Your Questions Answered
What are the different programs used in storing and utilizing umbilical cord stem cells?
Cord blood refers to blood taken from the umbilical cord after a baby is born, after the cord to the placenta is clamped and cut, and before the placenta is delivered. The stem cells found in this blood are useful in promoting bone marrow recovery and are already being used effectively to treat a variety of leukemic disorders, blood disorders, as well as some metabolic disorders.
Currently there are three types of cord blood banks: public banks, private banks, and directed donation banks. In the private donation system the couple pays a large amount of money ($1,000-$1750) as an initial fee and is then charged annually to store the cells. These cells are then potentially available exclusively for the use of the child, sibling, or parents. In the case of donation for public use, donors undergo an extensive screening for genetic disorders and infectious disease. These stem cells are then cross-matched to recipients in need; the process is similar to how donation of bone marrow, organs, and blood is now handled. This donation and storage incurs no debt to the patient. A directed donation public bank is one in which cord blood is collected at no charge. It is used in situations where a sibling has a disease which might be successfully treated with cord blood transplant.
There are some major differences between private and public banking which all patients need to consider. Private companies use direct advertising and incentives to recruit donors, while projecting startling statistics to urge a parent to prepare for the future. However, autologous donation is not always desirable, especially in cases of genetic problems, because the gene mutation is already present in the stem cells. This limitation applies to certain types of leukemia as well. Furthermore, current research suggests that the chance of autologous use is approximately 1:2,700, not 1:27 as some private banks claim. Usefulness is also hindered by problems in the quality of cells collected, long-term survival and viability of stored cells, not to mention long-term viability of the company storing the cells. The American College of Obstetrics and Gynecology has stated that “parents should not be sold this service without a realistic assessment of the likelihood of return on their investment.” Private banks are also under less rigorous FDA control than public banks. Public banks, on the other hand, are more cost effective, allow for greater access, and allow for ethnic diversity of inventory. In cases where there is a genuine concern regarding a specific diagnosis within a family, directed donation should be considered. Talk with your provider for more information about any of these programs.
Source: Obstetrics and Gynecology Vol. 106, No.6, December 2005
“Umbilical Cord Stem Cells” Kenneth J. Moise Jr., MD