Unlocking the Potential of Umbilical Cord Blood Stem Cells

Doctors harness the power of stem cells derived from umbilical cord blood to combat specific illnesses, including cancer.

When welcoming a new addition to their family, parents are often presented with an option in maternity hospitals. They can choose to donate their baby’s umbilical cord blood to a public bank, which stores it for future stem cell transplants. Alternatively, parents may decide to go with private banks that pledge to preserve these cells for potential future use, acting as a form of “biological insurance.”

In this article, we will delve into the applications of umbilical cord blood cells, assess the value of investing in their storage, and seek expert perspectives from oncologists on this subject.

Umbilical Cord Blood: What It Is and Why It’s Worth Preserving

Umbilical cord blood refers to the blood that remains in the umbilical vein and placenta after a baby’s birth. Stem cells are extracted from this blood, frozen, and stored for medical purposes, particularly for transplantation.

Stem cell transplants may be necessary to combat conditions such as leukemia, lymphomas, and certain inherited metabolic disorders. They are administered through injection, effectively replacing the bone marrow cells of the afflicted individual. Hematopoietic stem cells from umbilical cord blood have the remarkable capability to develop into all types of blood cells and some other cell types.

It’s important to note that umbilical cord blood isn’t the exclusive source of stem cells for transplantation. Hematopoietic stem cells can also be procured from a donor’s bone marrow. This can be done by puncturing the bone marrow or collecting them from peripheral blood after special drug injections.

In some cases, a small segment of the umbilical cord itself may be harvested along with the blood, as it contains mesenchymal stem cells. Although these cells are not currently employed in practical treatments, there is potential for future use in addressing a range of diseases, from diabetes to Alzheimer’s. This approach is referred to as cell therapy, but its development is still in the experimental phase.

Utilization of Umbilical Cord Blood Stem Cells in Transplantation

Which stem cell sources are typically employed for transplantation?

Transplantation physicians assign priority to three distinct sources of stem cells, with umbilical cord blood cells being the least preferred and final recourse.

The foremost preference is to locate a compatible related donor, such as a sibling. In the absence of a suitable related donor, doctors then explore other donor options based on their preferred techniques. For example, some prioritize a half-compatible haploidentical donor to expedite the transplantation process, while other centers may opt for an unrelated donor. The use of umbilical cord blood stem cells from registries only occurs when all other alternatives have been exhausted.

Statistically, bone marrow stem cells obtained from the donor’s peripheral blood are employed in a majority (70%) of transplantations. Stem cells collected directly from the donor’s bone marrow are used in 14% of cases, whereas umbilical cord blood cells find application in only 7% of cases.

Challenges Associated with Umbilical Cord Blood Cells

The rationale behind the notable variance in the utilization of umbilical cord blood cells is relatively straightforward. These cells have been in use for a considerable period, with the earliest data dating back to 1998. Initially, there was a prevailing perception that these cells held the promise of being a miraculous source of stem cells, capable of revolutionizing the availability of donors. This was attributed to various distinctive features of umbilical cord blood, including its wide availability, cost-effectiveness, and unique immunological properties rendering it suitable for a wide array of patients.

Around 2010, advanced technologies emerged that substantially enhanced the quality of alternative transplant options, including those from haploidentical donors, such as parents or children. Consequently, the use of umbilical cord blood unveiled its principal drawbacks.

At the time of collection, umbilical cord blood samples are gathered anonymously, with health status verification and bloodborne infection screening being the only procedures. However, it is not uncommon for the infant to carry an inherited genetic disorder that may become evident later in life. In such cases, utilizing these cells for transplantation could inadvertently cure one ailment while introducing another.

The volume of umbilical cord blood collected is sufficient for transplantation in individuals weighing up to 40-50 kg, making it a limited resource. Expanding the collection poses significant risks.

Umbilical cord blood is a unique, one-time sample. When additional cell material is needed, such as additional stem cells or the treatment of complications with other cells, obtaining them from the umbilical cord blood is unfeasible due to the absence of a donor. The finite and previously utilized sample also hinders comprehensive safety screening, as conducting all required tests would leave an inadequate sample for transplantation.

Instances in which Umbilical Cord Blood Cells Are Employed

Hospitals primarily employ umbilical cord blood cells for transplantation in patients facing urgent circumstances. This includes cases where the disease is in advanced stages or progressing rapidly, leaving insufficient time to locate an unrelated donor. Additionally, these cells are used in situations where finding an unrelated donor is exceptionally challenging.

In circumstances where financial resources are limited, and cost-effective methods are sought, umbilical cord blood cells may become a pragmatic choice.

Preserving Umbilical Cord Blood: A Valuable Choice

Umbilical cord blood, a remarkable source of stem cells, can be securely stored in two ways – either publicly or privately.

In the case of public banks, cord blood is stored for the benefit of the wider community. All samples are kept anonymous, and doctors can request a compatible match when treating a patient, all without any cost to the patient.

Parents also have the option to generously donate their child’s umbilical cord blood to a public bank. In some maternity hospitals, mothers are requested to provide informed consent for cord blood collection before giving birth.

