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Thread: Should people collect their baby's cord blood?

  1. #1
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    Umbilical Cord Blood Question for Wise

    Hi Dr. Young,

    I read your post to AM regarding his three-year-old daughter and I have some questions about umbilical cord blood. I emailed you some time ago about my daughter Emma (who is now five). Emma's SCI was a result of a spontaneous spinal epidural hematoma on 11/7/02. She is a T3 complete. When Emma was born I donated her umbilical cord blood. I recently found out that they never used it and they have graciously offered to hold it for us at no charge. I was wondering how long cord blood can be effectively stored? - as Emma will be six in April. Also, is there a big advantage to using one's own cord blood?

    Thank you,

    Ali

  2. #2
    akaltz,

    The umbilical cord blood from her is the best source possible because it is her blood and should be perfectly matched for her. You should definitely take advantage of it. The blood should still be good after 6 years of storage. While there is some controversy concerning whether stored blood is good for a decade or longer, I think that 6 years is still reasonable.

    The main questions is the way the stem cells should be applied. There are essentially three ways:
    1. Direct infusion of the blood. While there have been several studies suggest that infusion of blood may help in animal studies, I am not yet convinced of this. We have tried infusing neonatal blood into animals and have not seen a dramatic improvement in the animals. The cells are likely to be distributed all over the body. This would be a one-shot deal and it seems that this would not be the best use of her blood.

    2. Separation of nucleated cells from the blood and tranplantation of the nucleated cells into the spinal cord. Note that this is necessary because blood cells are not good for the spinal cord. The blood cells break down and cause vasoconstriction and other problem (it would be similar to having a hemorrhage in the spinal cord. Only cells that have nuclei should be transplanted into the spinal cord. Again, this would be a one-shot deal.

    3. Grow stem cells from the umbilical cord blood and implant the stem cells. While several groups have reported successful cultivation of stem cells from umbilical cord blood (including the group at Coriell Institute in Camden, New Jersey) and we recently had some success growing stem cells from fresh human umbilical cord blood and also fresh neonatal rat blood, the procedures are still not yet well-established. However, this would be the most desirable approach, i.e. to grow out specific stem cells and expand them so that they can be given multiple times if necessary and also in combination with other therapies in the coming years.

    In my opinion, umbilical cord blood stem cells should be more effective when it is combined with other regenerative therapies.

    Wise.

  3. #3

    Should people collect their baby's cord blood?

    Due to the fact that umbilical cord cells may potentially be used in treatment of SCI, does anyone know of places that will store it for future use?
    Thanks,
    CRJ

  4. #4
    Cathy J,

    Almost every hospital with a large obstetrics unit has some kind of arrangement with a company that collects and banks umbilical cord blood. The recommendation of the American Pediatric Academy is for people to donate the blood to public banks (rather than private banks). When the blood is donated to a public bank, anybody who matches the blood will be able to use it. The chances that the baby will need the blood within a decade is low and there is currently no guarantee that the blood will be as good when stored for decades. Please note that while blood from a relative is closer than blood from a stranger, the likelihood that the blood will match the mother or father depends very much on how close the HLA antigens of the father and mother match.

    The advantages of donating to a public bank is that the company pays for the costs of collecting and storing the blood. The blood will be used if it matches with somebody requesting it. One possible compromise is to use a public banking company that guarantees a unit for donors. For example, a company named Stemcyte provides a guarantee to donors that if they donate their baby's cord blood to their "public" blood bank, the donor will have access to their baby's blood if it has not been used already or an equivalent matched unit. This seems to be the most sensible way to go. Stemcyte only collects blood from certain hospitals because they have very high standards but there may be other companies that have a similar policy.

    Wise.

  5. #5
    Thanks Wise!
    Cathy

  6. #6
    Senior Member giambjj's Avatar
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    Talk to your OBGYN. They have commercial contacts that will handle everything for you. However, it is not cheap!


    JJG

  7. #7

  8. #8
    http://www.sciencedaily.com/releases...0418095036.htm

    Report Proposes Structure For National Network Of Cord Blood Stem Cell Banks

    WASHINGTON -- To achieve a more cohesive national system for storing and distributing lifesaving stem cells derived from umbilical cord blood, the U.S. Department of Health and Human Services should establish a new National Cord Blood Policy Board to set rules for the donation, collection, and use of this resource, says a new report from the Institute of Medicine of the National Academies. In addition, the department's Health Resources and Services Administration (HRSA) should call for proposals to identify an organization that can serve as a new Cord Blood Coordinating Center to manage daily operations of cord blood banking and allocation nationwide, says the congressionally requested report.

    Blood from umbilical cords -- a byproduct of normal childbirth -- is a good source of hematopoietic progenitor cells (HPCs), the type of stem cells also found in bone marrow that give rise to various kinds of blood cells. Transplants of these stem cells have saved the lives of roughly 20,000 Americans with leukemia, lymphoma, sickle cell anemia, and several other illnesses in recent years, the report notes. But thousands of patients who might benefit from a transplant die every year waiting for a match. Although 22 public banks have been established in the United States to collect, store, and distribute donated cord blood containing these cells, these banks operate without any centralized coordination, noted the committee that wrote the report.

    "The lack of centralized organization, universal quality standards, and uniform matching mechanisms makes it more difficult than it has to be for physicians to provide patients with suitable cells in a timely way," said Kristine Gebbie, associate professor of nursing and director of the Center for Health Policy and Doctoral Studies Columbia University, New York City, and chair of the committee that wrote the report. "Moreover, there simply aren't enough units of cord blood available now to meet the needs of the roughly 11,700 Americans who could benefit from a transplant of these cells every year. The structure we are recommending for a national cord blood banking program would assure that patients receive high-quality therapeutic cells in the most timely, ethical, and cost-effective manner possible."

