Information on Cord Blood Banking

Being pregnant is a wonderful experience. As the due date gets closer and parents look forward to the big day, they start to think seriously about their child's future. Of course, every parent wants the best for their child. And now you have the ability to protect the future wellness of your child as well as other family members. The answer? Umbilical cord blood banking.

In just five minutes, you can have peace of mind knowing that you are helping to protect your family against deadly illnesses.

We're With You All the Way

To understand cord blood banking, it is first necessary to define what cord blood is and the medical uses for it. In essence, cord blood is the blood found inside the umbilical cord, the flexible cordlike structure connecting a fetus at the abdomen with the placenta, from the mother, to provide the transfer of nutrients and removal of waste from the unborn baby.

Where Do Stem Cells Come From?

Following the birth of a baby, the umbilical cord is cut and usually discarded, along with the placenta. However, medical research has shown that the blood that is retrieved from the umbilical cord is a rich source of stem cells. Stem cells are unspecialized cells that can develop into specialized cells such as a muscle cell, a red blood cell, or a brain cell.

What Are Stem Cells?

Stems cells are what make cord blood valuable. Stem cells are important for living organisms for many reasons. Like donated bone marrow, stem cells from umbilical cord blood can be used to treat various genetic disorders that affect the blood and immune system, leukemia and certain cancers.

Cord blood has therapeutic advantages over adult stem cells. Cord blood stem cells, unlike adult stem cells, are less likely to contain DNA abnormalities caused by sunlight, toxins and errors in DNA replication during the course of a lifetime. Cord blood stem cells are also less likely to be rejected in transplants.

Cord blood is also a richer source of stem cells than bone marrow, with nearly 10 times as many blood-producing cells, so fewer cord blood cells are needed for a successful transplantation.

Cord blood banks recruit expectant mothers to donate their baby's umbilical cord blood for stem cell transplants. The cord blood banks collect, process, test and store the donated umbilical cord blood. Blood from each cord is frozen (cryopreserved) as an individual cord blood unit that is available to transplant.

Donating Cord Blood

When a mother is interested in donating her child's umbilical cord blood, she looks for a cord blood bank in her community. The cord blood bank asks the mother to complete a consent form and health history questionnaire and give a small blood sample. The cord blood is collected after the baby's birth.

Collecting cord blood poses no health risk to the mother or infant donor. The cord blood is stored only with the mother's signed consent, and no collection is made if there are any complications during delivery.

After the baby's birth, the umbilical cord is clamped, breaking the link between the baby and the placenta. Trained members of staff drain the blood from the umbilical cord and placenta. The blood is usually collected using a needle to draw the blood into a blood bag. The collection usually takes ten minutes or less and it is then sent off for cord blood storage. On average, about three to five fluid ounces are collected from the umbilical cord to produce enough stem cells.

Doctors can search the NMDP (National Marrow Donor Program) Registry of donors and cord blood units to find a match for their patients who need a transplant. If selected, the cord blood unit is transplanted to a matching patient.

Storing Cord Blood

Parents can also choose to save their babies cord blood in a cord blood bank in case of future need as a transplant alternative to bone marrow. A private bank ensures the cord blood stem cells are available only to the family who preserved the cord blood. The stem cells are an exact match for the baby, and the cells have at least a one in four chance of being an exact match for a sibling.

If the cells are needed for transplant, it's been shown that the transplant recipient is more tolerant of a partial match if the cells are from a related donor. Additionally, transplant recipients of cord blood stem cells are less likely to develop severe complications from Graft-versus-Host-Disease than those receiving bone marrow transplants.

1. Deciding on Cord Blood Banking

A Candid Look at the Pros and Cons of Cord Blood Banking

There are already so many decisions to be made toward the birth of your child; what kind of practitioner do you choose; what’s the perfect name for your little one; do you get an epidural or go the natural route. Add one more decision to your list: Should I bank my baby’s umbilical cord blood?

Whether you get a brochure in your mailbox or faintly hear a conversation down the hall while at your doctor’s office, the decision is facing more and more expecting parents. Should you bank your baby’s cord blood? Each situation is different, and so you’ll want to consider the pros and cons of cord blood banking.

The Pros of Cord Blood Banking

There are many families for which cord blood banking makes sense. Certain issues, such as family histories of genetic diseases or belonging to certain ethnic or racial groups, factor into the decision.

