Why You Should Give a Thought to Cord Blood Stem Cell Banking?

The field of stem cell biology has advanced the most over the last decade and the advancing technologies offer unique promise of regenerative medicine applications. Even though the embryonic stem cell harvesting and research has been surrounded by the social controversies, cord blood banking has managed to gain acceptance worldwide. Umbilical cord blood (CB), as the name indicates, is the blood present in the umbilical cord and placenta of the new born. According to the scientific findings, this blood is a rich source of stem cells. If you have been thinking about the significance of stemcell banking, then let us explain. Stem cells, also known as master cells possess self-renewal capability, which means it can act as an internal repair system. Differentiation and unspecialized nature are some of the unique properties that make stem cells highly valuable. Until recently, these master cells were harvested from blood and bone marrow. But with the discovery of stem cell presence in umbilical cord blood tissue, researchers have been encouraging the banking of new-born’s CB.  

Newborn baby’s cord bloodcan be either stored at a private bank or donated through a public bank. If you are an expectant parent, then it is essential to think through decisions. You may spend some time in research in order to check out the benefits of private cord blood banking and public cord blood donation. Once you are clear about the advantages of umbilical cord blood tissue storage and banking, you may have a detailed discussion with your doctor and family members. Have a look at your family health history to check whether there are any inherited diseases or conditions. If you are contemplating with the idea of banking your newborn baby’s cord blood,then make it a point to explore more about the private facilities. Keep in mind that CB cells have a remarkable potential to save lives and it would be a big mistake to discard it.

Milestones in Baby Cord Blood Banking History

Umbilical cord blood banking is a relatively new procedure that has been gaining wide acceptance over the past decade. Blood present in the umbilical cord and placenta is a rich source of adult stem cells. In the past, it was discarded as medical waste. But nowadays, after the child birth, the blood present in the cord is drawn to the sterile collection bank and sent to banks for storage or donation. Baby cord blood can be used to treat more than 80 diseases including cancers, blood disorders and immune deficiencies. Leukemia is one of the most common life-threatening conditions that can be treated with the umbilical cord blood stem cells. Moreover, several clinical trials are underway exploring the umbilical cord tissue benefits and therapeutic applications.  Stem cell research scientists have higher hopes that cord tissue cells can be used to treat the spinal cord injuries and heart damages in near future. So, the expectant families have three options before them – they can throw away the life-saving resource, donate it to a public bank or store it in a private bank. 

Baby cord blood banking industry has been evolving rapidly over the last decade. Why not check out the milestones in stem cell research and cord blood history? The world’s first umbilical cord blood transplantation (UCBT) took place in France on October 1988. The patient was a five year old boy named Mattew Farrow suffering with Fanconi Anemia (FA). This incredible medical event was made possible through an international collaboration.  Dr. Arleen Auerbach, Dr. Hal Broxmeyer and Dr. Eliance Gluckman joined their hands to perform the first umbilical cord blood transplantation at Hospital Saint-Louis in Paris. Mattew Farrow received the donor stem cells from his newborn baby sister. Since then, the field of cord blood research and banking have come a long way and has the potential to revolutionise the field of stem cell research.

Addressing the Misconceptions about Cord Blood Banking

Have you heard about the stem cell research? If yes, then you might be familiar with its remarkable benefits and recent developments. Discovery of stem cell presence in the umbilical cord blood was a major milestone in the field of stem cell research. In the past, umbilical cord and placenta were discarded right after the child birth, as it was considered as medical waste. But things have changed now. Have you been wondering why save your baby’s cord blood? Stem cells present in the new-born’s cord bloodhave remarkable potential to treat numerous life-threatening diseases. Currently, cord blood stem cells are used in therapy regimens for the treatment of cancer, sickle-cell anaemia, genetic diseases, marrow failure and more. Moreover, several trials and research works are underway exploring the promising applications of umbilical cord blood. 

