Common Misconceptions about Cord Blood Banking
There are many misconceptions about the reality and use of newborn stem cells. Here are a few of the more common ones:
"Doctors would never treat the child with his or her own cord blood because it would contain the disease."
Thousands of autologous stem cell transplants (using one's own cells) are performed every year for diseases such as leukemia, lymphoma, myeloma, and many solid tumors. Research from the Journal of Clinical Oncology reports that even with early-onset disease (within twelve months of birth), the child's stem cells are still recommended for use in transplantation.
In the study, autologous stem cell treatments for infants with acute leukemia were just as successful as allogeneic sibling transplants. Autologous cord blood stem cells have many advantages as a transplant source, including no risk of graft vs. host disease (GVHD-a leading cause of death for transplant patients), immediate availability, and low risk of the cells being contaminated with disease. In April 2001, a ten-month-old baby in Canada received the first-ever autologous cord blood transplant to treat retinoblastoma (eye cancer) that had spread to his spinal cord. His parent's foresight to preserve his cord blood provided him with his best chance for survival.
"Odds that a family will ever need their banked cord blood are so low that people shouldn't bother doing it."
Considering that the cause of most cancers is unknown and that the science of stem cell therapy is expanding rapidly, it is difficult to accurately calculate the odds that a family will use the cord blood or benefit from new treatments. However, according to medical research, the odds that a child will someday need to use his or her own newborn stem cells for current treatments are estimated at 1 in 400*. Odds that the newborn or a family member may benefit from banked cord blood are estimated at 1 in 200*. These odds do not include the emerging and potential use of newborn stem cells to treat heart disease, diabetes, Parkinson's, Alzheimer's, and spinal cord injury. The continued progress in medical treatments would greatly increase the likelihood of use by your baby throughout her life. Based on current data, there is no "expiration date" for newborn stem cells.
* Pasquini MC, Logan BR, Verter F, Horowitz MM, Nietfeld JJ. The Likelihood of Hematopoietic Stem Cell Transplantation (HCT) in the United States: Implications for Umbilical Cord Blood Storage. Blood 2005; 106(11): 1330.
"The baby or siblings will never need the stem cells if my family doesn't have a history of cancer."
People choose to bank their babies' cord blood in order to provide themselves and their families with an additional safeguard-just in case. The causes for most cancers and diseases are unknown, and in some cases, certain types of cancers are growing at alarming rates.(1) Recent reports indicate that one in 630 children will get cancer by age fifteen.(2) Additionally, treatments for cancer only reflect current uses and do not consider the increasing applications and promising therapies that are in development.
"If I bank my baby's stem cells, I will be taking it away from the public donor banks."
Currently, only a small percentage of the four million births every year in the U.S. result in family-banked cord blood, and even if that percentage increases, there will always be a generous cord blood supply for the public banks-if funding is available. More than 90 percent of families do not have access to a public cord blood bank that accepts donations. Other factors also significantly limit cord blood donation eligibility, such as maternal exposure to viruses, tattoos, and international travel. In fact, recent reports from public banks convey that only 30 percent of donated cord blood ends up being banked. The limited cord blood supply in public banks is 100 percent due to lack of funding-not private banks.
"There is no reason for me to bank my baby's own stem cells when public banks can provide donated samples."
If autologous cells are not available, or cannot be used, stem cells from a relative (preferably a sibling) are usually the best treatment option. In fact, according to a study in The New England Journal of Medicine, the one-year survival rate for patients treated with a sibling's cord blood stem cells is approximately 63 percent. With cord blood from an unrelated donor, the survival rate drops to 29 percent. In addition, unrelated cord blood also puts the patient at a much greater risk for developing potentially fatal GVHD (20 percent vs. 5 percent). Related cord blood also reduces the risk that the transplant sample may harbor genetic problems that could cause disease in the recipient because the family will know the genetic history. More importantly, because cord blood cells are less mature than adult stem cells, they have a 50 percent likelihood of being a suitable HLA match between siblings, compared to only 25 percent for bone marrow. Public banks can help ensure an adequate sample for transplant but not the best or most preferable sample. When the issue is survival, this is significant. The families who bank cord blood stem cells want to help ensure the BEST chance of survival if the cells are needed, not just A chance.
"I can donate to a public bank and retrieve the cells later if needed."
If the sample was banked and has not been used for research or by someone else, a family might be able to retrieve their donated sample. For families to make an informed decision, it is important for them to understand that not all donated samples are banked. Multiple studies have shown that more than half of potential cord blood donors are not eligible for donation. As many as 71 percent of donations may be rejected by public banks based on family medical history, maternal medical history, collection volume, and examination of the maternal blood sample (Transfusion, January 2000, Vol. 40:1, 124).
"Cord blood collection takes important blood away from my baby."
Cord blood is normally discarded with the umbilical cord after it is clamped and cut. When you ask to have your baby's cord blood collected, the one and only change from the normal procedure is that after birth-after the cord is cut-the baby's cord blood is collected rather than thrown away. Collections can take place even after the placenta has delivered.
"The cells may not remain viable after long-term storage."
The New York State Health Department Guidelines for cord blood banking state that umbilical stem cells can be stored indefinitely under liquid nitrogen. The policy states, "There is no evidence at present that cells stored at -196°C in an undisturbed manner lose either in-vitro determined viability or biologic activity. Therefore, at the current time, no expiration date need be assigned to cord blood stored continuously under liquid nitrogen." Current data reflects that cord blood cells that have been stored for fifteen years have the same composition as they did at the time of storage.(3) All science involving cryogenic storage of cells also indicates that the cells should remain viable indefinitely.
"Future uses for cord blood are limited."
Many experts describe the current time as an "inflection point" in science and medicine and believe that individuals who bank their cord blood stem cells will be in a position to take advantage of the many developing technologies involving stem cells. New approaches to treating and curing disease may be borne from the genome project and the infrastructure that is being built. An exciting area of stem cell research is that surrounding tissue regeneration. Cord blood has already been demonstrated to contain cells that may promote blood vessel growth ("Japanese Study Hints of Home-Grown Heart Bypasses," Reuters, November 7, 1999) and contains stem cells that can be redirected to grow into neural tissue, which was demonstrated at the University of South Florida. Recently, umbilical cord blood helped repair brain damage from stroke in rats.