Cord Blood Banking

Preserving your baby’s umbilical cord blood – cord blood banking – has become more common. You may hear about it in prenatal classes or see advertisements about private cord blood banks.

Why Is Umbilical Cord Blood So Valuable?

After your baby is born, the placenta and umbilical cord are normally discarded. But the blood from your baby’s umbilical cord is a rich source of special cells called stem cells.

Stem cells are immature, ‘unspecialized’ cells. They are valuable because they can quickly divide and renew, and have the ability to mature into different types of cells.

When transplanted, the stem cells in umbilical cord blood have the potential of producing the different ‘parts’ of blood: red blood cells which carry oxygen, infection fighting white blood cells and platelets, which are involved in clotting. Stem cells act like a factory, producing new blood cells to replace cells ‘worn out’ or destroyed through disease.

There are more than 45 medical conditions that can be treated with cord blood stem cells.

Are Stem Cells Found Elsewhere In The Body?

Stem cells are also found in bone marrow and some other tissues. Life-threatening diseases such as certain types of anemia, and the cancers leukemia and lymphoma, are treated today through bone marrow transplants, in which healthy bone marrow donated from another person is transplanted into a sick person. The stem cells from the bone marrow then work to replace the damaged or diseased cells.

The challenge with bone marrow transplants is that a sick person needs bone marrow donated from another person. There must be a ‘match’ between the tissue types of the two people, which can be difficult to find.

Stem cells saved from your baby’s umbilical cord blood might be used if she ever needs a stem cell transplant, such as in a bone marrow transplant. In this case, there would be no issue regarding tissue matching, since the stem cells would be a perfect match. A more likely situation would be if a sibling or immediate family member needed a stem cell transplant.

Advantages Of Cord Blood Stem Cells

Currently, most bone marrow transplants use stem cells from donated bone marrow. Research has shown, however, that there are some distinct advantages in using cord blood stem cells:

• Collecting stem cells is painless for mother and baby. It’s also relatively simple.
• There are nearly 10 times the number of stem cells in cord blood per volume than in bone marrow.
• Cord blood stem cells divide more quickly than stem cells in bone marrow.
• Cord blood stem cells are tissue-typed and stored for easy access if needed. (Patients with life-threatening illnesses cannot always survive the wait for a suitable donor to be found.)
• Cord blood stem cells have proven to be less likely to cause a life-threatening reaction, in which transplanted stem cells attack the recipients tissues.

Potential Future Uses Of Cord Blood Stem Cells

Research shows that cord blood stem cells have the potential to change into non-blood cell types such as neurons (nerve cells in the central nervous system, including the brain) muscle or liver cells.

This could lead to the use of cord blood stem cells for stem cell therapies that might one day help treat conditions such as spinal cord injury, liver damage or diabetes. These uses of cord blood stem cells are not currently clinically available. They do, however, offer exciting possibilities for the future.

Cord blood banking + you

Most families have no significant risk factors that would make a bone marrow transplant likely. But expectant parents with a significant family or personal history of genetic diseases or cancers which might increase the likelihood of a need for stem cell treatment might seek genetic or medical counselling about whether they should consider banking their baby’s cord blood as a family resource.

Families in which there is a child in need of a stem cell transplant would likely be encouraged by their doctors to collect and store a newborn sibling’s cord blood.

Expectant parents with no significant risk factors should have a realistic understanding of the potential uses and limitations of their baby’s stored cord blood.

Parents should also be aware of the costs involved for public and private cord blood banking, and of their rights and responsibilities if they participate.

They should not feel guilty if they do not want to or cannot afford to store their baby’s cord blood.
You should make your choice about cord blood banking well before your baby’s birth.

What are the options?

Expectant parents may:

• Register with a private cord blood bank that processes and stores the sample of cord blood (family banking).
• Donate their baby’s cord blood to a public bank where it may be accessed by anyone who needs a stem cell transplant.
• Donate their baby’s cord blood for stem cell research.
• Collect the cord blood and use it immediately or shortly after the birth for a planned, related stem cell transplant, in collaboration with a medical transplant team.

All of these options are subject to certain conditions of eligibility.

Parents may also:

• Choose to discard the cord blood at the time of delivery.

Choosing A Private Cord Blood Bank

There are now a number of facilities in Canada that offer private cord blood banking. Here are some questions you may wish to ask when making your selection:

• How many successful transplants have been performed using stored samples from the bank?
• How long has the bank been operating and how many samples have been processed?
• Does the processing comply with Canadian standards?
• What are the costs?
• Does the bank have a collaborative relationship with stem cell transplant scientists? Does it engage in research to improve stem cell banking techniques or to expand possible treatment applications for stem cells?

Dr. Barbara Cruickshank is Assistant Professor at the Reproductive Biology Unit, Division of Reproductive Sciences, Dept. of Obstetrics and Gynaecology, Mount Sinai Hospital in Toronto. She is also Medical Director of Insception Biosciences, formerly The Toronto Cord Blood Programme.