UMBILICAL CORD BLOOD BANKING: Insurance Against Future Diseases?

USA Today (Society for the Advancement of Education), March, 2000 by Holly Wagner

The Ross Cord Blood Bank aims for 1,500 to 2,000 cord blood samples within three to five years, Long says. Of the 10,000 privately stored stem cell units at the CBR, seven have been used for same-family transplants. None of the recipients has been the child who donated. This begs the obvious question surrounding family banking: Why bother? "The stem cell sample is for the whole family--brothers and sisters, fathers and mothers and grandparents," Kaesshaefer points out.

According to Lasky, more than 25 transplants are done each month with allogeneic cord blood. "A large number of these transplants are among siblings. If it's a HLA-identical sibling, the transplanted cord blood probably has a better chance of engrafting than would any other tissue, including bone marrow."

A 1997 study, published in the New England Journal of Medicine, found that the one-year survival rate in a group of 78 patients receiving cord blood from a relative was 63%, while the survival rate among 65 patients receiving cord blood from a non-relative was 29%.

Understanding options

Parents need to understand their options, notes Judy Hill, an Ohio regional cord blood educator for the CBR who teaches parents and physicians about cord blood storage. The public Ross Cord Blood Bank also does its share to educate the public.

"We make sure parents know there are other options," Long explains. "When a family decides they want to store a unit in our bank, they go through an informed consent procedure. Once they consent, the cord blood becomes property of our bank--the parents relinquish all control." Unlike donating a pint of blood through a private blood bank, where donors are usually paid, parents wishing to store the blood strictly for family use need to go through a private bank.

Cindy Monroe embraces the peace of mind the private banks sell. "The cord blood is now available to me in case I relapse and need a bone marrow transplant. Brent may save my life one day."

Had Cindy Monroe not had cancer, she likely never would have donated the blood, much less had it stored for future family use. After all, she didn't have a family history of cancer.

It is hard to say if any of her immediate family members will ever need the stem cell sample. There are no conclusive data on how long stem cells last in cold storage. Besides, the likelihood of Brent using his own cord blood sample seems small. Depending on which study you read, the chance of a child using his or her own stem cells is estimated at between one in 1,000 and one in 200,000 by age 18, according to the American College of Gynecologists and Obstetricians. Moreover, for youngsters who develop diseases, their own cord blood may not be the best option. "If a child develops a leukemia and uses his own cord blood, chances are that the cancerous genes are going to be in that cord cell unit and you'll be transplanting another leukemic cell line into that child," Long warns.

The Ross Cord Blood Bank does not routinely bank blood specifically for a family's use, he says. Yet, if a physician determines that the cord blood should be collected for an established family medical need, the bank would save the blood for the family.