Hello Expectant Parents,
Congratulations on your imminent bundle of joy!
This is a most interesting topic, and while many uses for stem cells
are in their infancy, umbilical cord blood has been used for over
twenty five years. I have seen firsthand the many successful donor
cord blood transplants, and, in the early stages, many failures. This
was before parents began banking their own children?s cord blood, and
cord blood from donors and family members was used.
?The first choice for a donor of stem cells is an HLA-matched
relative; however, such an ideal donor is only available for a
minority of patients, resulting in the need to expand the donor pool.
It has been determined that related donors who are mismatched for only
one HLA antigen are also suitable stem cell donors. Over the past two
decades, there has been a marked increase in the number of unrelated
donor transplants, with outcomes similar to that achieved with related
donor transplants. However, because of genetic disparity, unrelated
matched donors cannot be found for many patients, especially for those
with unusual HLA types such as those found in many minority
populations. In addition to the genetic problem, many patients die
while seeking an unrelated donor, which can be a lengthy process.
Umbilical cord blood offers an alternative source of stem cells that
are immediately available and there is evidence that the degree of
mismatching for HLA antigens is not as it is for marrow or blood stem
cells. The major limitation of umbilical cord blood transplants is the
low cell number with delayed or absent engraftment. There has been
skepticism that single units of cord blood would be adequate for full
engraftment in adults.?
http://professional.cancerconsultants.com/oncology_sct_news.aspx?id=32724
?The primary reason that parents consider banking their newborn's cord
blood is because they have a child or close relative with or a family
medical history of diseases that can be treated with bone marrow
transplants. Some diseases that more commonly involve bone marrow
transplants include certain kinds of leukemia or lymphoma, aplastic
anemia, severe sickle cell anemia, and severe combined immune
deficiency.
The odds that the average baby without risk factors will ever use his
or her own banked cord blood is considered low; however, no accurate
estimates exist at this time.?
http://kidshealth.org/parent/pregnancy_newborn/pregnancy/cord_blood.html
Should your child find the need for treatment with stem cells later in
life, you virtually erase the possibility of transplanting an unknown
genetic disease. While donor stem cells are prescreened, the donors
may not be aware of familial genetic disease, thus passing this onto
your child. You find the term ?allogeneic? in the following paragraph.
You may already be aware of this term, and it?s partner ?autologous?,
but let me briefly explain.
?Allogeneic? refers to blood and any blood/tissue/bone/organ
components (bone marrow, blood, cord blood cells, platelets, plasma,
etc.) from a matched donor. ?Autologous? refers to blood components
collected from the recipient, and later transplanted. If your child
were to utilize his/her own cord blood cells, it would be an
?autlogous? transplant. Many adults, facing elective surgery, donate
their own units of blood, to be reserved for their use only. This
ensures safer blood for their own transfusion. This blood is called an
?autologous? donation.
?Cord blood stem cell transplantation is a relatively new procedure,
compared with transplants that use stem cells from blood or bone
marrow. It is possible that genetic diseases, or diseases present but
not apparent at the time of birth, may be transmitted to patients via
allogeneic cord blood stem cell transplantation. Follow-up procedures
to track this possibility would require creating a long-term link
between the medical facility caring for the recipient, the donor
center, and the donor. This potential follow-up procedure has raised
concerns about privacy. A solution used by many centers is to obtain a
detailed questionnaire from potential donors prior to cord blood
collection. The questionnaire covers individual and family histories
of disease and a detailed sexual history. If responses to the
questionnaire generate medical concern, the cord blood is not
collected. This method is similar to procedures used to screen blood
donors.?
http://www.leukemia-lymphoma.org/all_mat_toc.adp?item_id=9622#_q7
While I would heartily encourage parents to bank their child?s cord
blood, it is not a perfect answer. It?s expensive, and can be risky.
Cord blood can be contaminated with maternal blood cells, and although
very rare, it can occur. Cord blood stem cells also graft/ ?Take? as
quickly as adult stem cells, so the patient is at a risk of infection.
Studies have shown however, that the rate of fatal infections is no
higher than adult cell transplantation. ?The mother's blood cells are
mature (not stem cells) and they are not the same HLA type as the cord
blood cells. Maternal lymphocytes could cause severe, and even fatal,
graft-versus-host disease in the transplant recipient. However, this
potential complication has not been encountered in more than 2000
unrelated cord blood transplants.?
http://www.leukemia-lymphoma.org/all_mat_toc.adp?item_id=9622#_q7
?Finally, it is not known how long cord blood can be stored without
losing its effectiveness. However, the supply of cord blood is
potentially so great that banks could discard older samples. Thus far,
cord blood samples have been preserved for as long as 8 years and then
successfully transplanted. By comparison, autologous bone marrow
stored for 2 years and longer (up to 11 years in one case) has been
successfully transplanted in 94% to 97% of patients.?
http://www.leukemia-lymphoma.org/all_mat_toc.adp?item_id=9622#_q7
?The expense of collecting and storing the cord blood can be a
deciding factor for many families. At a commercial cord-blood bank,
you'll pay approximately $1,500 to store a sample of cord blood, in
addition to a $100 yearly maintenance fee. You might also pay an
additional fee of several hundred dollars for the cord-blood
collection kit, courier service to the cord-blood bank, and initial
processing.?
http://kidshealth.org/parent/pregnancy_newborn/pregnancy/cord_blood.html
The Leukemia and Lymphoma Society recommends:
? Healthy parents with healthy children, or couples expecting their
first child, can donate their newborn's cord blood to banks and
research programs, if their hospital participates in a public cord
blood banking or a university-based research program.
