What is Cord Blood Banking?

Cord Blood Stem Cells

• What is the difference between cord blood and cord tissue?

  There are two primary types of newborn stem cells that have the potential to be used for different treatments: hematopoietic (he•ma•to•poi•et•ic) and mesenchymal (mes•en•chy•mal). Hematopoietic stem cells are blood-forming cells with the ability to self-renew. Mesenchymal stem cells can form bone, cartilage, and tissue cells and are predominantly found in the cord tissue. Cord blood predominantly contains hematopoietic stem cells and cord tissue primarily contains mesenchymal stem cells.

• What is cord blood?

  Cord blood comes from a newborn’s umbilical cord and is collected immediately after birth. Once the umbilical cord has been clamped and cut, the remaining blood in the umbilical cord is drawn into a collection bag.

  A Medical Resource

  This blood contains powerful stem cells that have been used to regenerate healthy blood and immune systems in more than 30,000 transplants worldwide.

  Doctors are using cord blood to save lives today and researching cord blood as potential treatment for diseases that currently have no cure.

• What are stem cells?

  Stem cells are the body’s “master cells” because they are the building blocks of organ tissues, blood, and the immune system. Stem cells from bone marrow were first used to regenerate blood and immune cells for patients who had received chemotherapy for cancer. In the late 1980s, doctors started using cord blood stem cells to treat diseases that had previously been treated with bone marrow transplantation.

  Today, cord blood stem cells are successfully being used to save lives. They also are being researched in an exciting new area of medicine called regenerative medicine, where scientists are studying the use of cord blood stem cells in experimental treatments for conditions like brain injury and acquired hearing loss.

• Are cord blood stem cells different from other stem cells?

  Yes. Cord blood stem cells are biologically younger and are more flexible compared to adult stem cells from other sources like bone marrow. When saved, they have unique qualities and advantages:

  • Less risk of complications when used in transplants
  • Ability to use one’s own stem cells for conditions that currently lack medical treatment options, also known as “autologous transplantation”
  • Immediately available and can minimize disease progression in early treatment
  • Preserving them “stops the clock” and protects the cells from aging and being exposed to environmental factors and common viruses that can decrease their function

  Comparison of Stem Cell Sources	Newborn	Adult	Embryonic
  Ability to differentiate into various cell types
  High proliferation capacity
  Low risk of tumor formation
  Low risk of viral contamination
  Capacity for autologous transplantation
  Established/proven treatment in human patients

  Stem cells can heal the body, promote recovery, and offer an enormous amount of therapeutic potential. Cord blood stem cells are not embryonic stem cells and are not controversial.

• How long has cord blood banking been available?

  The opportunity for expectant families to collect and store their newborns’ umbilical cord blood stem cells has been available since late 1995. Currently, thousands of parents are taking advantage of this once-in-a-lifetime opportunity. In fact, CBR has banked cord blood for more than 600,000 newborns.

• Why are there stem cells in the umbilical cord?

  Stem cells are found throughout the body, but in larger numbers in the blood system. Stress on the body can cause even more stem cells to circulate in the blood, and birth is a very stressful event for a newborn.

  Once the baby is born, the blood that remains in the umbilical cord still contains a “reservoir” of stem-cell rich blood that can be easily collected without risk to the newborn or mother.

Saving Stem Cells For Your Family

• Should I save cord blood for all of my children?

  Yes. Saving cord blood for each child gives your family more options because:

  • Each child has access to his or her own genetically unique cells. Your baby may use the stem cells for a number of diseases, however, not generally for inherited genetic conditions. In those cases, a matched sibling’s stem cells would be the first choice. For experimental regenerative medicine therapies that use cord blood, the child’s own stem cells are currently required.
  • There is increased likelihood that a family member in need will have access to a related source of cord blood for treatment.
  • Expecting identical twins? It is still important to save cord blood for each child as it is extremely difficult to determine if twins are indeed identical. Each child’s cord blood is banked separately.
• Can my child use his or her own cord blood stem cells?
  Who can use newborn stem cells

  Thousands of autologous stem cell transplants – those using one’s own stem cells from cord blood, bone marrow, and peripheral blood – are performed every year.

  • Autologous (using one’s own stem cells) transplants are performed for diseases such as: Hodgkin’s disease, non-Hodgkin’s lymphoma, severe aplastic anemia, myeloma, Ewing’s sarcoma, neuroblastoma, brain tumors, and other solid tumors.
  • Research from the Journal of Clinical Oncology reports that even with early-onset disease (within 12 months of birth), the child’s stem cells are viable for use in transplantation. In the study, an autologous stem cell treatment for infants with acute leukemia was just as successful as a sibling transplant.

  Autologous cord blood stem cells have many advantages as a stem cell source, including no risk of graft vs. host disease (a leading cause of death for transplant patients). In addition, like all saved cord blood, it is available quickly and the stem cells have a low risk of having been affected by environmental damage or viruses.