• History: If you have a family history or are worried about a predisposition to certain diseases, cord blood banking can give you peace of mind. Cord blood transplants treat over 45 diseases; malignancies, such as leukemia and other cancers; metabolic disorders; blood disorders, such as sickle-cell anemia, and immunodeficiencies. If this is your primary banking reason, then you should also consult a genetic counselor during your pregnancy.
• Recipient Compatibility: Because cord blood is a more primitive source of stem cell, the recipient runs a lower risk of graft vs. host disease (GVHD), a potentially life-threatening immune response.
• Accessility:Not only is cord blood easy to retrieve, because it's cryogenically stored, it is available for transplant whenever it is needed. Bone marrow, on the other hand, is more difficult to get a hold of; it is harder to find a donor matching your HLA type, and the process of retrieval is more complicated.
• Race: Belonging to certain ethnic or racial groups may mean a longer wait to find a bone marrow donor; therefore, donating or privately banking your baby's cord blood will make transplants readily available to these individuals.

The Cons

While every parent wants to ensure their child’s health, there are some hurdles to universal cord blood banking.

• Cost: While many companies in the profession view cord blood banking as an ‘insurance’, it’s understandable that the price may be too high for many families.
• Likelihood: The American Association of Pediatrics estimated that the chances of banking and later using the stem cells for a transplant are about 1 in 20,000.
• Size: When it comes to cord blood transplants, size matters. Since a typical harvest is enough to transplant a child or small adult (weighing approximately 115 lb.), although research is currently working on proliferating cells in the laboratory in order to match a larger sized adult.

For parents who find these hurdles unsurpassable, the option of donating your blood to a non-profit public bank is viable.

Decision Making

While pros and cons can help you sort out part of your concerns when making an informed decision, it’s certainly not the whole picture. You can only come to a conclusion to this personal decision once you’ve looked at more resources concerning the topic. So if you’re still unsure, browse the articles on this site to better inform yourself. Happy decision-making!

2.Cord Blood vs. Bone Marrow Transplants

Before 1998, bone marrow transplants were the standard recommended medical procedure. With the emergence of cord blood transplants, donors and recipients now had a practical and appealing alternative. While cord blood has not necessarily eclipsed bone marrow transplants, the two share equal-enough footing that they should be formally compared.

Cord blood and bone marrow each have their strengths and weaknesses. By examining the set of criteria, you can read which transplant choice comes out on top.

GVHD : Cord blood preferred

Graft vs. host disease is a serious, life-threatening immune response to blood transplants. It can be fatal for up to 40% of patients who get GVHD. Because cord blood is more primitive and therefore more ‘forgiving’, the T-cells found in cord blood that make up the recipient’s new immune system are less likely to attack the recipient’s body. This means a lower incidence of GVHD for cord blood transplants.

HLA Matching : Cord blood preferred

For a successful transplant to heal the recipient, there is a list of criteria that has to be matched. The more perfectly matched the transplant is to the recipient’s system, the lesser the incidence of GVHD. Again, because the stem cells in cord blood are younger, matching between donor and recipient does not have to be perfect. This means that you can treat a broader range of recipients with cord blood. It also means that a recipient is less likely to get GVHD.

Rich Source of Stem Cells : Cord blood preferred

Cord blood is said to contain 10 times the amount of stem cells as an equally sized portion of bone marrow.

Regenerative Source : Cord blood preferred

It is thought that because cord blood stem cells are younger, they have better proliferative properties—that is, they are able to regenerate more than bone marrow stem cells.

Availability : Cord blood preferred

About 30,000 individuals, of which 9,000 are children, are diagnoses every year with a disease treatable through bone marrow transplantation. About 75% of those do not have a matching relative, and 70% are unable to find a matching donor. It’s crucial that patients with severe cases of cancer, immune deficiencies and blood disorders such as anemia get treatment quickly. Many of these patients die before a donor is found. Cord blood on the other hand is readily available. The stored cord blood is available at notice to be used for a transplant. This is true of private and public banking.

Pain : Cord blood preferred

Bone marrow donation is an invasive, requires anesthesia and is a somewhat painful experience. It is removed from the rear of the pelvic bone through a series of injections. Cord blood removal is quick and painless; the blood is removed from the insensate umbilical cord.

