consider the family benefits of storing cord blood, says the March of Dimes.
A spokesperson for Philadelphia-based CorCell points to America’s ethnic diversity as another reason to bank. Matches can be hard to find for children of mixed racial marriages. Even when race is not a factor, America’s ethnic diversity makes matches less likely than in European nations, whose populations are more homogenous.
The American Academy of Pediatrics says that private storage of cord blood as “biological insurance” is not currently warranted, but adds that if a family member has a current or potential need for stem cell transplantation, parents should consider the possibility.
The Academy points out that there are encouraging results in the use of cord blood stem cell transplantation for a variety of genetic, hematology and oncologic (cancer) disorders, but these procedures are still being investigated.

Uses Increasing
Umbilical cord blood has been used in more than 3,500 transplants to date, mostly in blood cancers but also including inherited metabolic and immune system disorders.
Future uses are sure to increase. Researchers are studying the use of stem cell transplantation for Alzheimer’s disease, cardiac disease, diabetes, lupus, multiple sclerosis, muscular dystrophy, spinal cord injury, stroke, and other neurological or autoimmune disorders.
In a recent, groundbreaking case, stem cells taken from a newborn infant were given to her mother, who was diagnosed with leukemia during her pregnancy with this baby. The mother gratefully noted that the child she had given life to was now able to give her the gift of life in return.
Says Michael Lill, MD, Medical Director of California Cryobank, Inc., “The ability to store the vital stem cells from the newborn’s umbilical cord for possible future use is not just a novel approach to leveraging the future health of your baby and your family.
It is the wave of the future and prepares families for future medical advances that perhaps have yet to be imagined.”

Barbra Williams Cosentino is a registered nurse and freelance writer.