? Parents who have a child or family member with cancer, an immune
deficiency, or a genetic disease, and might be a candidate for
transplantation, should discuss the potential for cord blood stem cell
transplantation with their physicians.
? Selected cord blood banks monitor donor infants up to 2 years after
donation. If the cord blood unit has not yet been shipped or used,
parents can withdraw their permission to transplant the unit to an
unrelated recipient.
? Parents considering private collection should contact their health
insurance carrier well in advance of delivery to find out whether cord
blood collection and storage are covered benefits.
? Parents who do not have another child or family member in need of a
stem cell transplant should weigh the cost associated with private
cord blood banking against the low likelihood that the cord blood will
be used. Companies currently charge approximately $1000 to $3000 for
collection and storage, usually with an additional yearly storage fee.
? To minimize the risk to mothers and newborn infants, normal
procedures related to delivery should not be altered in order to
collect cord blood, particularly when collecting cord blood for
unrelated recipients.
? Because cord blood collection and transplantation can have
complications similar to allogeneic (unrelated) bone marrow
transplants, they should only be done at centers experienced in the
transplantation of allogeneic sources of stem cells.
? Parents and patients should inform themselves about cord blood
banking and cord blood stem cell transplantation and discuss their
concerns with health care professionals who are knowledgeable in these
areas.
http://www.leukemia-lymphoma.org/all_mat_toc.adp?item_id=9622#_q7
?n addition, it's not known whether stem cells taken from a relative
offer more success than those taken from an unrelated donor. Stem
cells from cord blood from both related and unrelated donors have been
successful in many transplants. That's because blood-forming stem
cells taken from cord blood are naive (a medical term for early cells
that are still highly adaptable and are less likely to be rejected by
the recipient's immune system). Therefore, donor cord-blood stem cells
do not need to be a perfect match to create a successful bone marrow
transplant.?
http://kidshealth.org/parent/pregnancy_newborn/pregnancy/cord_blood.html
This page, from a cord blood bank lists the conditions that cord blood
cells are being used to treat.
http://www.cordpartners.com/diseases/
This page, from the site above, offers an informational packet, and a
toll free number you can call with any concerns: 888-882-2673
http://www.cordpartners.com/
This page, from the same site has numerous links to news articles on
cord blood successes.
http://www.cordpartners.com/existingCustomers/news/
Request an information packet here
http://www.cordpartners.com/request/
Viacord is another cord blood banking service
http://www.viacord.com/index.asp?p=83
If you decide not to store the cord blood for yourselves, please
consider donating it for other?s use or research. You pay nothing to
donate, and it does not interfere with the birth of your child, as
the cord is discarded as standard procedure.
http://www.marrow.org/HELP/donate_cord_blood.html
http://www.marrow.org/FAQS/cord_blood_faqs.html
Further Information:
Duke Medical Center- Dr. Joanne Kurtzberg is a leading stem cell researcher.
http://dukemednews.duke.edu/global/download.pdf?ids=778
http://dukemednews.duke.edu/global/download.pdf?ids=599
http://www.rideforlife.com/archives/000638.html
http://www.dukehealth.org/physicians/385F24432A328A8285256DFD006A9443
http://dukemednews.duke.edu/news/article.php?id=7582
Japanese Study Shows Umbilical Cord Blood Transplants Superior to
Unrelated Donor Transplants for Adults with Leukemia
http://professional.cancerconsultants.com/oncology_sct_news.aspx?id=33009
http://www.fairviewbmt.org/
There you go! Kudos to you for considering cord blood banking! As far
as banking your child?s cord blood? if you can afford it, I?d
recommend doing so. You can?t go back later and retrieve it. However,
if you can?t bear the cost, donate the cord blood to an agency for
free, and feel no guilt. Chances are small your child will need it,
barring any familial genetic diseases. Since cord stem cells are
?naïve?, meaning, not completely specialized, your child could use
donor stem cells, should the need arise.
If any part of my answer is unclear, please request an Answer
Clarification, before rating, and I will respond as soon as possible.
I wish your family the best!
Sincerely,
crabcakes
Search Terms
cord blood transplant success + autologous
cord blood storage
Dr. Joanne Kurtzberg + Duke Medical Center + cord blood |
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