Cord blood banking: What it is, why consider it

 

What is cord blood? 

Cord blood is the blood in your baby's umbilical cord. It contains stem cells that can grow into blood vessels, organs, and tissues.
Cord blood stem cells are the subject of FDA-regulated clinical trials exploring their suitability for helping those with autism, brain injury, and other conditions. These specialized cells are already used to treat dozens of diseases.
Your baby's cord blood can be collected at birth and stored for future use

What is cord blood banking?

Cord blood banking involves collecting blood left in your newborn's umbilical cord and placenta and storing it for future medical use. Cord blood contains potentially lifesaving cells called stem cells. (The stem cells in cord blood are different from embryonic stem cells.)

For cord blood storage, you have two main options:

• You can donate your baby's cord blood to a public cord blood bank for anyone who needs it.
• You can pay to store your baby's cord blood in a family cord blood bank for your family's use.

How is cord blood collected?

Cord blood is collected right after birth. The collection process is painless and safe for you and your baby. In fact, it's so quick and painless that parents – caught up in holding and bonding with their new baby – are often unaware it has even happened.
Here's how it's done:
Clamping and cutting the cord
After you've delivered your baby, whether vaginally or by c-section, the cord is clamped and then cut in the usual way – either by your partner or your medical provider.
You can delay cord clamping, as long as the delay is brief – no more than a minute or two. (If cord clamping is delayed too long, the blood in the cord will clot. And once the blood clots, it's of no benefit to anyone – it doesn't go to your baby and can't be collected for storage.)
Extracting the cord blood
Your medical provider then inserts a needle into the umbilical vein on the part of the cord that's still attached to the placenta. The needle doesn't go anywhere near your baby.
The blood drains into a collection bag. Typically, 1 to 5 ounces are collected. The entire process takes less than 10 minutes.
Off to the bank!
The blood is shipped to a cord blood bank, where it's tested, processed, and cryopreserved (preserved by controlled freezing) for long-term storage if deemed acceptable according to quality standards.
Some family cord blood banks now offer to collect a segment of the umbilical cord in addition to the cord blood. Umbilical cord tissue contains stem cells that are different from cord blood stem cells, and researchers are studying their possible use.

What are the benefits of cord blood banking?

Cord blood is a rich source of blood stem cells. Stem cells are the building blocks of the blood and immune system. They have the ability to develop into other types of cells, so they can help repair tissues, organs, and blood vessels and can be used to treat a host of diseases.
Stem cells are also found in bone marrow, human embryos, fetal tissue, hair follicles, baby teeth, fat, circulating blood, and muscle. Every part of the human body contains some stem cells, but most are not a rich enough source to be harvested for therapeutic applications.
In patients with conditions like leukemia, for instance, chemotherapy is often used to rid their body of diseased cells so that normal blood cell production can be restored. Once that happens, the disease goes into remission.
If the treatment fails or disease recurs, however, doctors often do a stem cell transplant. A transfusion of stem cells from the bone marrow, peripheral blood (blood in the bloodstream), or cord blood from a healthy donor can help create a new blood and immune system, giving the patient a better chance of making a full recovery.
Unlike the stem cells in bone marrow or peripheral blood, stem cells in cord blood are immature and haven't yet learned how to attack foreign substances. It's easier to match transplant patients with cord blood than with other sources of stem cells because the cord blood stem cells are less likely to reject the transfusion. This makes cord blood an even more valuable resource for ethnic minorities, who have a harder time finding stem cell matches.
Cord blood will soon be the dominant transplant source for United States' patients of minority or mixed racial heritage. In 2012, 38 percent of Hispanic patients and 44 percent of African American patients undergoing stem cell transplants received cord blood.
More and more adults are receiving cord blood transplants, too, sometimes involving two cord blood donations if a single one doesn't contain enough cells.
As of the end of 2012, more than 33,900 cord blood units had been shipped for transplants worldwide.

Which diseases can be treated with cord blood?

