AAP Opposes Private Cord Blood Banking

But Doctors Group Favors Public Storage Efforts

Medically Reviewed by Louise Chang, MD on January 03, 2007

Jan. 3, 2007 -- Paying to have a newborn's umbilical cord blood stored as aninsurance policy against future disease is a bad idea, says the nation's toppediatric health group.

But new parents should donate cord blood for public use if they are able,adds the group, the American Academy of Pediatrics (AAP).

In a strongly worded policy statement, the AAP concluded that no scientificevidence exists to support the practice of banking a newborn's umbilical cordblood for his or her own later use.

Companies that bank umbilical cord blood argue that it may one day bepossible to use the stem cells in cord blood to treat an individual's diseasedheart or liver, repair an injured spinal cord, or for other uses.

But the AAP says the claim that stored cord blood can serve as"biological insurance" against future disease has not borne out.

Private companies that make such claims prey on new parents at anemotionally vulnerable time, William T. Shearer, MD, a pediatrics professor atBaylor College of Medicine, in Houston, tells WebMD.

Parents are led to believe that a child's own cord blood can be useful laterif that child develops cancercancer or many other diseases. But this has notbeen shown to be the case, Shearer says.

In fact, a child's own stored cord blood might not be considered safe foruse in the treatment of leukemialeukemia and many other conditions because"most conditions that might be helped by cord blood stem cells alreadyexist in the infant's cord blood," according to the AAP statement.

Private cord blood banking costs $1500 to $2500 at the time of collection,and most banks charge around $100 a year for storage.

"The web sites for these [cord blood banking] companies make you feellike the worst parent in the world if you don't do this," Shearer says."But the idea that saving a baby's cord blood will protect him or her inthe future is just patently false."

Charles Sims, MD, president of the American Association of Family Cord BloodBanks, agrees that some private cord blood banking companies have been lessthan forthcoming about the immediate benefits of cord blood storage for donoruse.

But he argues the AAP policy statement goes too far.

"You only have one chance to collect cord blood," Sims says."Future research may very well prove a value for this in terms ofregenerative medicine, so the decision should be made by individual families.Families should not be told what to do."

Public Banking Encouraged

While the AAP discouraged private cord blood banking in most instances,there was one exception.

The group supports directed cord blood storage in cases where an oldersibling has a cancercancer or genetic condition that might be helpedby cord blood transplantation.

The pediatrics group also encourages families to donate their newborn's cordblood to public banks if they have an opportunity to do so.

Public banks store cord blood to be made available for use by anyone whoneeds it.

Only a handful of hospitals across the nation currently allow cord blooddonation, but this may soon change, says pediatrician Bertram Lubin, MD

Recently enacted federal legislation is encouraging more hospitals toinstitute programs to allow cord blood donation for public use.

Cord blood stem cell transplantation from unrelated donors has been provenuseful in the treatment of a variety of pediatric diseases, including cancersand genetic illnesses. There is also promising research suggesting cord bloodcould help treat adult disease.

"Combined cord blood from different donors looks very promising as analternative treatment for adults," says Lubin, president of Children'sHospital Oakland Research Institute, in California.

Disclose Financial Gains

The new AAP cord blood banking recommendations, which Lubin and Shearerhelped write, call on doctors and others who promote private, for-profit cordblood banking to disclose any financial gains they derive from the procedure topatients.

Prospective parents who are encouraged by their doctor or anyone else to payfor directed cord blood banking should ask about financial conflicts ofinterest, Shearer says.

"It is an unfortunate truth in medicine today that financialconsiderations play an increasingly important role," he says. "That iswhy patients have to educate themselves."

Lubin says parents who still want to bank their baby's cord blood for thebaby's own future use should be very careful about which company theychoose.

"I talk to parents who tell me they understand the AAP's position onblood banking, but they say, 'I can afford it, so I am going to do it,'"Lubin says. "I say, 'Fine, but be sure to find a place that does a goodjob.'"

Show Sources

SOURCES: AAP Policy Statement: "Cord Blood Banking for Potential Future Transplantation." Pediatrics, January 2007, vol 119: pp 165-170. Bertram Lubin, MD, FAAP, president, Children's Hospital Oakland Research Institute, Oakland, Calif. William T. Shearer, MD, FAAP, professor of pediatrics and immunology, Baylor College of Medicine; chief of allergy and immunology service, Texas Children's Hospital, Houston, Texas.

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