Cord blood banking

What is cord blood banking?

The process of collecting the blood left in your baby's umbilical cord and placenta after birth, freezing and storing it for future medical use is known as cord blood banking.

Why is cord blood banking done?

The blood contained in the umbilical cord contains special cells called stem cells.

These cells can develop into blood cells, which fight infection, carry oxygen around the body and help with blood clotting.

These blood cells are the same as those affected in diseases such as leukaemia and other disorders affecting the blood.

In the unlikely event of your child ever needing a stem cell transplant, stored cord blood can provide a perfect match. There is also a good chance of the blood stem cells being a match for a sibling or other family member.

That being said, currently, the chance that your child's own cord blood stem cells will be needed to treat your child or a relative is very low (about one in 2700), but again estimates vary widely.

Donated cord blood stem cells have been used in India to treat some diseases, such as:
  • cancers of the blood, for example leukaemia, myeloma
  • other cancers, such as lymphoma
  • aplastic anaemia which is a blood disorder in which the body's bone marrow doesn't make enough new blood cells
  • inherited blood disorders, such as thalassaemia and sickle cell anaemia

So far, only a small number of cord blood transplants have been carried out in India. However, you may hear of many promises of cures in the future using stem cells.

Many studies are under way to explore new ways of using cord blood. They include trials on children with cerebral palsy, autism, type 1 diabetes and hydrocephalus.

Some researchers believe that adult cancer patients might one day benefit from treatment with their own cord blood stem cells. Others suggest that degenerative diseases such as multiple sclerosis (MS) might be treatable with stem cells at some stage in the future.

How is the blood collected?

After you've delivered your baby, either vaginally or by caesarean section, and the cord has been clamped and cut, your doctor inserts a needle into the umbilical vein on the part of the cord that's still attached to your placenta.

As the blood flows out, it's usually collected in a special blood bag called the collection kit. The collection kit must be arranged in advance. Approximately 60ml to 150ml of cord blood is collected and the entire process takes less than ten minutes. The blood is collected either before or placenta is delivered. This process is quick and painless for you and your baby.

Once the blood is sealed in the bag, trained personnel from the cord cell bank will collect the blood. It is then sent to the cord blood bank laboratory within 48 hours, where it's processed, tested and frozen for long-term storage.

Because cord blood has only been used in transplants for 20 years, it is not known for how long cord blood can be successfully stored. Studies have shown that cord blood frozen for longer than 15 years can be used.

Why is cord blood so valuable?

Cord blood is prized because it is a rich source of blood stem cells, which are similar to those found in bone marrow. Stem cells are the building blocks of the blood and immune system.

Stem cells have the ability to develop and mature into other types of blood cells, such as red blood cells, white blood cells or platelets, so they can help repair tissues, organs and blood vessels. Every part of the human body contains some stem cells, but most are not rich enough sources to be harvested for medical purposes.

For patients with conditions like leukaemia, for instance, chemotherapy is often used to rid their body of diseased cells and restore normal blood cell production. Once normal blood cell production starts up again, the disease goes into remission.

However, if the treatment fails or disease recurs, doctors often add a stem cell transplant to the treatment regimen. By using a transfusion of stem cells in cord blood from a healthy donor, a new blood and immune system can be generated and the patient has a better chance of making a full recovery.

Unlike the stem cells in bone marrow, which is the most common source of stem cells today, stem cells in cord blood are immature and haven't yet learned how to attack foreign substances. As a result, patients who receive stem cells from cord blood are less likely to reject the transfusion.

What diseases can be treated with cord blood stem cells?

Cord blood stem cells have been used successfully in many countries to treat a range of different diseases, including:
  • leukaemia
  • immune deficiency
  • sickle cell anaemia
  • aplastic anaemia
  • rare inherited metabolic disorders
  • thalassaemia
  • cancers of the blood, such as leukaemia and lymphoma (Hodgkin's disease and non-Hodgkin's lymphoma)

That being said, some in-born diseases or conditions can't be treated with your child's own stem cells.

