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:
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.
