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Umbilical cord blood stem cell banking

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					Umbilical Cord Blood Stem Cell Banking

Umbilical cord blood stem cell banking is a simple, painless, non invasive procedure. Umbilical
cord connects baby to mother. After birth, this cord and its contents are normally thrown away.
However, this cord contains blood with many stem cells.

Stem cells have ability to regenerate almost any tissue in body. In umbilical cord blood (UCB)
banking, after birth, blood is collected from cord using a syringe and is stored at very low
temperature (minus 196 C). With current technology, storage of stem cells is possible for up to
21 years. It is likely, however, that storage would be possible for more years as technology is
improving. Procedure of collection takes only ten minutes, and can be done at any hospital.

UCB stem cells are useful for treatment of children who require Stem Cell Transplant, for many
diseases, such as blood cancers, genetic diseases. First such transplant was done in 1988, for a
genetic disease known as Fanconi’s anemia. Already, over 15,000 transplants have been done
worldwide using UCB stem cells. According to one estimate by NMDP (a USA agency), by
2015, there will be 10,000 transplants per year using UCB stem cells. Majority of these would
come from public cord blood banking.

Research is ongoing for use of stem cells in many other diseases e.g. heart diseases, brain
diseases, diabetes, spinal cord injury and other areas of regenerative medicine. At present,
proven use is only for treatment of blood related diseases, and many genetic diseases. Also,
many different sources of stem cells are used in research, not just UCB stem cells.

All parents should be given information about this procedure, and option of storage. In majority
of states in USA, it is mandatory to give following options to parents.

Parents should be given three options:

1. No storage. It should be completely voluntary.

2. Public cord blood banking i.e. storage with donation in mind, as in blood donation. This is
free of cost, and stem cells could be given to anyone in need.

3. Private banking i.e. stem cells are stored for future use by child or family only.

Many more uses of stem cells may be possible in future, and many more sources of stem cells
may be available in future. Hence, parents should be given all the three options noted above.
Since private cord blood banking involves a cost for parents, giving unbiased information is very
important. Use of “Biological Insurance” concept should be discouraged, as it seems to promise
much more than what is known today about future of stem cell therapy in general. And it leads to
pressurizing of parents. Such type of marketing is almost certain to backfire, and may lead to a
negative attitude for this excellent treatment option, at least for many blood diseases as of today.
Advantages of UCB stem cells include:

   1. No risk to donor during collection, as the collection is done after birth, after separating
      cord from baby.
   2. Rapid availability of stem cells, as the cells are stored after all necessary tests. There is no
      need to find donor, test him, and then collect cells.
   3. Less GVHD compared to other current sources of stem cells – gvhd is a type of reaction
      that can happen after transplant, especially if there is a mismatch between HLA antigens
      of donor and patient. This allows more patients to be treated even when there is some
      mismatch.
   4. There is no risk of reaction if one is using own stem cells stored for future use.

Disadvantages of UCB stem cells include:

   1. Low cell dose – number of stem cells is small. Hence this is useful only for children,
      generally below 20 kg weight. Adults need much larger number of stem cells. This may
      change in future, however, with changing methods of transplant, such as intra osseous
      stem cell implantation or ex vivo stem cell expansion.
   2. Slow engraftment – these cells take longer time compared to adult bone marrow or blood
      stem cells to establish themselves in patient body and start making enough blood cells.
      This leads to longer hospitalization and more risk of infection and need for blood support.

In summary, UCB stem cells offer various current, and potentially many more future therapeutic
uses. Parents should be given information about what is known and should be given three options
noted above.

				
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