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Some Davis families banking on cord blood

Heidi and Vince Yee of Davis say they saved their twins' umbilical cord blood because a bone marrow match is hard to find for people of mixed ancestry.



By Sara Kashing/Enterprise staff writer

Some Davis parents have chosen to preserve their newborns' umbilical cord blood for the future health of family members who may one day be diagnosed with a form of cancer or blood disease.

These families are freezing cord blood because research indicates that this biological resource is rich in stem cells. When transplanted, those stem cells have the potential to save lives. Studies show that cord blood can be used to treat as many as 47 different diseases and disorders.

But, unless a family requests that the blood from an umbilical cord and placenta be collected, it is usually discarded at the time of a baby's birth, said Bil Paul, a spokesman for Cord Blood Registry, a private cord blood bank in San Bruno.

"For eons and eons umbilical cords were merely symbolic. Saving the umbilical cord was a significant tradition only among Chinese families," he said. "Now, those who know about cord blood's possible applications consider it a tragedy to just throw umbilical cords in the trash."

Until the late 1980s, bone marrow transplants were regarded as the most effective way of treating cancer patients because marrow contains a high number of stem cells. Stem cells are the body's "master" cells and serve as the "building blocks" of organ tissue, blood and the immune system.

Chemotherapy and radiation therapy destroy a patient's stem cells as they work to attack cancer cells, Paul said. Following these types of cancer treatments, doctors transplant stem cells for the purpose of multiplying and regenerating a new blood and immune system.

How trend began

Soon after scientists discovered that high concentrations of stem cells also exist in umbilical cord blood, researchers began to investigate whether cord blood cell transplants might prove useful in the fight against certain cancers. In 1988, the first cord blood transplant was done in France, to an American child, Paul said.

The first cord blood transplant on American soil took place in 1990. Since then, there have been approximately 2,500 cord blood transplants worldwide.

Sixteen family cord blood banks have been established in the United States. Since 1992, thousands of parents have collected and frozen their newborn's blood as a safeguard against the sometimes fatal effects of diseases such as leukemia.

19 area families

Nineteen Davis families are storing their children's cord blood with Cord Blood Registry. The company is storing 45,000 units of blood at its facility in Tucson, Ariz. Dr. Davis Harris, Cord Blood Registry's scientific and stem cell bank director, was the first to bank cord blood for future use.

A professor of microbiology and immunology at the University of Arizona, he founded what is now Cord Blood Registry after having preserved the cord blood of his newborn son, Paul said.

"His colleagues were so intrigued by the cord blood's potential applications that they asked him to freeze their newborns' cord blood as well," he said.

During the past decade, 23 cord blood samples that were stored by Cord Blood Registry have been used for inter-family transplants, Paul said.

"The word 'registry' might confuse people," he said. "Our facility is for families who want to store cord blood for their own use, at any time," he said.

Public cord blood banks were established so those who have no donor within their family will also have a greater chance at life. Parents can donate their newborn's cord blood to a public bank at no cost, but must decide to make the donation prior to delivery. Before a bank will accept a donation, a blood sample is tested to ensure quality. When a bank receives a donation, results of the testing are entered into a central database.

Doctors can search the database in the hope of finding a match for their patients.

While only some of the Davis families have specific risk factors for diseases and disorders that are potentially treatable with the cord blood, all of the families believe they are taking a proactive approach to their health by banking their newborns' cord blood, Paul said.

Peace of mind

UC Davis cardiac physician Kathy Glatter is expecting a baby boy on Sept. 29. Glatter has decided to have his cord blood stored so that he will have every possible advantage in the event of illness.

"I know that his chances of having a life-threatening disease is rare. But, God forbid, if he should get cancer, need a kidney transplant or become paralyzed, the cord blood could make the difference," she said.

Cord Blood Registry's clients receive a collection kit that contains all the items a doctor or midwife would need to collect a baby's cord blood. After delivery, a syringe is used to draw the blood from a clamped and cut umbilical cord.

The client's main responsibility is to bring the kit to the hospital.

"I keep telling my husband that, when the time comes, we can't forget to grab the kit," Glatter said.

Once the blood is collected, clients must arrange to have it shipped to Cord Blood Registry's laboratory and processing facility in Tucson.

Each of CBR's kits has a bar code that uniquely identifies a baby's blood sample. Prelabeled packaging for shipping is provided in advance by the company. All of the kits are insulated and padded to ensure that the blood sample will arrive intact, Paul said.

Cryogenic storage helps assure a cord blood samples long-term integrity, Paul said.

"We store the blood in liquid nitrogen at minus 384 degrees Fahrenheit," he said.

Only a small percentage of families in the United States are banking their newborn's cord blood. Between 1 and 2 percent of the country's 3.8 million births result in banked cord blood each year, Paul said.

A limitation to cord blood banking becoming universal is the cost involved, Paul said.

"Storing cord blood is an intricate process. Therefore, it's not inexpensive," he said.

The fee for enrollment with Cord Blood Registry is $1,290 and $95 for every year the blood is preserved.

Cord blood banking is not covered by insurance nor is it nationally regulated.

"I realize I might have bought the Brooklyn Bridge, but the company appears to be well-established. I really see this as a good investment in my family's future," Glatter said.

In July 1999, a panel of experts within the Academy of Pediatrics concluded that not enough evidence was available to support "routine" collection and storage of umbilical cord blood. The experts did, however, acknowledge that cord blood can be used to treat some life-threatening childhood diseases.

According to the UCLA Umbilical Cord Blood Bank's Web site, the chance of a child developing a disease that can be treated by a cord blood transplant is estimated at less than 1 in 10,000. The Web site also states that children diagnosed with leukemia are unlikely to be treated with their own stored cord blood because, in all probability, that blood would also carry the disease.

Better than marrow?

Because cord blood is more readily available than bone marrow, cord blood may become more commonly used, Paul said.

"Finding a person to donate bone marrow can be a time-consuming and even unsuccessful process, especially for patients who are adopted or have a mixed racial background," he said.

Heidi Yee, a Davis resident and mother of 4 1/2-month-old twins, said she and her husband Vince preserved their children's cord blood for that reason.

"I am Caucasian and my husband is Chinese. We've been told it would be nearly impossible to find a donor. We wanted to have more peace of mind," she said.

For parents would have difficulty getting pregnant again, cord blood storage could prove to be a particularly important decision, Paul said.

"This could be their one chance to protect their family from a medical catastrophe," he said.

Unlike bone marrow, cord blood cells can be used by siblings or relatives in many instances.

Whereas perfect matches are needed for bone marrow transplants, cord blood transplants can be effective when there is only a partial match, Paul said. That means a newborn's first and second-degree relatives may be saved through the use of its stored cord blood cells.

Clinical studies have indicated that the survival rate for certain diseases is almost double when the cord blood cells being used have come from a relative.

Cord blood transplant patients also have reportedly fewer, less-severe side effects than those who undergo bone marrow treatments.

Viability

Core Blood Registry has been storing cord blood since 1992, with no sign of a loss of viability of the stem cells. According to the New York state guidelines for cord blood banking, no expiration dates need to be assigned to cord blood that is being stored continuously under liquid nitrogen.

Paul said his company tells prospective clients that cord blood stem cells can be stored indefinitely.

"We will store core blood for as long as a client wishes," he said.

-- Sara Kashing can be reached at skashing@davisenterprise.net

Sunday, September 15, 2002