July 29, 2005

Is cord-blood banking right for your family?

By Dr. Meena Sathappan
Special to the Times

“No cord or cable can draw so forcibly, or bind so fast, as love can do with a single thread.” - Robert Burton
Many parents are beginning to ask what cord blood banking is and to contemplate if it is right for them.

After a baby is delivered, the mother’s body releases the placenta, the temporary organ that transferred oxygen and nutrients from the mother to the baby via the umbilical cord when it was in her uterus. Historically, the umbilical cord and placenta were discarded after birth.

Yet during the 1970s, researchers discovered that umbilical cord blood could supply the same kinds of blood-forming stem cells as a donated bone marrow. It was also believed that stem cells found in cord blood could potentially give rise to other types of cells in the body. This is when umbilical cord blood started to be collected and stored.

Some serious illnesses such as cancer require radiation and chemotherapy to kill diseased or “bad” cells in the body.

In the process, many “good” cells are killed as well, like the stem cells that are contained in the bone marrow.

Some children might need a bone marrow transplant—typically from a donor whose marrow cells closely match their own. The stem cells thus transplanted produce healthy blood cells and improve the child’s blood production and immune system.

Hence, if a child’s cord blood is collected and stored, should he or she need a bone marrow transplant in later years, their own stem cells can be used without having to wait for a matching donor’s cells.

Cord blood collection takes place shortly after birth and the collected blood is taken to the cord-blood bank where the stem cells are separated from the rest of the blood and are stored cryogenically—frozen in liquid nitrogen—in a very controlled manner.

The maximum time for storage and potential use is still being determined. Blood-forming stem cells that have been stored up to 14 years have been used successfully in transplants.

Cord-blood banking has many pros and cons. The procedure isn’t routine and hence most hospitals do not offer it. Interested parents will have to make their own arrangements.

Additionally, it is a very expensive procedure where some of the private banks charge anywhere from $3,000 to $4,000 for the collection and storage to 20-plus years. Cord Blood Registry (www.cord.com) and ViaCord (www.viacord.com) offer collection and storage services.

There are many considerations before deciding whether cord-blood banking is right for you and your child. The American Academy of Pediatrics (AAP) does not recommend cord-blood banking for families who don’t have a history of disease. That’s because research has not yet determined the likelihood that a child would ever need his or her own stem cells nor has it confirmed that transplantation using self-donated cells rather than cells from a relative or stranger is safer or more effective.

According to the AAP, “Private storage of cord blood as ‘biological insurance’ is unwise. However, banking should be considered if there is a family member with a current or potential need to undergo a stem-cell transplantation.”

Other doctors and researchers support saving umbilical cord blood cells, because research into the use of stem cells for treatment of disease is ongoing and the future looks promising.

If you do decide to bank your newborn’s cord blood, be sure to discuss your options with your obstetrician. The sibling Cord Blood Program at the Oakland Children’s Hospital (www.chori.org/siblingcordblood/) lets you bank your child’s umbilical cord blood for free if you meet their eligibility requirements.

Alternatively, you may decide to donate it to a nonprofit cord-blood bank for research or to save the life of another child.

The National Marrow Donor Program (www.marrow.org) operates cord blood banks where you can donate your child’s cord blood for free and also find a stem cell match from unrelated donors. California is one of the 14 states that has the National Marrow Donor Program Cord Blood Bank.

With the recent passage of Proposition 71, many in California are becoming familiar with stem cell research. In May, San Francisco won the bid to house the California Institute of Regenerative Medicine (CIRM), which will regulate stem cell research and provide funding, through grants and loans.

Source: The American Academy of Pediatrics and www.kidshealth.org.

Dr. Meena Sathappan is a board-certified pediatrician who lives and practices in Evergreen. She is available for questions and consultation at Aasha Pediatrics, 2060 Aborn Road, #230, San Jose, Calif., 95121, at the corner of Aborn Road and Capitol Expressway. You can call her at (408) 274-9099, e-mail her at msathappan@gmail.com or visit her Web site at: www.aashapediatrics.com.