Even though cord blood (CB) is a potentially lifesaving resource, majority of the expectant parents chose to throw it away postpartum. Umbilical cord blood banking and donation is a relatively new concept that is surrounded by several set of misconceptions. This can be considered as one of the reasons that result in the disposal of umbilical cord and placenta.  However, if the expectant parents are knowledgeable about the benefits of saving their baby’s cord blood, then they might think about banking or donating the CB. Parents who find it hard to afford the private cord blood banking prices may consider donating CB to a public bank. Your baby’s cord blood may serve as a life-saving option for a cancer patient.

Some parents question about the safety of cord blood collection. However, the truth is that cord blood collection is a painless, safe and quick procedure that neither hurts the mother nor the baby. When you sign up for private banking or public donation, a collection kit will be provided. Blood is drawn to this sterile collection bag and sent to the laboratory for cryogenic preservation.  No matter whether you plan to donate or bank your baby’s cord blood, make it a point to collect as much information as possible and have an in-depth understanding regarding the same.

Why Donate Cord Blood and Tissue?

Stem cell-rich blood present in the umbilical cord of a new born is termed as cord blood (CB). Until recently, this blood was discarded along with the placenta right after the child birth. But with the recent advancements and remarkable benefits of stem cell research, scientists have discovered its life saving potential. Cord blood stem cells can be used to treat more than 80 life-threatening diseases. It is also considered as a better alternative to bone marrow transplants. Moreover, the future perspectives of CB and umbilical cord tissue look bright and promising. And that is why new-born baby’s cord blood banking has been gaining wide acceptance over the past decade. If you are an expectant parent, then you might be faced with a challenging question – whether or not to bank your baby’s cord blood and tissue? For many, the answer depends on their family medical history, financial structure and personal preference. 

Most of the parents-to-be who can’t afford the higher costs of private cord blood banking may decide to discard the CB after the child birth. On the other hand, if you decide to donate the cord blood and umbilical cord tissue, then it can be a life-saving option for someone. Patients with leukemia, lymphoma or other debilitating conditions can be treated with the cord blood stem cell transplant. Donation of cord blood to a public bank is free. When you donate your newborn’s cord blood, it will be listed on the registry and provided to a patient who needs transplant quickly. 

If you have decided to donate your baby’s cord blood, then you need to discuss the same with your doctor. Go through the eligibility criteria for public cord blood donation and check whether you meet them. Find more information about the list of hospitals that are tied up with the public cord blood banks so that you can work through the enrolment process.

What is cord blood banking?

Cord blood banking is when cord blood is collected and stored for treating a disease

or illness.

              -Types of cord blood bank:

     -Public banks:
If you give birth in one of three hospitals in the south east of England, you can donate
cord blood to a public bank, such as the NHS cord blood bank. There is also a small
NHS public bank in Belfast in Northern Ireland (See section Is there anything else I
should know?). Donation is voluntary and collection and storage are free of charge. A
public bank stores cord blood for use by anyone anywhere in the world, thus ensuring
fair access for all patients requiring stem cell transplantation. It is an alternative to a
volunteer bone marrow donor registry.

The RCOG supports public banking and donation to the NHS cord blood bank.
If there is a known genetic condition in your family or you already have a child with
leukaemia or blood-related disorder, your clinician may recommend that you consider
banking your baby’s cord blood. Your clinician may be able to arrange for cord blood to
be collected and stored in the NHS cord blood bank for future use by your family. You
should also discuss this with the doctor looking after the person in your family who is ill.

     -Private (commercial) banks:
People can store cord blood with a private bank in the hope that, in the future, cord
stem cells may be useful, should a member of their own family develop a disease
treatable by stem cell therapy.

The chances of your child ever needing to use his or her own cord blood are extremely
small, so there is no guarantee that the cord blood will ever be needed. Nevertheless,
you may feel this is worthwhile, like an insurance policy.

There is a fee for collection and long-term storage of up to £1,500. Depending on
circumstances, some private banks may store cord blood free of charge for certain
families where there is a known genetic condition.