    Three-quarters of the patients who require a transplant of HPCs do not have a relative whose cells would be a suitable match and must turn to public bone marrow donor registries or umbilical cord blood banks for donated cells. By increasing the size and quality of the cord blood inventory, nearly 90 percent of all patients who need a transplant should be able to find a suitable match from either cord blood banks or marrow donor registries, the report says.

    The new National Cord Blood Policy Board should be established at the level of the office of the DHHS secretary to ensure that it is distanced from the day-to-day concerns of other parts of the department responsible for managing relationships with and funding for bone marrow donor programs and cord blood programs, the committee urged. The board should routinely review the results of cord blood stem cell transplants and guide DHHS and the cord blood banking program on procedures and standards for banking and allocation and on any changes to the inventory of cord blood units.

    Decisions about which source of HPCs to tap must be made on a case-by-case basis and driven by the patient's needs, the report notes. To that end, the board should actively encourage collaboration between marrow donor registries and cord blood banks, as well as support cord blood banking's emergence as a transplant option.

    Although the National Marrow Donor Program (NMDP) and other organizations have developed several of the components necessary to manage daily coordination of banking and allocation on a large scale, no organization currently has all the necessary capabilities to serve as the Cord Blood Coordinating Center, the committee concluded. HRSA officials should use a competitive process to solicit proposals and identify an organization to take on this function. NMDP and other organizations would have an opportunity to present plans for ensuring that all the necessary elements are in place to link participating transplant centers and cord blood banks; establish standards for cord blood storage and matching; and make sure that data on the results of transplants are available for decision-making and quality assurance. Although the new center would coordinate these various activities, it need not assume all of these functions itself, the report says.

    The majority of funding available for the national cord blood bank program should be targeted to expanding the inventories of participating banks. Based on the current estimate that 50,000 useable units of cord blood are now available through public banks and the NMDP, the committee projects a need for at least 100,000 more high-quality units. The larger the inventory, the greater the likelihood that a patient will be matched to a suitable unit and receive an optimal dose of cells, although the costs of collecting and storing cord blood also must be considered. The point at which the costs of banking cord blood exceed the benefits for the patient population is 200,000 units, according to an economic analysis conducted for the study.

    Cord blood banks should strive to provide units with a high-enough concentration of stem cells to make up for imperfect matches between donor and recipient -- a frequent occurrence, the report notes. The more closely surface markers on donated cells match those on a patient's own cells, the less likely that the patient's body will reject the transplant. In many cases, a mismatch of one or two degrees is the best that can be found in public banks. Patients for whom an ideal match cannot be located should receive units that contain at least 2.5 x 107 cells per kilogram of body weight, the report says. When perfect matches can be found, cell concentration is less important.

    For many racial and ethnic minority patients, it is difficult or impossible to find suitable matches because many cord blood collections are not ethnically and racially diverse. The committee's own survey determined that 62 percent of the current total inventory in the United States came from white donors, 15 percent from Hispanics, 7 percent from African-Americans, 5 percent from Asians, 5 percent from mixed race donors, and 1 percent from American Indians. However, individual cord blood banks have achieved greater diversity through geographically targeted collection efforts and other means, the report notes.


    ###
    This study was sponsored by the Health Resources and Services Administration. The Institute of Medicine is a private, nonprofit institution that provides health policy advice under a congressional charter granted to the National Academy of Sciences. A committee roster follows.

  9. #9

    Smile Should people collect their baby's cord blood?

    Dear Wise,

    I am coming up to the 20 week mark in my pregnancy and although I have a bit to go, Im already planning to bank the little rascal's cord blood cells!! Its not as easy to do over here as in the US but hey. I know there's controversy surrounding their usefulness post-freezing but its definitely a risk Id like to take - I mean they may contribute to getting me into my stilettos again one day soon!

    Although I have an upcoming obstetrician's appt, I was wondering if you could shed any light......

    Basically my boyfriend is blood group A+ while Im O neg - great huh?! I dont do things by halves for sure! My question is, rhesus wise, if my baby shares his Dad's bloodgroup does this mean I would reject them if used?

    Thanks in advance

    J

  10. #10
    Pixie,

    The chances whether the umbilical cord blood of your baby is O-negative depends on your boyfriend. If your boyfriend is homozygote for A and Rh, it will not be compatible with you. There is of course a chance that one side of his genes may be O- but that probability is low, i.e. less than half of the probability of finding an O- blood in the general population since we know that at least half or more of his genes are A and Rh-positive.

    Let me comment in general. Umbilical cord blood will be of course exactly matched with your baby (since it is your baby's blood). The probability that umbilical cord blood will precisely match one of the parents depends on how closely related the parents are to each other. Parent with more common ABO and HLA types are more likely to find a match. (Since you have a rare O-neg type, you will be harder to match). Please note that some data suggesting that umbilical cord blood does not have to have identical matching and there is as high as an 80% probability of engraftment is 4 of 6 HLA antigen match. So, the chances of your finding a match from a sufficiently large and diverse public bank is reasonable. Since most blood in umbilical cord blood banks are from caucasians, the chances of finding a match is better than finding a match for Asian or African blood but this will probably change as more Asian and African umbilical cord blood units are collected.

    Wise.
    Last edited by Wise Young; 07-13-2005 at 06:06 PM.

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