  Experimental treatments with cord blood focus on regenerative medicine – where doctors study the use of stem cells to repair damaged tissues and organs in the body. Currently, for these applications, a child’s own cord blood is required.

  However, there are certain medical conditions that would not use autologous stem cells:

  • Genetic Diseases: Cord blood stem cells may not be usable if the donating child has certain genetic diseases, such as sickle cell anemia. However, gene therapy, which uses the child’s own stem cells to deliver the corrected genetic element is being investigated. Gene therapy is still experimental and may never become clinically available.
  • Certain Cancers: In earlier years of life, doctors may choose to not use a child’s own stem cells for treatment of certain cancers such as leukemia, due to the concern that an early onset may indicate a genetic component. However, if the cancer occurs later in life, the child’s cord blood stem cells may be preferable to their own adult stem cells collected during remission from the cancer. This is because of the risk of residual tumor cells in the adult stem cells, which may cause relapse.

  In cases in which autologous stem cells cannot be used, a matched sibling’s cord blood is the next best option, which is one of the key reasons why it is important to bank cord blood for each child in the family.

• Who can use my babys cord blood stem cells?
  Who can use newborn stem cells

  Any family member who is a suitable match may be able to use your baby’s cord blood stem cells for transplant medicine. Siblings are the most likely to be compatible matches, with 25% of these cases offering a perfect match. It is less likely that other family members will be a sufficient match, and there is no guarantee that an adequate stem cell match will be found for any given patient.

  Your baby will always be a perfect match to his or her own stem cells and may use them for a number of diseases, however, not generally for inherited genetic conditions. In those cases, a matched sibling’s stem cells would be the first choice.

• How likely is it that my family will need to use stem cells?

  The use of cord blood has increased significantly in the past 15 years. As uses expand, so does the likelihood that the stem cells may be needed by a member of your family. Based on the most recent data, the likelihood of needing a stem cell transplant from any source is:

  • 1 in 217 – for an individual (by age 70), using his or her own stem cells or someone else’s

  However, this data does not reflect potential therapies using stem cells that may be developed in the future. Currently, there are more than 30 FDA-regulated clinical trials researching medical uses for cord blood stem cells, including studies for cerebral palsy, brain injury, juvenile diabetes, and hearing loss.

• Is cord blood collection safe?

  Cord blood collection is painless, easy, and safe for both mother and newborn. The cord blood is collected after your baby is born and the umbilical cord has been clamped and cut. The cord blood being collected is blood that would normally be discarded after birth. Your caregiver will not alter the normal birthing process in any way, except to collect your baby’s cord blood. Cord blood collection can take place after a vaginal or C-section birth and collection can still be performed after delayed clamping.

• Are there benefits to storing if my family doesn't have a history of cancer or disease?

  Many families have no history of disease but recognize the current and future value of their newborns’ cord blood stem cells as a resource for medical treatments.

  Family History:
  Family history is not a reliable indicator of need because most forms of leukemia (the most common reason for needing a stem cell transplant) are not hereditary, and the causes of many cancers and diseases are unknown. In fact, numerous serious diseases treatable with cord blood are not hereditary and occur without warning.

  Odds of Use:
  Although no one can predict future illness or injury, published estimates of the odds of needing stem cells for current uses in transplant medicine are 1 in 217.

  Based on current data, cord blood stem cells should remain useful indefinitely, so your family may be able to use the cells for diseases and injuries that occur decades from now. The fastest growing use of cord blood stem cells for CBR families has been in regenerative medicine research for the treatment of brain injury, for which there is no family history, and juvenile diabetes.

  Transplant Medicine:
  In transplant medicine, a patient generally will undergo chemotherapy to treat the underlying disease and then receive an infusion of cord blood stem cells to create a new healthy blood and immune system. In fact, cord blood stem cells have been used to treat many life-threatening diseases, such as leukemia and other cancers.

  Regenerative Medicine:
  New research with cord blood focuses on regenerative medicine, where doctors evaluate stem cells ability to repair damaged tissues and organs in the body.

• What if someone in my family is sick now and needs my childs' cord blood?

  Our Newborn Possibilities Program® provides cord blood and cord tissue collection, processing, and five years of storage at no cost to eligible families with a medical need. Families may apply to the Designated Treatment Program for a qualifying relative who has been diagnosed with a life-threatening disease treatable with donor stem cells. For more information on the Designated Treatment Program, please click here.

• Are there risks involved in newborn stem cell treatments?

  Like any medical procedure, newborn stem cell treatments may involve risks, which should be discussed with your doctor. Ultimate use of newborn stem cells will be determined by your treating physician.

• Why do families choose to collect and store their babies cord blood?

