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UMBILICAL CORD BLOOD BANKING: Insurance Against Future Diseases?
USA Today (Society for the Advancement of Education), March, 2000 by Holly Wagner
Both methods yield from 60 to 120 milliliters--equivalent to about one-half to one cup. The chances of the mother's blood mixing with her infant's blood are slim to none, according to Long. "There's less than a one percent chance--like 0.02%."
Once the cord blood is collected, it is shipped to a lab for testing and processing. Lab technicians run the blood through a battery of tests, extract the stem cells from the sample, and prepare the sample for the freezer, where the cells remain until they are needed.
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The umbilical cord contains two arteries and one vein, all connected to the placenta. Here, in the umbilical cord and through the placenta, is where nutrients and waste travel between the fetus and the mother. The placenta is the interface between the mother and the developing baby. It serves as a temporary lung, intestine, and kidney, supplying the growing baby with food, water, oxygen, and waste removal throughout fetal development. The placenta also serves as a barrier, making sure maternal and fetal blood never mix. This protects the fetus from a reaction by the mother's immune system.
Cord blood stem cells are naive--even more so than bone marrow stem cells. This means they don't know "self"; that is, the immune system hasn't developed enough for recognition. This makes sense, since it takes about six to nine months for the immune system to develop fully after a baby is born.
Also, using umbilical cord stem cells in transplants seems to decrease the occurrence of graft-versus-host disease (GVHD), a condition that happens when the transplanted tissue, or graft, attacks the recipient, or host. "Since the lymphocytes in cord blood have not yet developed a strong sense of self, they tend not to produce graft-versus-host disease at the same rate unrelated marrow does," Lasky explains. Lymphocytes are white blood cells that help the body fight infections.
In addition to less incidence of GVHD, there seems to be less of a need to precisely match the six HLAs, while "bone marrow transplants have a poor chance of success unless at least four of the six major HLAs ... are alike in donor and recipient," according to the Journal of the National Cancer Institute.
Transplant success
Studies within the past five years have shown success in using cord blood stem cells in allogeneic transplants. Allogeneic transplants mean the tissue comes from a person other than the recipient--either a sibling, another relative, or a non-relative. Conversely, an autologous transplant means the patient uses his own tissue.
A 1998 New England Journal of Medicine study on utilizing allogeneic umbilical cord blood stem cells reported that, during the first few years of using these cells in transplants, "the placental blood was obtained from siblings, but now recipients of transplants from unrelated donors ... account for almost all patients who receive transplants." The researchers followed 562 children who had received non-related cord blood in a transplant.
In the study, information concerning acute--or short-term--GVHD was available for 399 of the 562 patients. Of those 399 patients, 118 (30%) had no GVHD, while 42 (11%) had severe GVHD. Of the 562 patients in the study, 378 (67%) had leukemia or lymphoma; 137 (24%) had a genetic disease; and 47 (eight percent) had an acquired disease.
