Banking on a healthy future
July marks the beginning of Cord Blood Awareness Month, and with today’s advances in medical research and technology, there is a world of information on its therapeutic uses.
Dr. Rodney Armand with Willis- Knighton Women’s Health Associates said the collection of cord blood was relatively simple, and though the technological use is still somewhat new, it has extensive potential.
“The benefits from utilization of cord blood in current practice center on its therapeutic use in the transplantation and reconstitution of bone marrow, to treat malignant and nonmalignant hematologic disease, immune dysfunction and inherited metabolic disease,” Armand said. “It is a readily abundant resource available at delivery via the umbilical cord.
“Additionally, there are a number of clinical trials that are ongoing involving the use of cord blood in the treatment of cerebral palsy, traumatic brain injury, type 1 diabetes and other hematologic diseases.”
Armand said cord blood is so beneficial because it was a reservoir of stem cells, which are “pluripotential.”
“This means these cells uniquely maintain the ability to transform into multiple cell types and thus have the ability to reconstitute the bone marrow,” he said. “Reconstitution of the bone marrow can be critical and potentially curative for such conditions as acute and chronic leukemia, lymphoma, aplastic anemia, sickle cell anemia, thalassemia major and a number of other genetic and acquired disorders.”
“The first utilization of cord blood was in 1988 involving donation to treat a sibling with Fanconi’s anemia; thus, the technology is still relatively new,” Armand said. “We are continuing to expand our knowledge of the effects of shelf life on stored cord blood products.”
Armand said there is a recent study in which human cord blood stored up to 21-23 years by being “engrafted in mice similar to freshly obtained cells.”
“In another study, cold blood [that was] stored for up to 12 years showed minimal loss of hematopoietic progenitor cells. Thus, data appears to indicate that the ‘shelf-life’ of these products will likely last long enough to reach the age where most of these diagnoses are made in patients.”
The collection of cord blood is done so at the time of delivery, and Armand said, is a relatively simple procedure.
“The delivery provider clamps the umbilical cord and then cuts the cord allowing the newborn to be brought to the nursing care team,” he said. “The cord still attached at the placental end ... and a sterile needle is introduced and cord blood is allowed to drain via gravity into the collection bag.”
After the cord blood is collected, there are a couple of ways in which to store the collection, which vary in price.
“This blood tends to be stored via two different approaches, private and public blood banking,” Armand said.
“Private cord blood banking involves the family paying a collection fee and storage fee to a private company to maintain their child’s cord blood. Typical fees are approximately $2,000 for collection and around $125 per year storage. Public cord blood banking is done free of charge to the provider and is currently performed at about 19 major processing centers in the United States as well as their satellite locations and several of these sites accept mail in products.”
It’s important to know a family medical history before choosing to collect and store cord blood.
For the patients who would benefit from the blood, it’s crucial the family knows about the options and procedures of how to collect.
“Families with a child with rare hematologic disorders, such as anemias, malignancies of the blood or immune disorders should be encouraged to have cord blood from future siblings and other relatives in the family collected and stored for possible treatment of these conditions,” Armand said.
“If a family has no history of these conditions, then I would recommend proceeding with private cord blood banking with caution,” he continued. “The likelihood of needing to use a cord blood product in this scenario only about one in 2700 according to the American College of Obstetrics and Gynecology.”
Armand said the collection of cord blood is not often done and that there are a number of limitations in the process but yet still much to be hopeful for in the future.
“Despite its ease of collection very few people request the collection of their cord blood,” he said.
“The limitations to the increased collection of cord blood in the United States are multifactorial.”
“The limitations involve counseling [and] education at the provider-patient level, usually during routine prenatal care, the time constraints of a busy clinical practice and the complex nature of discussions on this topic certainly play a role in this regard,” Armand said. “If a patient chooses to pursue private cord blood banking, then cost is certainly a limiting factor.
“With regards to public cord blood banking, limited locations are presently a factor; however, the number of public cord blood collection sites continues to grow in the United States allowing for a more diverse cord blood pool and the promise of increased availability to this service and all it may promise in the future.”
