What You Need To Know About Umbilical Cord Blood Banking

By Gad Lavy, M.D., FACOG, Board Certified in Reproductive Endocrinology and medical director of Lifeline Cryogenics LLC.

By Michele Brown, M.D., FACOG. Dr. Brown is a practicing obstetrician and the founder of Beaute De Maman, a unique line of organic pregnancy products.

What is umbilical cord blood?

Umbilical Cord blood is collected from the portion of the umbilical cord that is still attached to the placenta after the baby has been delivered.

Umbilical cord blood is a rich and unique source of stem cells. These cells are the building blocks of tissues and organs and thus have the capability of developing into more mature cells of almost any organ, tissue, or blood cell in the body.

Recent surveys have shown that the majority of pregnant women are not familiar with the fact that their newborn child’s cord blood can be saved and provide the child and even family members with  “biological insurance” against a variety of disease conditions that can be treated with stem cell transplantation.

It is important to learn about umbilical cord blood banking and decide early in the course of the pregnancy. An early enrollment will provide ample time to prepare and thus maximize the chances of a successful collection.

Why collect cord blood?

• The stem cells in cord blood can be used to treat more than 70 different malignant and nonmalignant diseases, blood disorders, and immune conditions (see table). Radiation or chemotherapy used to treat various benign and malignant conditions often destroy the bone marrow and its ability to produce blood and immune cells. Umbilical cord stem cells can be used to replace the damaged bone marrow in these cases.
  
  
• Future applications: As our knowledge of stem cell function improves, other applications such as treatment of diabetes, heart disease and Alzheimer’s disease are likely to be added to the existing list of conditions treatable with stem cells. 

How is cord blood collected?

Cord blood is collected in the delivery room by the clinician immediately following the delivery of the baby. The blood is collected into special bags that contain an anticoagulant solution, which will prevent it from clotting. The collection bag is provided to the couple by the cord blood facility at the time of enrolment. After the sample has been collected, the family is responsible for returning the kit to the cord blood facility by pre-arranged shipment.

What are some of the advantages of cord blood stem cells over bone marrow stem cells?

Umbilical cord blood has several major advantages over bone marrow, which is an alternative source of stem cells and is used to treat the same conditions. 

Advantages of umbilical cord blood over bone marrow include the following:

• The chances of finding a successful match between donor and recipient are higher when using umbilical cord blood as compared to bone marrow. When inflicted with one of the conditions that require stem cell transplantation, a search for a compatible bone marrow donor is initiated. In most cases (over 70%) a compatible bone marrow donor is not found in time. By storing the newborn’s umbilical blood a ready source of compatible stem cell is available when needed.
  
  
• Even when a match is found, the chances of successful therapy is higher with umbilical cord as compared with bone marrow. A mismatch is the most common cause for treatment failure.
  
  
• Ease of collection- Bone marrow stem cells are collected through a puncture biopsy of the hip. The procedure is often associated with moderate discomfort, a clear deterrent, especially if the donor is a child. The collection of umbilical cord blood is risk free and is not associated with any discomfort to the baby or mother.
  
  
• The number of stem cells obtained from umbilical cord is higher than those obtained from alternative sources such as bone marrow or peripheral blood.
  
  
• Risk of Infection: The use of umbilical cord blood is associated with a lower risk of infection to the recipient. The adult bone marrow can carry various viruses, which would make the cells unusable.

How long can cord blood stem cells be stored?

Stem cells are stored in liquid nitrogen at temperature of -196 degrees Celsius. When stored under these conditions the cells can be stored indefinitely.  Stem cells have been successfully used after having been stored 15 years.

Public and Private (family) Cord blood banking: Why store cord blood privately?

Public Cord Banks operate the same way as blood banks. The cord blood is collected and stored in large repository. There is no possibility of tracking the original donor and blood units are matched to potential recipients based on blood type and other markers (HLA Typing). If the original donor requires cord blood there is no guarantee that their unit is still there and has not been given away.

Private or Family Banking refers to storing individual cord blood units for use by the donor or a family member. The cord blood is available for use at any time on short notice. The family is charged for the collection of the blood as well as annual storage.

Private umbilical cord blood banking should be encouraged to all pregnant women and particularly to minorities whose chances of findings a suitable match in the public bank are even lower.

Many families store cord blood as a form of “insurance” in case a member of the family or close relative develops a condition treatable with stem cells. If one of these conditions already exists in the family, cord blood banking should be strongly encouraged.

Research into stem cell function is growing rapidly. Consequently, more diseases are being added daily to the list medical condition that can be treated with stem cell transplant.

Diseases treated by stem cells

1. Blood Disorders 
• Alpha and Beta Thalassemia
• Sickle Cell Disorders
• Combination Sickle and Thalassemia
• Aplastic Anemia
• Pancytopenia
• Fanconi Anemia
• Congential Thrombocytopenia
• Various Red Cell, Platelet and White Cell Disorders
  
  
2. Cancer Related Disorders
• Leukemias
• Acute Myelogenous
• Acute Lymphoblastic
• Chronic Myelogenous
• Chronic Lymphocytic
• Lmyphomas
• Hodkin's
• Non Hodkin's
• Multiple Myeloma
  
  
3. Inherited Immune System Disorders
• Server Combined Immunodeficiency
• Wiscott-Aldrich Syndrome
• Hypogammaglobulenemia
  
  
4. Metabolic Disorders
• Tay Sachs Disease
• Neimann Pick Syndrome
• Hurler Syndrome
• Gaucher's Disease
• Leukodystrophy

There are over 70 disorders treated by stem cells. For a complete list of the diseases treatable by stem cells refer to the National Marrow Donor Program web site at http://www.marrow.org.

What is the future of cord blood?

Over 4000 transplants have been reported worldwide to date. Once collected, cord blood can be stored indefinitely. It has proven to be life saving for numerous malignant and genetic diseases. Preliminary studies now suggest that cord blood stem cells can be of benefit to adults, although currently the small volume obtained will require cord blood expansion or  “cloning” for use in adults.

Research is now being done to investigate ways that stem cells can be used to treat other conditions such as spinal cord injury, heart disease, diabetes, brain damage, and autoimmune diseases. Most recently reports on the possible use of stem cells to treat cerebral palsy offer hope to infants suffering from this condition.

Summary:

• Umbilical cord blood is collected from the placenta after the birth of the baby.
  
  
• The stem cells in cord blood can be used to treat approximately 70 diseases of the blood and the immune systems. In the future it is likely that these stem cells will be used to treat many more conditions including diabetes, heart disease and brain disorders.
  
  
• Family banking allows the child and their family immediate access to the stored blood and a high probability of a match in the event that it is needed.
  
  
• Pregnant women should investigate this option with their obstetrician. Early enrollment will insure optimal collection and processing.
  
  

Gad Lavy, M.D., FACOG is the medical director of Lifeline Cryogenics LLC and of The New England Fertiltiy Institute.

Lifeline Cryogenics is located in Stamford, CT and is the only family cord blood bank in Connecticut.

Lifeline is accredited by the American Association of Blood Banks (AABB) and the American Association of Tissue Banking (AATB) as well as the FDA.

Please visit Lifeline Cryogenic web site for more information at
www.lifelinecryogenics.com or e-mail your questions to info@lifelinecryogenics.com.