Expectant parents have another decision to make before they arrive at the delivery room. It involves the controversial topic of umbilical cord blood banking. Although this practice has been around for over a decade, many physicians and parents have little information on how, where, and to what purpose umbilical cord can be obtained and stored. What follows is a brief answer to these most basic questions.
Umbilical cord blood is collected at the time a baby is born. It is a source for stem cells which can be used to treat different malignancies, blood, immunologic and metabolic diseases. The cord blood is “naïve”, having not been exposed to the outside world. Therefore, it is less likely to transmit disease or cause a reaction in an individual that has received cord blood, typically known as graft versus host disease. One large disadvantage in the use of umbilical cord blood is that only about ten percent of the volume of a traditional bone marrow harvest may be obtained at the time of birth.
If a family would like to collect umbilical cord blood at the birth of their baby they usually must make this decision prior to the delivery so that the appropriate collection tools are available. These tools are usually kits given to the family through either a public or private cord blood bank in the weeks preceding their baby’s birth.
Public banks store umbilical cord blood at no cost, but it may be used for any individual in need as long as the sample has passed a rigorous screening. The major benefit to the family is the rigorous screening that the umbilical cord sample undergoes that may uncover a chromosomal or other anomaly. Public banks in general are not meant to be storage for later autologous transplant of stem cells.
In contrast, private banks often market themselves to families as providing storage as a type of ”biological insurance”. At this time research indicates less than a 1 in 2000 chance that a newborn would later be a recipient of his own cord blood. In its 2007 policy statement, the American Academy of Pediatrics recommended umbilical cord blood banking as a public resource, or in the event that a sibling or family member suffers from a disorder that could be helped by the newborn’s cord blood. The AAP believes there is insufficient evidence at this time to support the idea that umbilical cord blood would be available and appropriate for any particular medical problem that a child might develop later in life. Oncologists generally avoid autologous or self donations when treating childhood leukemia since stem cells from the individual likely demonstrate pre malignant changes. Private umbilical cord blood banking facilities usually charge greater than $1000 to provide an initial collection kit to a family. Thereafter, there is an annual fee to maintain the sample.
Public umbilical cord blood banking is free of charge, but not of responsibility. Families must contact the bank they donated to with any update in family disease progression or illness that develops after the initial donation. This data may cause the blood bank to take the sample out of circulation. Remember, public banks are not meant as personal storage. Any sample contributed may be used for a person in need.
Any families interested in finding out about public umbilical cord blood banking facilities may look via the National Bone Marrow Donor Program. Their website is www.marrow.org or CryoBanks International at www.cryo-intl.com. Inquires usually should be completed by thirty-five weeks gestation so that families can receive their umbilical cord blood collection kit and get it ready to take with them to the hospital. Families who are interested in private facilities must research and contact them directly. The timeframe is usually the same for coordination and planning for delivery.