  Banking may give families a powerful resource against injuries and diseases that can occur in the future. Every month, thousands of new parents, a number of them doctors, nurses, and scientists, store their newborn’s stem cells with CBR. Some of the important reasons to save cord blood include the following:

  • Cord blood is a rich source of hematopoietic stem cells, which are used in transplant medicine to treat many life-threatening diseases, such as leukemia and other cancers. As with other medical procedures, therapies using cord blood may involve risk, which should be discussed with a physician.
  • Cord blood is being evaluated today for its ability to treat cerebral palsy, traumatic brain injury, acquired hearing loss, and juvenile diabetes.
  • Your baby’s cord blood is available for your family if needed for treatment, without the need for painful and potentially time-consuming bone marrow harvest surgery. Early treatment can minimize disease progression.
  • If ever required for a transplant, using your own family’s cord blood instead of an unrelated donor’s can have significant advantages, including fewer complications and improved medical outcomes
  • Current clinical trials in the U.S. that use cord blood require the child’s own stem cells

  • Having a family history of disease
  • Having a baby of an ethnic minority or mixed ethnicity, in which there is greater difficulty finding stem cell donors
  • Adopting a newborn and wanting a valuable source of stem cells genetically identical to the adopted baby

  It is important to know that, for certain inherited genetic conditions, the child’s own cord blood may not be used; in those cases, a matched sibling’s stem cells would be the first choice. There is no guarantee that an adequate stem cell match will be found for any given patient.

• If I move internationally will you ship the sample if I need it?

  Yes. CBR can generally send your family’s sample for treatment anywhere you need it, subject to local regulations. Please contact us so that we can discuss specifics about your family’s situation.

• What is HLA matching

  HLA matching is the criteria used to determine donor and recipient compatibility. In cord blood, it generally refers to six proteins called human leukocyte antigens (HLA) that appear on the surface of white blood cells and other tissues in the body. A transplant will only be performed if there is an adequate HLA match between the donor and recipient. A perfect six out of six match is best. Siblings have a 25% chance of being a perfect match.

Donating Stem Cells to the Public

• What are my options for saving my babys cord blood?

  You have two options to save your baby’s cord blood:

  Family banking: Your baby’s cord blood is stored for a fee for exclusive use by your family.

  Newborn Possibilities Program®: CBR offers cord blood and cord tissue collection, processing and storage at no cost for five years when a family member has been diagnosed with a condition that can be treated with stem cells.

  Public donation: Your baby’s cord blood is donated anonymously for potential use by a patient who needs a transplant. You must give birth in a participating hospital.

  If you choose not to family bank or donate, your baby’s cord blood is discarded at the hospital.

• Can I get a sample from a public bank?

  When you donate for public use, if the sample is eligible and stored, the cord blood may be available to any patient who needs a transplant, so you cannot assume that it will be available for your family if ever needed.

  • For families to make an informed decision, it is important to understand that not all donated samples are banked. As many as 71% 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.
  • Private banking helps ensure that your baby’s cord blood is saved and available for your family if ever needed.

  If someone in your family needs stem cells, the most important considerations are:

  • Quality of the sample – Collected, processed, and stored so that sterility and stem cell count are optimized
  • Matching donor – Stem cells from a matched relative (preferably a sibling) are generally the best treatment option in transplant situations, such as cancers and blood disorders. For those cases, having a matched family member’s cord blood available may have significant advantages, including fewer complications, improved survival, and a better quality of life without the need for anti-rejection medications.
  • Access to a matching sample – Many patients are unable to find a donor in the public system, especially those who belong to minority ethnic groups that are not adequately represented in public banks. There is no guarantee that a matched sample will be available in a public bank or within your family.

  As with other medical procedures, therapies using cord blood involve risk, which should be discussed with your physician. For current experimental regenerative medicine applications, the child’s own cord blood is required, so storing your baby’s cord blood in a family bank is the only option.
  “A patient’s best chance of finding a match is with a brother or sister.” -National Marrow Donor Program

• If someone in my family needs a transplant could we find a donated sample from a public bank?

  Possibly. However, if a patient is in need of a transplant, the physician will look first for a suitable stem cell donor within the patient’s family. Using cord blood from your own family has advantages for treating cancers and blood disorders. Matched cord blood from within your own family can result in:

  • Fewer complications
  • Improved medical outcomes

  Additionally, saving cord blood for all of your children is important for participation in current clinical trials, for which the child’s own cord blood is required. There is no guarantee that an adequate stem cell match will be found in either a public bank or within your family.

• Can I donate to a public bank?

  Donating to a public bank may not be possible for several reasons:

  • Only certain hospitals are able to collect cord blood donations, so not all families can donate.
  • Based on requirements for the donor and cord blood donation, many families are not eligible for donation for a variety of reasons, including family health history, maternal exposure to viruses, and international travel.
  • As many as 71% 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.
  • If families decide too late, they may be denied access to donating.
• How do I donate my baby's cord blood to a public bank?

  With public donation, you may be able to donate your baby’s cord blood for use by an anonymous patient in need. In 2009, the National Marrow Donor Program® facilitated more than 4,800 marrow and cord blood transplants for patients who did not have matching donors in the family. For more information about donation, visit BeTheMatch.org.