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What is cord blood? |
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Umbilical cord blood is the blood remaining in the umbilical cord and placenta following the birth of your baby.
This blood has been shown to contain a source of stem cells which are very naïve and plastic i.e.
can be directed to transform into a range of other cell types.
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What are stem cells? |
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Stem cells are primitive cells, that can turn into other types of cells e.g. skin, liver, nerve.
Umbilical cord blood stem cells are one of the most primitive types of cells in the body.
Created during the earliest phases of development they have the potential, given the right stimuli, to become specialised cells such as red or white blood cells. It is these properties and the fact that the umbilical cord is a rich source of stem cells that has prompted private companies to offer frozen storage of these cells from umbilical cord blood collected at birth.
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How can stem cells be used? |
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Stem cells can be used therapeutically to help restore function to the immune systems and blood producing systems,
e.g. when these systems have been damaged by chemotherapy or radiotherapy.
Stem cells are the basis for bone marrow transplants which are used to treat haematological,
immunological and metabolic storage disorders, mostly in children and young adults.
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What future stem cell applications may be available? |
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Research into many areas of stem cell therapy is being vigorously pursued. The areas of research attracting most attention include heart disease, stroke, diabetes, muscular dystrophy and organ engineering.
Methods for expanding the stem cell numbers are already at an advanced stage, clinical trials on expanded populations of these cells have been and are being conducted.
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When is the cord blood collected? |
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Cord blood can only be collected from the umbilical cord and placenta for a short period following the birth, once the cord has been clamped and the placenta delivered. It has to be achieved before the clotting reactions make blood collection impossible.
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How is the umbilical cord blood collected? |
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The collection process is safe, easy and painless for both mother and baby. Our collection procedure does not interfere with the delivery or subsequent care for mother or baby. After the safe delivery of your child, the placenta is delivered and your obstetrician or midwife cleans the umbilical cord (with the materials provided) and inserts the blood bag needle into the umbilical vein. The blood flows into the bag by gravity. The blood bag tubing is clamped, sealed and labelled to await courier collection. The whole process takes only a few minutes.
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After collection, how much time do I have before processing is completed? |
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There is clear evidence that the viability of cord blood stem cells deteriorates quickly with time. Indeed after 24 hours a significant proportion of the stem cells will be non-viable. At Cells4Life we operate a 24-hour window, which means that all samples are processed within 24 hours from collection to completion of processing. Viability is assessed before and after the cells are taken through the freezing process and viability results are sent to customers within 24 hours of birth (Full results are sent around 4 weeks after birth). |
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Is there any risk to my baby or me? |
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There is no risk to mother or child during the blood collection process of a normal uncomplicated birth. If there is a complication during delivery, the midwife and or consultant attending your birth may not perform the collection to ensure you and your baby's health and well being. This is clearly detailed in our contract.
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Will either my baby or I feel any discomfort during the collection? |
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At the time of collection, both you and your baby will be physically separated from the umbilical cord and placenta. There will therefore be no discomfort felt by either of you during the collection of the cord blood.
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How does caesarean section affect the collection process? |
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The collection process proceeds essentially the same way with a caesarean section as it would in a natural birth.
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How long do the cells remain viable in the collection bag after collection? |
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Though there is some documented evidence to suggest viability for up to 72 hours, other evidence clearly shows significant deterioration may begin to occur by approximately 24 hours.
We perform viability testing on all samples upon arrival at our laboratory, ensuring that only viable (living) cells are cryopreserved for storage. At Cells4Life we prefer to have our samples processed and banked within 12-24 hours (typically 12 hours) to prevent any potential loss of viability. |
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How can Stem Cells be used in relation to Cancer? |
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Rare childhood cancers have been successfully treated with stem cells after chemotherapy treatment. In these cases the stem cells are replenishing the immune system that is destroyed by toxic chemotherapy and radiotherapy required to treat the cancer itself. There are clinical trials of stem cells in the treatment of breast cancer where they are used in combination with other conventional treatments such as chemotherapy. There have been individual reports of adult patients with cancer using stem cells to replenish their immune system after chemotherapy treatments. It is likely that the main role of stem cells in cancer will be in combination with other already existing treatments.