On the flip side, private banks offer cord blood collection and storage services for a fee. They often promote these services as a form of biological insurance for the child, with parents paying to secure samples that can be utilized in the future for the child or their siblings in case of medical necessity.

Key Considerations for Cord Blood Storage

At first glance, a private bank might seem like the most appealing choice. The stem cells collected from the child’s cord blood are a perfect match for the child, reducing the risk of rejection in case of a serious illness. It’s a seemingly foolproof solution.

However, there are some important factors to bear in mind. For instance, a child’s own blood-forming cells are typically not suitable for transplantation, as they may carry the same genetic defects that led to the illness, like leukemia.

Moreover, comprehensive tests are not available to identify all potential genetic defects. Relying on one’s own cells carries a risk of disease recurrence, necessitating repeated treatments. It’s often more dependable to use donor bone marrow cells from a completely healthy individual.

To enhance the chances of saving patients who don’t have access to a suitable bone marrow donor, the World Marrow Donor Association actively promotes the donation of cord blood to public banks, a service provided at no cost to donors.

Assessing the Value of Private Umbilical Cord Blood Storage

Currently, there are roughly five million samples of umbilical cord blood stored by various organizations, with the majority being held privately. When the potential of umbilical cord blood for medical treatments came to light, numerous entrepreneurs saw an opportunity to capitalize on this concept.

In my view, it’s not a worthwhile investment. When parents are approached with the option to pay for the storage of their child’s umbilical cord blood, they are often not given a transparent explanation of the reasons for doing so.

In reality, the chances of using a child’s own umbilical cord blood for a transplant are quite slim. There’s a possibility that an illness could be related to a genetic anomaly present in those stem cells. It’s impossible to guarantee with 100% certainty that the disease isn’t connected to a mutation the child may have had since birth but only manifested later.

While there are a few diseases that aren’t tied to genetic abnormalities, they are relatively rare. Generally, the odds of a child needing a stem cell transplant due to an illness are very low. If we were to calculate the likelihood of the cord blood being of use, it would be akin to the odds of a stroller being struck by a meteorite. Purchasing this form of “biological insurance” doesn’t make practical sense.

However, there are situations where doctors might recommend parents to store their child’s umbilical cord blood. This typically occurs if the parents already have another child with a medical condition that could necessitate a stem cell transplant in the near future. In this case, the preserved cord blood from the younger child could be used to benefit the older child if there’s a match.

Harvesting and Preservation of Umbilical Cord Blood

In the typical process of collecting umbilical cord blood, parents of the newborn receive a collection kit from private banks, which they take with them to the hospital. In the case of public banks, the hospital provides the necessary kit.

When a baby is born, the medical team usually clamps and cuts the umbilical cord while simultaneously extracting blood from it. This entire procedure does not pose any risk or discomfort to the baby or the mother.

Within a day, the blood bank receives the package containing the newborn’s umbilical cord blood. The bank then rigorously assesses the sample for any signs of infections or microbial contamination. Additionally, they determine the blood type, Rh factor, and identify the HLA phenotype.

Each cell in the body possesses unique protein markers that assist the immune system in distinguishing between the body’s own cells and foreign ones. To ensure a successful transplant, it’s essential that the donor and recipient share the same or compatible HLA phenotypes. The more similar they are, the greater the chances of a successful outcome.

Following this, the umbilical cord blood goes through a processing step to isolate the valuable stem cells. This process involves removing excess plasma and unnecessary blood cells. The stem cells are then frozen and securely stored in a cryopack. A specialized substance known as a cryoprotectant is added to the pack to prevent ice formation and safeguard the stem cells during storage.

It’s worth noting that only private banks collect umbilical cord tissue. After removing the blood from the umbilical cord, the doctor extracts a piece of tissue, which is then placed in a collection dish. This tissue fragment is also stored in the bank for future potential uses.

Private Cord Blood Collection and Storage Costs in the USA

In the United States, as of 2023, the price range for collecting and delivering cord blood to the hospital falls between $1,500 and $2,000. If you’re considering collecting both cord blood and tissue, the cost typically falls within the range of $2,500 to $3,000. Keep in mind that these costs can vary based on the specific technology used for cord blood processing and the method of stem cell isolation. Some methods result in a higher yield of stem cells, which can be more expensive.

When it comes to storing these valuable stem cells, you can expect an annual fee of approximately $180 for stem cell storage and around $350 per year for the storage of both cord blood and tissue.

Keep in Mind

• Hematopoietic stem cell transplantation necessitates the use of umbilical cord blood.
• Typically, transplantation relies on donor bone marrow cells obtained through a puncture or from peripheral blood, where they are released following the administration of specific medications.
• Umbilical cord blood stem cells do have their limitations, including an inability to undergo genetic mutation screening, a relatively small sample size, and a lack of capacity to generate new identical cells as required.
• However, despite these limitations, umbilical cord blood stem cells are still employed when a suitable bone marrow donor cannot be located.
• Healthcare professionals typically source umbilical cord blood cells from public banks. In most cases, transplanting a child’s own cells carries significant risks, making it a relatively uncommon procedure.