If you have not banked with a private bank and your child develops a blood-related
disorder, immune system disorder or metabolic storage disorder in the future, then
you still have other options. These are:

•        ●  Cord blood from a public bank in the UK or internationally.

•        ●  Use of other sources of therapy such as bone marrow transplants. There is a worldwide collaboration with international bone marrow registries to find suitable matches for patients who require a bone marrow transplant.

•       ●  Treatment from a sibling who matches a family member who can give bone marrow.

Full written information on the private banking policy at your hospital should be given
to you at your antenatal booking appointment. This information may not be given
routinely, so you may need to ask if you would like to find out more.

The RCOG remains unconvinced about the benefit of storing cord blood with a private bank for families who have no known medical reason to do so.

               -How is cord blood collected safely?

     -The cord blood must be collected safely. It is important that:

•     ●  A trained technician who is not involved in your or your baby’s care collects the cord blood. It is important that neither your obstetrician nor your midwife should be distracted from looking after you and your baby during and immediately after childbirth. 

•     ●  There should be no alteration in your ‘usual management’ of labour, such as the delivery of the placenta or clamping of the cord. Some evidence indicates that immediate cord clamping may be harmful to babies. However, delaying cord clamping can prevent a successful cord blood collection.

•     ●  Cord blood should be collected after the placenta has been delivered in a clean environment using methods and facilities, which meet the required regulations including the EU Tissue and Cells Directive.

     -Cord blood collection may not be advisable or possible if:

•     ●  The baby is premature.
•     ●  You have a multiple pregnancy.
•     ●  The cord around the neck needs to be cut early to deliver the baby.
•     ●  You are delivered by emergency caesarian section.
•     ●  You are being prescribed certain medication.
•     ●  You or the father of the baby have tested positive for a transmissible infection(s).

              -Making an informed decision:

If you are considering private banking you should discuss this with your doctor or

midwife. You may wish to consider the following points:

•     ●   Not all hospitals allow collection by private banks. You should ask about the private banking policy at your hospital during your antenatal booking appointment. Once you have made a decision about banking, you should let your doctor or midwife know.

•     ●   You may find that your midwife or obstetrician has been advised by their the professional organisation not to collect blood for a private bank.

•     ●   There are a number of uncertainties surrounding cord blood storage. For instance, who owns the cord blood legally? What are your rights if the facility storing the cord blood breaks down and the cord blood becomes unusable?

•     ●   Private banks are run by private companies. If you decide to bank through a private company, you will enter into a contract between yourself and the company. It is your responsibility to check that you are happy with all the terms and conditions of the contract. Some private companies make additional charges to screen for bacterial diseases.

•     ●   Since April 2006, all UK cord blood banks come under the EU Directive on tissue Cells 2004/23/EC and are required to be licensed by the Human Tissue authority (HTA). Cord blood should be collected and banked in accordance with this. If you choose to use a private bank, it is your responsibility to check that the private bank is approved and follows correct procedures.

              -Some questions to ask are as follows:

•     ●   Is the bank accredited/licensed for storage of cord blood?
•     ●   If it is a UK bank, has it been licensed by the Human Tissue Authority (HTA)?
•     ●   Does the bank follow proper collection procedures?
•     ●   What happens if no stem cells are collected?
•     ●   Does the bank follow best practice testing regimens?
•     ●   Does the bank follow best practice sample storage?
•     ●   Where is the cord blood stored?
•     ●   Is the transportation to the storage facility checked to ensure the blood is kept appropriately?
•     ●    When is the stored cord blood no longer useful?
•     ●   What happens to the cord blood when it is no longer needed?
•     ●   Who is responsible for screening the blood to ensure that HIV/hepatitis positive cord blood is stored separately?
•     ●   Could my child or any of my children use the cord blood, if I am not around?
•     ●   What will happen to my cord blood, if the bank is no longer functioning in the future?

