FAQs

Cord Blood Stem Cells

Cord Blood Stem Cells - FAQs

What is cord blood?

Cord blood is the blood that remains in your newborn's umbilical cord after birth. Cord blood, like bone marrow, is an invaluable source of a type of stem cell that can be used in a variety of medical treatments. A process known as cord blood banking allows families to save this valuable resource for potential future medical use. If it is not saved, it is discarded at the hospital.

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What are stem cells?

Stem cells are the body's "master cells" because they are the building blocks of organ tissue, 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 and saving many lives. And they are being researched in an exciting new area of medicine called regenerative medicine, where scientists are using cord blood stem cells in experimental treatments for brain injury and juvenile diabetes.

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Are cord blood stem cells different than other stem cells?

Yes, cord blood stem cells are biologically younger and have unique qualities and advantages compared to other stem cell sources like bone marrow:

  • There is less risk of complications when used in transplants.1
  • They are immediately available, and early treatment can minimize disease progression.2
  • Freezing them "stops the clock" and protects them from environmental damage, age, and common viruses that will impact the stem cells in our bodies over time.3
  • Collection of cord blood is simple, safe, and painless.

Cord blood stem cells are not embryonic stem cells and are not controversial.

References:
1. Rocha V, Wagner JE, Jr., Sobocinski KA, et al. Graft-versus-host disease in children who have received a cord-blood or bone marrow transplant from an HLA-identical sibling. Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources. N Engl J Med. 2000;342(25):1846-1854. 2. Pazdur R, et al. Cancer management: a multidisciplinary approach. 1998. Second edition. 3. Behzad-Behbahani A, Pouransari R, Tabei SZ, et al. Risk of viral transmission via bone marrow progenitor cells versus umbilical cord blood hematopoietic stem cells in bone marrow transplantation. Transplant Proc. 2005;37(7):3211-3212.

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What is cord blood banking, and how is it done?

Cord blood banking is a once-in-a-lifetime opportunity to save your baby's cord blood stem cells for potential medical uses. Having cord blood saved can be lifesaving or life-changing for your baby or other family members and ensures that these cells are immediately available if ever needed.

Collecting cord blood is a simple, safe, and painless procedure that usually takes less than five minutes and happens immediately after birth. After the umbilical cord has been cut, the remaining blood in the cord is collected. The cord blood is then shipped to the laboratory and frozen in cryogenic storage tanks for long-term preservation.

If you do not save your baby's cord blood, it will be discarded after birth.

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How is cord blood used in medical treatments?

Cord blood stem cells have been successfully used in transplant medicine for more than 20 years. To date, cord blood has been used to treat nearly 80 serious diseases, including leukemia, other cancers, and blood disorders.

Cord blood is being researched now for use in regenerative medicine where stem cells may help induce healing or regenerate cells to repair tissues. This exciting new area of medicine has led to clinical trials using cord blood in experimental therapies to treat cerebral palsy, brain injury, and juvenile diabetes.

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Who can use my baby's cord blood 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, although siblings are the most likely to be compatible matches for using stem cells. Your baby will always be a perfect match and may use his or her own stem cells for a number of diseases, however, not for inherited genetic conditions. In those cases a matched sibling's stem cells would be the first choice.

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

Although it is difficult to estimate the odds of using stem cells, a few published studies have estimated the odds of needing a stem cell transplant from any source (cord blood, bone marrow, etc.):

  • The odds of a child (ages 0 to 21) needing a transplant using his or her own stem cells are about 1 in 2,700.1
  • The odds of an individual needing stem cells, either their own or from someone else, are about 1 in 217 (ages 0-70).2

These estimates do not include future therapies that may be developed.

References:
1. Johnson F. Placental blood transplantation and autologous banking-caveat emptor. J Pediatr Hematol Oncol. 1997;19(3):183-6. 2. Nietfeld JJ, Pasquini MC, Logan BR, Verter F, Horowitz MM. Lifetime probabilities of hematopoietic stem cell transplantation in the U.S. Biol Blood Marrow Transplant. Mar 2008;14(3):316-322.

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How long can the stem cells be stored?

According to the New York State Health Department guidelines for cord blood banking,1 cord blood stem cells can be stored indefinitely under the proper conditions.

Reference:
1. Linden JV, Preti RA, Dracker R. New York state guidelines for cord blood banking. Journal of Hematotherapy. 1997;6:535-41.

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Does having more stem cells matter for treatment outcomes?

Yes. In transplant medicine, having more stem cells can improve medical outcomes, including faster recovery and fewer complications if the cells are ever needed for treatment.1, 2

Reference:
1. Lichtenstein P, Holm N, Verkasalo P, et al. Environmental and heritable factors in the causation of cancer-Analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med. 2000; 343(2):78-85. 2. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med. Nov 26 1998;339(22):1565-1577.

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What is graft vs. host disease (GvHD)?

GvHD is one of the most common and life-threatening side effects of a stem cell transplant when using stem cells from another individual or "donor" to treat the patient. In fact, GvHD is the leading cause of death after transplant so it is a critical consideration. GvHD occurs when the transplanted stem cells from a donor recognize the recipient's body as foreign and then attack it. Family banked cord blood can help reduce GvHD due to the following:

  1. Cord blood transplants have a reduced incidence of GvHD because the immune cells within the cord blood are less reactive than the immune cells in bone marrow or peripheral blood.
  2. Cord blood used between family members, called "allogeneic-related," has a lower risk of GvHD compared to bone marrow used between family members. GvHD risk is generally highest in transplants using unrelated donors and recipients and is called "allogeneic-unrelated."

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What is HLA matching?

HLA matching is the criteria used to determine donor and recipient compatibility and 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 can only be performed if there is an adequate HLA match between donor and recipient. A perfect six out of six match is best.1

Reference:
1. Harris D, Schumacher M, LoCascio J, et al. Phenotypic and functional immaturity of human umbilical cord blood T lymphocytes. Proceedings of the National Academy of Sciences. 1992;89:10006-10010.

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Banking cord blood does not guarantee that the cells will provide a cure or be applicable for every situation. For inherited genetic conditions, the child will not be able to use his or her own stem cells. A matched sibling's stem cells would be the first choice. Ultimate use will be determined by the treating physician. Treatment for brain injury and juvenile diabetes is experimental and currently requires the use of your own cord blood. Medical treatments using family banked cord tissue are in early research and are not available today; there is no guarantee that therapies will be developed in the future.
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