The Origins of Cord Blood Banking

In the 1980's, doctors began treating some types of cancer with a procedure called stem cell transplant.

Blood forming (hematopoietic) stem cells reproduce to form the bone marrow cells that mature and develop into red blood cells, white blood cells, and blood platelets. In adults most stem cells are found in the bone marrow, the soft tissue in the center of some bones. Stem cells are also in the blood that flows through arteries and veins (peripheral blood).

High-dose chemotherapy can be very effective in treating some types of cancer, but it also severely damages stem cells. The resulting blood cell deficiency would be fatal, but can be corrected by transplanting of stem cells. These stem cells can be "harvested" from bone marrow or circulating blood of patients, their relatives, or unrelated donors.

Recently doctors have discovered that umbilical cord blood or placental blood also is a good source of hematopoietic stem cells, and can be used for transplantation. Umbilical cord blood stem cells are slightly different from stem cells from other sources. Studies have found they are less likely to cause certain side effects from transplantation.

The National Institutes of Health (NIH) has organized several cord blood banks nationwide to collect and store this blood. Expectant mothers are asked about their willingness to donate to a NIH cord blood bank by obstetricians who participate in the program. The donations are kept anonymous and registered with national "banks" to be made available for public use.

Cord blood is harvested after a mother gives birth. While the placenta is still attached to the uterus, the umbilical cord is sterilized. A special syringe is attached and the blood remaining in the placenta and cord is "milked" into a storage container. The blood is sent for processing and testing, with the hope it can provide a match for someone in need of a transplant.

At the NIH donation centers, this procedure is done free of charge and the blood can be used by anyone in need of stem cells for the treatment of cancer or other diseases. The service is similar to the National Marrow Donor Program for bone marrow donations, and the American Red Cross program for voluntary blood donation.

Recently, privately owned companies have entered the cord blood bank business. Charging between $850 and $1500 for collection and around $100 a year for storage, these for-profit companies work on the premise that parents are protecting their child's future by saving cord blood for use if the child ever develops a life-threatening disease. However, with no previous family history, the likelihood that a child will ever develop such a diseases is low.

"The lifetime odds of acquiring a transplantable type of cancer are so low that the cost vs. benefit ratio does not make it worthwhile," said Christopher Hillyer, MD, a Hematologist and the Director of the Blood Bank and Transfusion Service Unit at Emory University in Atlanta.

Most hematologists agree with this view and support public cord blood and bone marrow stem cell banks. Studies show blood from donors is no less effective than your own umbilical cord blood and is much more likely to be put to good use. Donated stem cells may have an actual advantage - they may help fight any cancer cells remaining after chemotherapy.

Beth Ludwin, RN, Director of Client Relations at CorCell, (a private, for-profit, blood banking service) has a different perspective. "It's the ultimate in recycling," she said. "Look at it in the same perspective as you would car insurance or travelers insurance - hope you never need it but be thankful if you do."

The CorCell blood bank, a joint venture between CorCell and the Coriell Institute for Medical Research, is a collection and storage service located in New Jersey, one of the few states to require licensing of blood banks. In less than two years of operation, the bank has collected over 2,000 specimens. These specimens, said Ms. Ludwin, are tested thoroughly for infectious diseases and immediately stored. In CorCell's case, if a client cannot pay their yearly storage fee the blood is donated to a public bank. But, she also stressed every effort is made to work with the client to ensure their blood will be available for them, if needed. If CorCell were to ever go out of business, the company has already contracted with a public bank that would continue to store the blood.

"Umbilical cord blood research and treatment is in its infancy stage and its medical utilization is bound to progress at a rapid pace," said Timothy Brown MD, of LifeBlood Cryogenics, Inc., a private cord blood bank in Atlanta, Ga. "Although considered experimental at this time, I am convinced that this technology will yield a myriad of treatment options."

Making the decision to bank your baby's blood is an important one. Talk to your health care provider about the pros and cons of banking and if it is right for you.