April 1, 2008 (New York) -- Leading scientists have an important public health message for all expectant moms: Donate your infant's umbilical cord blood to a public bank.
The life you save may be your own, your child's, a close relative's, or even a complete stranger's.
As the amount and diversity of cord blood in public banks grow, researchers will be increasingly able to supply cord blood to those in need of bone marrow transplants, study diseases that may originate in these cells, and develop new technology to allow the existing supply to stretch even further, said experts speaking here Monday at a conference on cord blood.
The Importance of Cord Blood
Umbilical cord blood is a rich source of blood-forming or hematopoietic stem cells. These cells are found primarily in the bone marrow and can morph into three types of mature blood cells -- red blood cells, white blood cells, and platelets. Because of these unique properties, cord blood can be used for transplantation instead of bone marrow for a growing list of diseases including leukemia, a type of cancer that begins in the bone marrow.
Cord blood may one day be used as a regenerative source of other cells such as the endothelial cells, which line blood vessels, or mesenchymal cells, which help regenerate bone and cartilage. And cord blood does not have the moral or political controversies of other stem cell sources; in fact, it is normally discarded after a baby is born.
"Technologies are helping researchers extract even more value from cord blood that was previously thought to be medical waste," says Robert L. Jones, MD, president and CEO if the New York Blood Center in New York City. Going forward, "we can expect the supply and the diversity of the supply to increase," he says. The benefits of this research will be exponential.
"It's clear that the general public is catching on to one of today's medical miracles."
Public vs. Private Cord Blood Banks
The real issue facing new parents is not whether to donate their cord blood, but where to donate it. For-profit private cord blood banks are increasingly clamoring for their business. An autologous (self) transplant can also be done if a child's umbilical cord blood has been stored in a private cord blood bank, and that may seem very attractive to new parents. It costs about $600 to $1,900 for the initial collection, and there are also annual storage fees.
Parents can also donate their baby's umbilical cord blood to a public bank for free where it will be used for research and transplants to treat a variety of diseases.
"Private cord blood banks recruit for more mothers to donate, but the the likelihood of their cord blood having any benefit for their own children is essentially very low," says Pablo Rubinstein, MD, the chief scientist for cord blood, stem cells, and tissue at the New York Blood center in New York City. He says cord blood from public banks has been used for more than 15,000 transplants. In contrast, cord blood stored in private banks has only been used for about 60 or 70 transplants.
The limitations of private cord blood banking are twofold, he says. They include the low likelihood of usage and the viability of the cells over the long term.
If a child develops leukemia, for example, there are likely cells in his or her cord blood that would retrigger the disease process.
What's more, "companies that do private banking promise that the cells will be available for some time, but [they will not be viable] when the child is 50 or 60 and has some type of disease that cord blood may help like Parkinson's tremors or dementia," he says.
However, "if anything happens to their child or relatives with disease that require bone marrow transplants -- such as leukemia and lymphoma -- they would have access to their cord blood and that of many others in the public bank," adds Malcolm A.S. Moore, DPhil, the Enid A. Haupt Professor of Cell Biology at Memorial Sloan-Kettering Cancer Center in New York City.
That's not to say that there aren't downsides to public cord blood banks.
For one, there is no guarantee that people who donate cord blood to a public bank will have access to their blood if and when they need it. What's more, public banking is currently only available in a limited number of U.S. hospitals and often only on certain days of the week.
New Technology in Cord Blood Banks
New technology is being developed that helps maximize the existing supply of public cord blood.
Researchers are learning to expand the number of stem cells in an individual's cord blood with the use of certain growth factors. The more cells there are, the better the chances for engraftment, the process in which a new blood system is formed.
Double cord transplants that use two matched cord blood donors instead of one are also helping improve the chances of engraftment. "If done properly, we have data that these transplants work," says Rubinstein.
"We are trying to make storage more effective," adds Moore. "This will potentially allow a single cord blood donation to be used to transplant multiple individuals," he explains.
Here's how it may look:
"We take some cord blood out of the bank for transplantation, expand the rest [using growth factors or other technologies] and then put it back in the bank for several years until it is needed again," he says. In this case, the cord blood will likely be available if and when the initial donor needs it.
Looking into his crystal ball for WebMD, Moore predicts that umbilical cord blood may hold the secrets to eternal youth.
"We know that old stem cells are not as good as young stem cells and that if we put young stem cells into an older person, these cells regenerate better," he says. In the future, we may develop the technology to stop aging using cells from cord blood. Stay tuned.