Cord blood stem cells have been used successfully to treat more than 70 different diseases, including some cancers, blood disorders, and immune deficiencies. Among these are leukemia, aplastic anemia, thalassemia, Hodgkin's disease, and non-Hodgkin's lymphoma. (Cord blood stem cells have also been used to treat sickle cell anemia, but that procedure is not yet on the FDA-approved list.)
Cord blood transplants are also used to treat rare metabolic disorders that would otherwise be fatal for infants (Krabbe disease and Sanfilippo syndrome, for example).

Is it best to be treated with your own stem cells?

Not necessarily. It depends on the illness or condition being treated.
When doctors use stem cells to help the body repair itself, the patient's own cells are ideal. There's no concern that his body will reject his own stem cells or react against them.
But when the body is making the wrong cells – for example, if the illness is cancer or a genetic blood disorder – then the transplant must come from a donor, not the patient's own cells. That's because the patient's stem cells probably carry the same defect that caused the cancer or the genetic disease, and you'd be transplanting the seeds of the disease back into the patient.

What else is cord blood used for?

Studies are under way around the world to explore new ways of using cord blood.
Cerebral palsy and autism
Children in clinical trials are being treated with their own cord blood for cerebral palsy, a condition that afflicts about 1 in 300 children in the United States. Children in clinical trials are also being treated with their own cord blood for autism, a condition that affects 1 in 88 children.
Hydrocephalus, type 1 diabetes, and more
Babies and young children in the United States are also being reinfused with their own cord blood stem cells in clinical trials to develop therapies for hydrocephalus (fluid in the brain), oxygen deprivation at birth, traumatic brain injury, type 1 (juvenile) diabetes, and congenital heart defects that require surgery. If the clinical trials are successful, these therapies may become commonly available within a few years.
Treatments for adults
Researchers believe that adult cancer patients may one day benefit from treatment from their own cord blood stem cells that were collected at birth. The hope is that stem cells will be useful for treating cancers that aren't genetically based.
Much of the promising stem cell research in adults that uses stem cells from bone marrow may one day use stem cells from cord blood. Current studies registered with the U.S. federal database are treating people with conditions as varied as diabetes, spinal cord injuries, heart failure, stroke, and neurological disorders such as multiple sclerosis.
Animal studies
Scientists at the University of South Florida's Center of Excellence for Aging and Brain Repair found that cord blood stem cells helped rats with stroke and spinal cord injuries recover some motor function and helped mice programmed to develop Lou Gehrig's disease develop symptoms more slowly and survive longer. The center is looking at cord blood treatments for diseases like Alzheimer's and cerebral palsy as well.
"Most of these studies have been performed on animals, but the results have been very encouraging," says Paul Sanberg, executive director of the Center of Excellence for Aging and Brain Repair and vice-chair of the Department of Neurosurgery and Brain Repair at the University of South Florida.
But many experts urge parents to view such studies (especially those conducted on animals) cautiously. It's difficult to predict when, if ever, these treatments will become available for people.
Cautious optimism
Researchers "Breakthroughs occur daily," says Laura Riley, an obstetrician at Massachusetts General Hospital, "but most people are overly optimistic about the amount of progress thus far." Still, scientists are hopeful that someday adult patients will routinely be able to receive cell therapies based on cord blood stem cells.
A full list of the current clinical trials with cord blood is available on the Diseases Treated page of the Parent's Guide to Cord Blood Foundation website.

What parents need to know

The field of medical research with stem cells is exploding, and the topic can be confusing.
The most important thing for parents to understand about the stem cells in cord blood, says Frances Verter, founder and executive director of the nonprofit Parent's Guide to Cord Blood Foundation, is that you can either 1) donate your baby's cord blood to help patients seeking transplants now or 2) save your baby's cord blood for your family in case you need it later, most likely for a therapy that's still being studied.

How much cord blood is stored in the United States, and where is it stored?

More than 1 million units of cord blood are stored in family banks in the United States. And the national Be the Match Registry provides nearly 185,000 donated cord blood units in the United States, with additional access to more than 425,000 cord blood units through partnerships with international registries.
Verter estimates that about 5 percent of parents now bank their baby's cord blood. Ninety percent of that cord blood goes to family banks and 10 percent goes to public banks.