              -Useful additional information:

A Parent’s Guide to Cord Blood Banks:

"www.cordbloodbank.com"

The Society of Obstetrician and Gynaecologists of Canada patient information leaflet:

"www.sogc.org/health/pdf/cord-bloodfinal_e.pdf"

The Anthony Nolan Trust is a charity that recruits and registers bone marrow donors:

"www.anthonynolan.org.uk"

              -Is there anything else I should know?

•    ●   The commercial company advertising itself as the UK Cord Blood Bank is not the same as the NHS Cord Blood Bank.

•    ●   The hospitals that routinely collect cord blood for storage in a public bank are Northwick Park Hospital in Middlesex, Barnet Hospital in Hertfordshire, the Luton and Dunstable Hospital NHS Trust in Luton and the Mater Hospital Trust in Belfast.

              -Get now What is cord blood banking (video):

Just like we didn't envision the powers of PCs thirty years ago, we may not be seeing all the uses of cord blood yet.
                                                                                       Dr. LeeAnn Jensen

Bone Marrow and Peripheral Blood Stem Cell Transplants

Some children who have leukemia or other types of cancer may need a bone marrow transplant (BMT) or a peripheral blood stem cell transplant (PBSCT). In these treatments, the blood cells in the diseased or damaged bone marrow - the spongy material that fills the inside of bones and makes blood cells - are replaced with healthy cells (Stem Cell Transplants), which will grow new healthy cells.
Stem cells are immature cells that produce the three types of blood cells:

1. 1. White blood cells, which fight infection.

1. 2. Red blood cells, which carry oxygen to and remove waste products from organs and tissues.

1. 3. Platelets, which enable the blood to clot.

Most stem cells are found in the bone marrow, but some - called peripheral blood stem cells (PBSCs) - are collected from the bloodstream. Umbilical cord blood also contains stem cells. If your doctor proposes a stem cell transplant for your child, the stem cells may come from a donor's bone marrow, bloodstream, or umbilical cord blood or from your child's own bone marrow or bloodstream.

Healthy stem cells grow in two ways:

•     . They divide to form more stem cells.

•       .They mature into white cells, red cells, and platelets.

When transplanted into a cancer patient, stem cells can rescue the damaged blood-forming system.

Two circumstances create the need for a transplant. The first is when the cancer itself has injured the bone marrow. BMT and PBSCT are commonly used in the treatment of leukemia and lymphoma. The second circumstance is when a treatment requires such large doses of chemotherapy or radiation therapy that the child's bone marrow is damaged during treatment. Chemotherapy and radiation therapy target all cells that divide rapidly. Cancer cells divide more rapidly than most healthy cells and so are destroyed by the therapies. Bone marrow cells, however, also divide more rapidly than other healthy cells, so high-dosage treatment can have a damaging effect on them as well.

A BMT or PBSCT can be done in three ways: as an autologous transplant, an allogeneic transplant, or a syngeneic transplant.

• Autologous transplant - The child's own stem cells or PBSCs cells are used. They can be obtained from the bone marrow or from blood, using the apheresis procedure. Stem cells are collected while the child is in remission. To make sure that any cancer cells that remain are destroyed, the marrow may be treated with anticancer drugs. After the marrow or PBSCs are collected, the child receives high-dose chemotherapy, usually over 2 to 6 days, and, frequently, total body irradiation, during which the whole body is radiated, in one dose or in many doses over several days, to get rid of the cancer. The collected marrow or PBSCs are then returned to the child through a vein, as in a blood transfusion.

• Allogeneic transplant - The marrow or PBSCs from a sibling, parent, or someone not related to the child are used for the transplant. The transplanted material must be as closely matched to the patient's blood cells as possible. Cord blood transplant is allogeneic.

• Syngeneic transplant - The perfectly matched marrow or PBSCs from an identical twin are used for the transplant.