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How will the sample be destroyed after 25 years? |
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If the sample were ever to be destroyed for any reason the blood would be thawed and then disposed of by incineration which is how all clinical waste is disposed of.
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Why is the blood only stored for 25 years? |
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We believe that stem cells may be able to be stored for a much longer than 25 years and we anticipate extending our storage term as the required scientific evidence becomes available for the safety of long-term storage. Currently the longest cells of this type have been stored for is around 28 years. We therefore are using the available clinical evidence to determine our storage term. Many other biological samples and cell types have been cryogenically stored and used successfully after much longer periods.
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Has stored Whole Blood been used in any successful transplants? |
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Yes! Click here to read a recent report, from the Official Journal of the American Academy of Pediatrics, on a successful transplant using stored Umbilical Cord Whole Blood http://pediatrics.aappublications.org/cgi/content/full/119/1/e296.
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"Doctors would never treat the child with his or her own cord blood because it would contain the disease." |
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Fact: 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.
"... stem cells in cord blood should be normal and free of malignancy, giving them a potential advantage over autologous cells collected during hematologic remission from a patient with malignancy."
- J. M. Wiley, M.D., and J. A. Kuller, M.D.
"Storage of Newborn Stem Cells for Future Use"
Obstetrics and Gynecology, Vol. 89, No. 2, February 1997
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"Odds that a family will ever need their banked cord blood are so low that people shouldn't bother doing it." |
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Fact: 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, et al. The Likelihood of Hematopoietic Stem Cell Transplantation (HCT) in the United States: Implications for Umbilical Cord Blood Storage. Blood. 2005;106(11)
"What was a discard has become valuable-indeed priceless to many children with leukemia, and perhaps in the future to children with AIDS and autoimmune diseases, such as diabetes and rheumatoid arthritis."
- Science, Vol. 268, May 12, 1995
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"The baby or siblings will never need the stem cells if my family doesn't have a history of cancer." |
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Fact: 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.
1. Lichtenstein, P., et al. Environmental and Heritable Factors in the Causation of Cancer. New England Journal of Medicine. 2000;343(2):78-85.
2. Freedberg, L. Cancer Rates for Children Worry Experts. San Francisco Chronicle. September 17, 1997.
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"If I bank my baby's stem cells, I will be taking it away from the public donor banks." |
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Fact: It has been suggested that the growth of private UCB storage is at odds with the altruistic donation of UCB to public banks. This is not the case since there are only 4 hospitals that will deal with altruistic donations at present and there are no current plans to extend the project since it would require a significant capital investment with few gains to be made. The four sites have been carefully chosen to cover areas with diverse ethnic communities and therefore hold samples representative of the greatest proportion of the population. The public bank has been gathering samples for around 11 years now and so far has collected approximately 9000 samples. They suggest that to attain a 'good coverage' of the population HLA types, they require approximately 20,000 samples. In order to achieve this level of cover, assuming the birth rate is stable and that no other factors change the rate of collection, it will be another 11 years or so before a 'good coverage' is achieved. In the meantime, parents in perceived risk groups such as mixed heritage parents can justifiably request that they store UCB privately. Parents with a child suffering from disorders treatable with UCB stem cells are offered the opportunity to store subsequent UCB from siblings in the hope that it will match and therefore treat the affected sibling. However, if the UCB is not a match, current practice is to destroy that sample despite the known familial risk, these parents often then choose to move that sample to private storage
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"There is no reason for me to bank my baby's own stem cells when public banks can provide donated samples." |
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Fact: If autologous cells are not available, or cannot be used, stem cells from a relative (preferably a sibling where there is a 1 in 4 chance of a match) 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.
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"I can donate to a public bank and retrieve the cells later if needed." |
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Fact: Samples are donated anonymously to public banks. If cells were needed at a later date, the best match will be found by searching, but might not be the one donated.
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).
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"Cord blood collection takes important blood away from my baby." |
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Fact: 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.
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How important is it to ensure the laboratory is an accredited facility operating with strict standards according to the relevant regulating authorities? |
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Parents should never assume that a laboratory actually has the required accreditation. It is very important to ask for a certificate of the accreditations the lab holds, as there are many laboratories that are still in the process of receiving accreditation or simply are not accredited. A parent must be made aware of the importance of this when it comes to such a long term commitment of such a sensitive natured service.
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