One study found that while 11% of cord blood transplants don’t ‘take’ to the recipient, only 2% of bone marrow transplants don’t ‘take’. Graft rejection is when the patient’s immune system destroys the new marrow.

3. Diseases Treated By Cord Blood Stem Cells

Stem Cells and Cancer

Acute Lymphocytic leukemia (ALL): This type of leukemia is characterized by the rapid production of defective white blood cells. The large amount of the white blood cells blocks the production healthy red and white blood cells as well as platelets.

Acute Myelogenous leukemia (AML): This cancer is marked by the abundance of immature white blood cells which quickly replace other white blood cells in the bone marrow.

Chronic Myelocytic leukemia (CML): This cancer differs from ALL and AML in that it affects mature white blood cells. These cancerous cells rapidly increase and affect the bone marrow. They may also enter the blood stream.

Myelodysplastic syndrome (MDS): People with MDS usually have a shortage of blood caused by their body’s inability to effectively produce blood cells. Those blood cells that are formed are often immature and therefore defective. MDS may progress into an acute leukemia.

Liposarcoma: Cancer of the fat cells that affects soft tissue.

Neuroblastoma: A type of cancer made up of a solid tumor that originates in the nerve tissue of the neck, chest, pelvis or, most commonly, in the adrenal gland tissue found in the abdomen.

Non-Hodgkin’s lymphoma: Cancer of the lymphatic system. Unlike Hodgkin’s disease, Non-Hodgkin’s lymphoma tends to be unpredictable and is much more likely to spread to other areas of the body.

Yolk Sac sarcoma: A type of cancer that usually originates in the testicles before spreading to other areas of the body.

Blood Disorders

Amegakaryocytic thrombocytopenia (AMT): A blood disorder that causes a marked decrease in the production of platelets. This leads to frequent bruising and problems clotting when bleeding.

Aplastic anemia: A type of blood disorder caused by the body’s inability to produce enough blood cells. The lack of blood cells causes sufferers to have a lowered immune system and troubles clotting.

Diamond-Blackfan anemia: Unlike Aplastic anemia, Diamond-Blackfan anemia sufferers have troubles producing only red blood cells. Those affected by Diamond-Blackfan anemia are also likely to have physical deformities, most notably malformed thumbs. They may also be short in stature.

Congenital cytopenia: A hereditary deficiency of the blood cells.

Evan’s syndrome: An autoimmune disorder where the body produces antibodies to attack red and white blood cells along with platelets.

Fanconi’s anemia: A genetic disorder that is marked by the body’s lack of essential bone marrow material including red and white blood cells and platelets. People who suffer from this disorder may have an abnormal heart, kidney and/or skeletal structure. They may also have brown skin discoloration on some parts of their body.

Kostmann’s syndrome: A genetic disorder wherein sufferers have a deficiency of neutrophils, a particular kind of white blood cells. The lack of neutrophils makes it more difficult for sufferers to fight bacterial infections.

Sickle cell anemia: A genetic disease wherein sufferers have misshapen red blood cells. The cells therefore do not work properly and cause small blood clots.

Thalassemia: A genetic blood disorder that is marked by the body’s inability to properly produce hemoglobin. As a result, the red blood cells are under produced yet also destroyed too frequently.

Inherited Metabolic Disorders

Adrenoleukodystrophy: A genetic disorder that is characterized by the body’s inability to breakdown long chain fatty acids due to a lack of a particular enzyme. This disorder can affect the adrenal glands, nervous system and testes. There are seven recognized forms of this disease.

Bare-lymphocyte syndrome: A rare disorder affecting the immune system. People with this disorder are especially vulnerable to viral and bacterial infections, which can cause them to suffer from chronic diarrhea and stunted growth.

Dyskeratosis congenital: A rare disease whereby those affected tend to have premature aging and are more vulnerable to developing cancer due to their bone marrow failure.

Familial erythrophagocytic lymphohistiocytosis: A rare genetic disorder, it is characterized by an over active immune system. T-cells will attack the liver, spleen, bone marrow and central nervous system causing multiple problems in a person.

Gaucher disease: A genetic disorder caused by a person’s lack of the glucocerebrosidase enzyme. This results in toxic fatty materials building up in the liver, spleen and bone marrow.