Before the transplant, a catheter is usually inserted into a large vein in the chest for transplanting the marrow or PBSCs, as well as for giving blood, antibiotics, and other drugs and for drawing blood. The child is given high doses of anticancer drugs and/or radiation. When the cancer cells - along with some healthy bone marrow cells - are destroyed, the new, healthy marrow or PBSCs can be given. The healthy marrow or PBSCs are given through the catheter and travel through the bloodstream to the bone marrow where they start to make red and white blood cells and platelets.

It usually takes 14 to 30 days after the transplant for the transplanted stem cells to make enough white blood cells to fight infection and to make other blood cells. During this time, your child will be at higher risk for infections, anemia, and bleeding. Complete recovery of your child's immune system can take 1 to 2 years after an autologous, allogeneic, or syngeneic transplant. Your child may need to remain in a hospital room that is kept as free as possible from anything that may cause an infection. Supportive care, which includes receiving blood transfusions and antibiotics, will be given.

• Supportive Care

Children having a BMT or PBSCT usually stay in the hospital for 1 to 2 months (sometimes longer), although outpatient BMT can be done for children who have brain tumors. Children receiving BMT or PBSCT may need supportive care.

For more information on side effects from chemotherapy and radiation therapy, see the charts in those sections.

• Graft-Versus-Host Disease

The graft-versus-host disease (GVHD) may occur in patients who receive bone marrow or peripheral stem cells from a donor. In GVHD, donated stem cells realize they are in a different body, so they may attack the patient's tissues, such as the liver, skin, or digestive tract. GVHD can be mild or very severe and can occur any time after the transplant - even years later. The doctor may give drugs to reduce the risk of GVHD and to treat the problem if it occurs.

Supportive Care for BMT and PBSCT:

Problem:	Supportive Care Provided:
Low counts of all types of blood cells	Isolation from people with infectious diseases. Transfusion with blood products, including platelets and red blood cells. Treatment with proteins that increase the number of white blood cells.
Infections	Intravenous antibiotics. Isolation from other people.
Gastrointestinal Infections	Low-bacteria diet. Mouth care. Liquid antibiotics.
Difficulty eating enough food	Intravenous nutrition-giving nutrients through a vein.

Cord blood donation

Cord blood donation – Many countries have a national cord blood banking system.  Unfortunately, the US is not one of them.  There are banks in the US which do take donations from the general public in certain areas.  Some of them are for-profit brokers who sell the cord blood to patients and research facilities, and others are set up as non-profit collection centers.  Most of them all connect their databases to the National Marrow Donor Program, which conducts searches for patients needing cord blood for transplant or treatment.  It is important to understand that once you give your cord blood away, it will most probably never be available to you or your family.  If you have decided not to bank privately for your family, please consider donating it to one of these collection facilities as opposed to throwing away this valuable resource.

Cord blood donation, blood collected and stored from the umbilical cord of a baby at birth, is one of three sources for blood transfusions in illnesses like leukemia and lymphoma. The other two sources are bone marrow and peripheral or circulating blood. This type of transplant does not have to match the recipient as closely as the other two. At birth, a mother can have the infant cord blood stored for her own family. Some people also will donate cord blood to blood banks or specific people who are seriously ill.Cord blood is rich in blood-forming cells and that is why it can be used for transplants.

Cord blood donation, Some examples of where banked cord blood might be used include people who are in need of a transplant quickly, or people who are having a hard time finding a matching bone marrow donor. Because cord blood does not need to match a tissue type as closely as other tissue transplants, people from racially or ethnically diverse communities can be helped more readily by a cord blood transplant. Cord blood is often stored on site at a hospital or trauma center and can be used more quickly when needed in an emergency. It is a viable choice to have a cord blood donation used in these situations. Many hospitals now have banked umbilical cord blood.

Donating cord blood to a public cord blood bank is free. When you donate umbilical cord blood, it is available to any patient in need of a blood stem cell transplant--it is not reserved for your family's own use. For more on donating cord blood, call the National Marrow Donor Program at 1-800-627-7692.

I've been involved with blood donation since the 1980s because there is a critical need.
Donna Reed 

Get here how to donate a blood