‘Cord Blood Myths and Facts’ by the Cord Blood Association (CBA) offers a useful guide to the accuracy of popularly held views about cord blood banking. Through their piece, the CBA hopes to counter some of the conjecture heard by health professionals with medical fact.
Here are 20 myths that can get in the way of cord blood banking and treatment; 20 facts that could save your life:
Fact: A baby’s umbilical cord contains blood-forming stem cells that, when transplanted, can rebuild the bone marrow and immune system and save the life of a patient with a serious blood disease such as leukaemia, lymphoma or sickle cell disease. Infusion of these cells can also treat patients with inherited genetic disorders, bone marrow failure or inherited immune deficiencies.
More than 40,000 patients with serious diseases and disorders have benefited from cord blood treatments since the first transplant in 1988.
Fact: Cord blood is collected from the umbilical cord and placenta (often called “afterbirth”) after the baby is delivered and the cord has been cut. No blood is taken directly from your baby. The collection procedure does not interfere in any way with labour or the baby’s delivery and poses no risk to the mother or baby.
Fact: Preparations need to be made in advance of delivery for the collection of cord blood. Expecting parents should talk to their obstetrical physician or other health care provider between the 28th and 34th week of pregnancy about their interest in storing or donating a baby’s cord blood.
Some public donation programs allow mothers to consent to donate their baby’s cord blood after they are admitted to the hospital to deliver their baby if they are in early labour.
Fact: Unfortunately, not every hospital offers the option of cord blood donation. The National Marrow Donor Program/Be The Match maintains a website that lists many of the U.S. hospitals that collect cord blood for public banks. Similar information for many other countries is available on the website of the Parent’s Guide to Cord Blood Foundation.
If you are considering donation, ask your health care provider if donation is possible at the hospital where you plan to deliver your baby.
Fact: Cord blood stored in a family bank cannot be used to treat just anyone in the family. Cord blood cells have genetic markers called human leukocyte antigens (HLA) that need to closely match those of the patient. Brothers and sisters with the same biological parents have a 25% chance of being a perfect match, and a 50% chance of being a partial match. Other family members are much less likely to be a match.
Fact: Cord blood is one of three sources of blood-forming stem cells used in transplants. The other two sources are bone marrow and the blood that circulates through the body (called peripheral blood). Each source has advantages and disadvantages for various diseases, stages of disease and patients. Among other advantages of cord blood are:
Consequently, cord blood may be the preferred source for patients who have an urgent life-threatening genetic disorder, need a transplant quickly, or have an uncommon tissue type because of their racial or ethnic heritage. The transplant physician team, together with the patient, can determine the best stem cell source from the available options.
Fact: Cord blood is an accepted source of blood stem cells for patients undergoing a blood transplant. As such, they are used in treating more than 80 blood cancers, inherited genetic diseases, bone marrow failure, and immune diseases. A list of these diseases is available online.
In other areas, cord blood therapies are being studied for nerve, heart, bone and metabolism diseases, especially in the rapidly advancing field of regenerative medicine. The value of cord blood therapies for these diseases is being determined by ongoing studies.
Fact: Several obstetric organizations in the United States, the United Kingdom and Canada have recently recommended a delay of 30-60 seconds between delivery and umbilical cord clamping in healthy, full-term babies. It is believed that delayed clamping may have a beneficial effect in the newborn.
Delayed clamping can reduce the volume of stem cells remaining in the umbilical cord, but that does not necessarily make the volume unsuitable for storage or donation. On the other hand, if the baby’s cord blood is being stored for a known use – such as transplant of another family member with leukaemia – delayed clamping is not advised.
Expectant parents should discuss options for delayed clamping with their obstetric provider.
Fact: Regulations in most countries do not allow cord blood that has been stored in a family bank to later be donated to a public bank. However, a few countries do allow privately banked cord blood to be used publicly if the family who stored the cord blood unit agrees.
Fact: Cord blood transplantation is an accepted treatment for blood diseases such as leukaemia, lymphoma or sickle cell, as well as inherited genetic disorders, bone marrow failure and immune deficiency diseases.
In addition to these, research is underway to determine whether components of cord blood can treat other medical conditions such as birth asphyxia (brain damage from lack of oxygen), cerebral palsy and autism. Cord blood therapies for these brain injuries and diseases are not standard medical practice, but are being evaluated in ongoing clinical studies and may prove useful in the future.
Fact: In the early years of cord blood transplants this was true because of the limited dose of stem cells in a typical umbilical cord unit. However, as dosing of cord blood cells has become more completely understood, it is known that about 12% of adults can be transplanted with a single cord blood unit. But most adult patients typically require more cells than are contained in a single cord.
Yet, in recent years treatment of adults has become more common, in part because of “double cord” transplants in which the cells from two umbilical cords are transplanted. Also encouraging are processes now under investigation that expand the number of cells in a unit of cord blood. With increased doses of stem cells, more adult patients can be transplanted.
Fact: Theoretically, properly frozen and stored cord blood may remain useful for a lifetime. This isn’t known for certain, however, because cord blood banking has existed for fewer than 30 years. Cord blood stored for more than 20 years has been used for successful transplants.
Fact: Public banks incur considerable costs for collecting, processing, storing, selecting, testing and shipping cord blood. Although some of those costs may be subsidized by the government or private funds, most of the cost is typically charged to the transplant facility, the patient or the patient’s insurance or health care payment program.
Fact: Voluntary standards have been developed by two accrediting agencies: AABB and the Foundation for the Accreditation of Cellular Therapy (FACT). These organizations gather data from the banks and conduct on-site inspections to ensure that the cord blood is collected safely, and handled in a way that protects the quality, purity and potency of the cells.
The Cord Blood Association recommends that expecting parents ask about and consider a bank’s accreditation status when selecting a cord blood bank.
Fact: For a child born into a family that has no history of blood diseases, the chances of ever needing a privately stored cord blood unit are small, but not zero.
Through 2014, of the estimated 4 million privately stored cord blood units in the world, more than 400 units have been used for donor transplants. In addition, more than 500 donor units have been used in promising clinical trials in areas such as brain injury, among others.
Fact: If you banked cord blood for your first child, the reasons for banking cord blood for other brothers and sisters are the same. There is about a 25% chance that any two siblings will have identical typing.
Fact: Every year, new uses for cord blood and cord tissue are proposed or discovered. Umbilical cord blood, as well as other birthing tissues, hold promise for treating a range of diseases, and you may wish to consider saving both at the same time.
There is no standard method to store birthing tissues other than cord blood at this time. You should ask your cord blood bank about how the cord tissue is stored and how it might be used in the future.
Fact: Secondary cancers are rare after transplantation from any stem cell source, including cord blood stem cells. Screening and procedures to prevent secondary cancers are an important part of the long-term follow-up and patient care after all chemotherapy and transplants. There is no increased risk of post-transplant malignancy after a cord blood transplant, compared to any other type of blood transplant.
Fact: While cord blood does contain stem cells, it also contains many types of mature blood cells. Some of these are being investigated for development into clinical products for cellular therapies in the future.
Fact: Anyone in need of an unrelated donor for transplantation can access public banks.
Biovault Family are a Cord Blood Association (CBA) member bank. This means that the CBA recognises the quality and integrity of our service: “CBA member banks must be actively engaged in the collection, processing, testing, storage, selection and/or release of umbilical cord blood or related tissues. They must adhere to the principles of the Cord Blood Association, be either AABB or FACT accredited, or in the process of application for accreditation.”
Biovault Family is a highly accredited cord blood bank. Details of our certifications and accreditations can be found here.