That's because the problem may still be present in his stored stem cells. So a close match from one or two other donors would be needed instead. Currently, many diseases cannot be treated with a person's own stem cells.

If a child with leukaemia, for instance, is treated with his own cord blood, he might eventually develop the disease again because his cord blood contains the genetic code for leukaemia. Researchers are investigating ways to remedy this.

It is hoped that one day cord blood stem cells may eventually be used to treat people with conditions as varied as:
  • diabetes
  • spinal-cord injuries
  • heart failure
  • neurological disorders such as multiple sclerosis

Most of the studies to date have been performed on animals, however, and many experts say that the results are much more preliminary, than the public has been led to believe. An early clinical trial, for example, investigating cord blood treatment for childhood type 1 diabetes was unsuccessful.

At the moment, most of the future applications for cord blood are theoretical ones, and we don't have any answers yet.

Also, a newborn's cord blood doesn't contain enough stem cells to successfully treat an adult, so they are usually used to treat children. To treat an older child or adult, more than one cord blood donation or a bone marrow transplant is usually needed.

Is cord blood the only source of stem cells?

No, the stem cells used in most transplants today come from bone marrow, the spongy tissue found inside larger bones. Bone marrow transplants have been performed successfully since 1969, nearly 20 years before the first successful cord blood transplant.

Stem cells are also found in blood circulating in the body, fetal tissue, hair follicles, fat, and muscle. And new sources of stem cells are being discovered regularly.

A preliminary research, for example, showed that stem cells isolated from baby teeth can develop into nerve cells and induce bone and outer-tooth cell formation. Further research on this was conducted and researchers used stem cells harvested from extracted adult wisdom teeth to restore tooth function in an animal model.

It's possible that stem cells baby teeth will someday be used to repair damaged teeth, regenerate bone, and even treat nerve tissue injuries and degenerative diseases.

Are cord blood stem cells better than bone marrow stem cells?

Not necessarily. Bone marrow and cord blood stem cells both have advantages and disadvantages, and certain conditions dictate the use of one over the other.

In the unlikely event of your child ever needing a stem cell transplant, the surgeon may reject cord blood in favour of bone marrow or vice versa.

What are the advantages of cord blood as a source of stem cells compared to bone marrow?

  • Unlike the stem cells in bone marrow or peripheral blood, stem cells in cord blood from a newborn baby are immature and haven't yet learned how to attack foreign substances. So it's often easier to match transplant patients with cord blood than with other sources of stem cells such as bone marrow, because the cord blood stem cells are less likely to be rejected. This makes cord blood a particularly valuable resource for people from certain ethnic groups, who may have a harder time finding stem cell matches.
  • The waiting time for a cord blood unit averages about two weeks (compared with two months or longer for bone marrow). Speed is important for patients with rapidly advancing diseases.
  • It's usually more difficult to collect bone marrow than it is to collect cord blood. Collecting bone marrow poses some risks and can be painful for the donor.
  • Some sources suggest that cord blood is less likely than bone marrow to be contaminated by viruses such as Epstein-Barr or cytomegalovirus, which can cause pneumonia and a variety of other infections in transplant patients.

What are the advantages of bone marrow transplants over cord blood stem cell transplants?

  • Bone marrow transplants often start producing new cells (a process known as engraftment) in about 18 days, one to two weeks faster than cord blood transplants. The longer the engraftment period, the more likely patients are to develop complications.
  • Bone marrow can be used to treat patients of any size. Cord blood units are small, so cord blood transplants are usually limited to children and older patients under about 45kg, unless multiple units are used.
  • More than one unit of bone marrow can be collected from the same donor. This may be necessary if a patient relapses or a transplant fails to produce new cells. Only one unit of cord blood is available from each donor.
That said, keep in mind that doctors will suggest the right type of transplant based on a patient’s individual circumstances.

We don't know what the future may hold for the potential uses of cord blood. But research is being done all the time into new uses for stem cells.

It's also worth considering that research may uncover new ways of treating diseases that do not involve stem cells.

Read more on:


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