Gunter disease: Also known as congenital erythropoietic, this genetic disease causes a sufferers skin to be extremely sensitive to sunlight. Exposure to sunlight can result in blistering (with a long healing time), scarring and skin pigmentation changes among other things.

Hunter syndrome: A hereditary disease that results in the body’s inability to properly breakdown a specific chemical. This causes the chemical to build up in different body tissues whereby it can cause damage and inhibit proper organ function.

Hurler syndrome: A genetic disease that is caused by the body’s inability to produce a particular enzyme (lyposomal alpha-L-iduronate) necessary for the breakdown of certain chemicals. This causes the chemicals to build up and affect the internal organs as well as mental development.

Inherited neuronal ceroid lipofuscinosis: A genetic disease that is marked by a build of an abnormal pigment (lipofuscin) in the brain. It is thought to be caused by the brain cells inability to remove or reuse brain proteins.

Krabbe disease: A rare disorder which affects the nervous system. It is caused by the lack of a crucial enzyme required for the proper development of the myelin sheath (a protective coating around the nerve fibers in the brain composed of a fatty covering).

Lanegerhans’-cell histiocytosis: This disorder occurs when there is an abnormal increase in the quantity of particular immune cells. The excessive amount of immune cells can form tumors in different bones possibly resulting in fractures. It can also cause problems with a person’s immune system resulting in rashes, gum problems, and lung problems among other things.

Lesch-Nyhan Disease: A genetic disorder that directly affects the body’s ability to produce and breakdown purine, a chemical that makes up RNA and DNA molecules. It is marked by an increase in blood and uric acid levels in addition to the absence of a particular enzyme (hypoxanthine guanine phosphoribosyltransferase).

Leukocyte adhesion deficiency: A rare genetic disorder that stems from the bodies inability to effectively produce a particular protein, CD18. The lack of CD18 protein inhibits white blood cells from traveling to parts of the body that are infected or injured, leaving a person more susceptible to sicknesses and prolonged healing times.

Osteopetrosis: A rare genetic disorder that causes the density of bones to increase. This can inhibit bone growth; make the bones weaker and more susceptible to breakage; and can also crowd out bone marrow.

Immunodeficiencies

Adenosine deaminase deficiency (ADA or SCID-ADA): A rare genetic disorder that is caused by the body’s inability to adequately produce the adenosine deaminase enzyme, which is responsible for proper functioning of the immune system. The lack of the enzyme seriously compromises the immune system and may cause those affected by it to live in isolation.

Severe combined immunodeficiency (SCID): A genetic disorder that is caused by the body’s inability to efficiently produce T- and B-lymphocytes. This makes people unable to effectively fight off infections and may cause them to live in isolation. SCID is sometimes also known as “Bubble Boy syndrome” in reference to a boy who was affected by SCID and lived in a germ-free plastic bubble for 12 years.

Wiskott-Aldrich syndrome: A hereditary disorder that is marked by defects in the immune systems production of T- and B-lymphocytes as well as platelets. People affected by this disorder tend to be more susceptible to infections, especially those that affect the respiratory tract, as well as have bleeding problems. There is also an increased chance of developing certain cancers.

X-Linked lymphoproliferative disease (XLP): A rare hereditary disorder that is marked by a person’s inability to adequately develop the appropriate antibodies needed to fight off the Epstein-Barr virus (a common herpes virus). XLP sufferers are more susceptible to infections and some forms of cancer as well as possible deficiencies in blood production, low levels of antibodies in their blood and aplastic anemia.

Hyper-IgM immunodeficiency (HIM): This rare disorder is marked by the body’s normal to increased production of poor quality IgM antibody, which is found on the B cell of white blood cells. This hyper production of poor quality cells interrupts the development of other important antibodies. Those afflicted by HIM are vulnerable to bacterial infections as well as autoimmune disorders and cancers.

This is not an exhaustive list. New ways of using cord blood stem cells to treat diseases and disorders are constantly being developed.

4. Autologous vs. Allogeneic

There are two types of stem cell transplants: autologous and allogeneic.

