Docs push cord blood storage
12/20/99 00:00 a.m. ET (by John Martin TheHealthNetwork.com News) -
While no disease is predictable in most cases, one way to give expectant parents some piece of mind about their planned bundle of joy is to ensure that the proper treatments are available as soon as possible should a particular disease arise.
That's where cord blood storage comes in. Cord blood, which runs throughout the placenta and umbilical cord during a fetus's development, is typically discarded following birth. Instead, some experts say that blood should be stored - for years in some cases - in the event that the original infant, or someone else, may need the stem cells of which it is made in a future transplant.
"It would be tragic for any expectant parent to see their newborn's cord blood discarded, which has been done since the beginning of time," said Daniel Richard, founder and chief executive officer of Cryo-Cell, a cord blood storage facility based in Clearwater, Florida. "Probably 99 percent of every umbilical cord in the United States today is being discarded, and we know now that it can save lives."
The stem cells found in cord blood are typical of those that research has discovered may be more beneficial than bone marrow transplants in treating leukemia and certain other cancers. While medical science may be a long way off from choosing stem cell transplants as the procedure of choice, researchers are beginning to realize their benefits.
One drawback is that stem cell transplants can potentially increase the risk of chronic graft-versus-host disease, in which the body's natural immune system invades anything that is foreign to the body. The disease is typically treated with the use of immunosuppressive drugs.
Several current studies, such as one at the Fred Hutchinson Cancer Research Center in New Orleans, are following high-risk leukemia patients for the next three years to determine if the stem cell transplants that they've received will bring on chronic graft-versus-host disease.
Nonetheless, Richard says there are many benefits to saving cord blood for future use. "It's very, very painful to collect the bone marrow, whereas with cord blood, there's no pain to the mother or child because the cord has already been cut," said Richard, who founded Cryo-Cell in 1989. "It's also been proven that the transplantation between siblings has proven far more successful with less opportunity for graft-versus-host disease."
In addition, he said, the stored cord blood is a guaranteed match in the future for the infant, and there's a one-in-four match for a sibling.
At Cryo-Cell, where special lab facilities have been built, the cord blood is separated into its plasma and red blood cell components. From there, lab workers remove what are known as "mononuclear" cells, which are then stored in specially built vials of liquid nitrogen at extremely cold temperatures - minus 196 degrees, Celcius. They are then housed indefinitely until the family member may need it.
There's also no chance of error, Richard stressed, because a unique bar code is attached to each vial, which is read by a computer, and placed in a database, at the time of storage. If the vial ever needs to be retrieved, there must be a perfect match when the barcode is read a second time.
Interested patients receive a special collection kit from Cryo-Cell, which includes a collection bag that the attending physician uses after an infant's birth.
The controversy over stored cord blood has focused mainly on whom is being targeted. While other blood banks around the country allow new mothers to store their cord blood for use by anyone in an emergency, Cryo-Cell mandates that the cord blood only be used for family members.
"The private banks, like ourselves, focus on storing for the family first," Richard said. "But I want to be quick to add that we absolutely support the need for third-party public banks. That's where people donate their cord [blood] for use by an unrelated party."
Cryo-Cell clients keep their cord blood within the family ranks, Richard maintains, so that costs can be kept in check. Cryo-Cell charges a $275 first-year storage fee and $50 per year after that.
"The only reason we encourage storing for the family is that most of the public banks, if they find a match, there could be a charge of up to, say, $15,000 or more for the person receiving the match," Richard said. "And there's no assurance that insurance will always cover that."
While there is no guarantee that disease will arise in a particular family, or that a stem cell transplant will cure a particular disease, some doctors are applauding the benefits of cord blood storage.
Madeleine Butler, MD, a Tampa, Florida obstetrician/gynecologist learned about cord blood storage, and has recommended it to her patients, in addition to signing up herself.
"It's sort of like a life insurance policy," Butler said. "That's how I see it. If your child should develop leukemia in the first five years of life, there is good evidence to show that a stem cell transplant from the cord blood is effective in potentially being curative..."
Butler admits that leukemia is such a rare disease that it does not warrant out-of-pocket expenses to store cord blood that may never be used. But she's "banking on future research."
"I think there's a lot of promise that cord blood is going to hold for the future for various diseases," she said. "I think, certainly, as our molecular genetics advances, I think that we will have many, many more applications for stem cell ."
Stem cells only benefit a small number of patients, as well, so its utilization in adults is currently limited. Yet, molecular genetic research may discover that stem cells can be cloned and use them for other applications as children become adults, Butler explained.
"Certainly if somebody has a family history of leukemia, especially childhood leukemia, I would probably recommend it in that case," she said. "But in the rest of the population, it's something that they should consider, based on cost and probability."
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