When a person receives stem cells that have come from their own blood, it is referred to as an autologous transplant. For some diseases, an autologous transplant is the preferred method. A benefit of an autologous transplant is that the body is able to recognize the stem cells and therefore does not attack them or reject them (graft-versus-host disease or GVHD). Additionally, the difficulty of locating a donor can be avoided.

An allogeneic transplant is when the stem cells come from someone other than the person who requires them. For some diseases, like leukemia, an allogeneic transplant is the preferred method. While there is an increased risk of a person’s body rejecting the donor stem cells, by closely matching a patient’s HLA with the transplanted stem cells, adverse effects can be minimized. However, a person who receives an allogeneic transplant will require heavy medication in order to avoid GVHD.

It has been found that where the stem cells come from can make a difference in the likelihood of helping a disease. While in some cases patients seem to respond better to transplants of stem cells that have come from a donor, for other illnesses patients respond best when the transplanted stem cells have come from themselves. Depending on the form of disease that needs to be treated, along with the degree of severity, and the transplant recipients’ age, one form of transplant may be favored over the other.

Disorder	Autologous Stem Cell Transplant	Allogeneic Stem Cell Transplant
Leukemia : acute lymphocytic, acute myelogenus, chronic myelocytic	variable results	effective
Non-Hodgkins lymphoma	variable results	effective
Sarcomas : liposarcoma and yolk sac sarcoma	studies still investigating	studies still investigating
Neuroblastoma	variable results although it is the preferred method	variable results
Blood disorders	studies still investigating	effective
Immunodeficiency	variable results	effective
Metabolic Disorders	studies still investigating	studies still investigating

5. Stem Cells Research

Many people are excited about the future of stem cells. Not only can stem cells help researchers learn more about the way the body functions, it can also help to possibly treat many diseases, test drugs for toxicity and even aid in gene therapy.

Gene Therapy

Scientists have been trying for some time now to find an effective way of correcting genes that carry diseases, a process known as gene therapy. This is usually done by inserting an altered, non-diseased gene into the genome to replace the defective gene. The most common method of infusing the defective gene is through a virus that has been altered with the therapeutic gene. However, this carrier method possesses the problem of triggering an immune system response as well as the potential for the virus to revert back to its ability to cause a disease. Some nonviral methods have been tested but they have proven to be somewhat less effective than using altered viruses.

Overall, gene therapy has not proven to be very effective. In addition to finding a more successful carrier method, scientists also need to overcome the obstacle of treating disorders that are the result of multiple defective genes. Researchers are hoping that stem cells can be used as a more efficient carrier method of therapeutic cells as well as being able to treat disorders involving multiple genes.

Disease

Clinical trials are currently on-going to find new ways to treat a host of diseases, disorders and injuries through stem cells. While researchers are always looking for new uses of stem cells, there are certain areas that hold the most promise.

Muscular dystrophy, Alzheimer’s disease, liver disease, heart disease, stroke, burns, rheumatoid arthritis and spinal cord injuries are some of the main areas currently being investigated. Clinical trials are already underway for treating juvenile diabetes and Parkinson’s disease. Some Australian researchers have said they believe an effective treatment for multiple sclerosis is less than five years away after they performed some promising research on mice. Stem cells have even been shown to generate growth of new hair in people suffering from hair loss.

Understanding the Human Body

In order to find effective treatments for these diseases, disorders and injuries, experts must first understand just how the cells work. Currently, the biggest obstacle for researchers is figuring out just which stimulants work best to generate differentiation in stem cells. However, the more investigation that takes place, the more scientists can learn about how human cells work.

Having a better understanding of how human cells work can help researchers identify all the intricate details that occur during human development. This will aid researchers in recognizing those people at greater risk of developing diseases, disorders, and even birth defects. Once this is understood, researchers can begin to develop new ways of preventing or treating certain diseases or disorders.

Drugs

Many experts are now looking for ways to test new drugs on stem cells that have been manipulated to imitate a diseased cell. If a drug proves to be safe and beneficial to the cell line during these tests, it could then go on to be tested on humans and animals.

Unfortunately, in order to do this, scientists need to understand exactly how to accurately stimulate stem cells in order to get them to differentiate properly. At this time, the differentiation process is still not fully understood which is the biggest hindrance to stem cell research. While stem cells hold a lot of promise for the future, many investigations still need to performed before they can be utilized to their maximum potential.

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