Cord blood
From Wikipedia, the free encyclopedia
Umbilical cord blood is human blood from the placenta and umbilical cord that is rich in hematopoietic stem cells. Cord blood is collected after the umbilical cord has been detached from the newborn, and utilized as a source of stem cells for transplantation.
Cord blood is stored by both public and private cord blood banks. Public cord blood banks store cord blood for the benefit of the general public, and most U.S. banks coordinate matching cord blood to patients through the National Marrow Donor Program (NMDP). Private cord blood banks are for-profit organizations that store cord blood for the exclusive use of the donor or donor's relatives.
Public cord blood banking is strongly supported by the medical community. However, private cord blood banking is generally not recommended unless there is a family history of specific genetic diseases. Private banking is unlawful in France and Italy, and opposed by the European Group on Ethics in Science and New Technologies. See cord blood bank.
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[edit] Properties
Cord blood stem cells are more proliferate and have a higher chance of matching family members than stem cells from bone marrow. Fathers have a 25% chance of matching their child's cord blood stem cells. Siblings have a 25% chance of being a perfect cord blood match.
[edit] Collection, storage and costs
There are 2 main methods in cord blood collection from the umbilical vein; before the placenta is delivered (in utero) or after (ex utero.)
With ex utero collection method, the cord blood is collected after the placenta is delivered and the umbilical cord is clamped off from the newborn. The placenta is placed in a sterile supporting structure with the umbilical cord hanging through the support. The cord blood is collected by gravity drainage yielding between 40-150 mL.
A similar collection method is done for in utero except that the cord blood is collected after the baby has been delivered but before the delivery of the placenta.
After collection the cord blood units must be immediately shipped to a cord blood bank facility. At public cord blood banks, this blood is then analyzed for infectious agents and the tissue-type is determined. Cord blood is processed and depleted of red blood cells before being stored in liquid nitrogen for later use.
New parents have the option of storing their newborn's cord blood at a private cord blood bank or donating it to a public cord blood bank. The cost of private cord blood banking is approximately $2000 for collection and approximately $125 per year for storage as of 2006. The donation of cord blood may not be available in all areas, however the opportunity to donate is becoming more available. Several local cord blood banks across the United States are now accepting donations from within their own states. The cord blood bank will not charge the donor for the donation, but the OB/GYN may still charge a collection fee of $100-$250, which is usually not covered by insurance. However, many OB/GYNs choose to donate their time.
"According to research in the Journal of Pediatric Hematology/Oncology (1997, 19:3, 183-187), the odds that a child will need to use his or her own stem cells by age twenty-one for current treatments are about 1:2,700, and the odds that a family member would need to use those cells are about 1:1,400." [1]
After the first sibling-donor cord blood transplant was performed in 1988, the National Institute of Health (NIH) awarded a grant to Dr. Pablo Rubinstein to develop the worlds first cord blood program at the New York Blood Center(NYBC)[2], in order to establish the inventory of non embryonal stem cell units necessary to provide unrelated, matched grafts for patients.
In 2005, University of Toronto researcher Peter Zandstra developed a method to increase the yield of cord blood stem cells to enable their use in treating adults as well as children.[3]
[edit] Usage
When cryopreserved cord blood is needed, it is thawed, washed of the cryoprotectant, and injected through a vein of the patient. This kind of treatment, where the stem cells are collected from another donor, is called allogeneic treatment. When the cells are collected from the same patient on whom they will be used, it is called autologous and when collected from identical individuals, it is referred to as syngeneic. Xenogeneic transfer of cells (between different speies) is very underdeveloped and is said to have little research potential.[citation needed]
[edit] Diseases treated with cord blood
Beginning in the late 1980s, following a successful sibling-donor transplant, cord blood stem cells have been used to treat a number of blood and immune-system related genetic diseases, cancers, and disorders. Because of medical issues around using one's own cells, in nearly every instance the treatments are done using cells from another donor, with the vast majority being unrelated donors.
In 1993, Dr. Joanne Kurtzberg, of Duke University Medical Center, performed the first two successful unrelated donor cord blood transplants[4]; one of which cured acute lymphoblastic leukemia.
The principal diseases and disorders currently treated are listed at the National Donor Marrow Program website.
[edit] Federal Efforts to Promote Cord Blood Usuage and Research
In 2005, U.S. Rep. Chris Smith passed legislation to increase usuage and research into cord blood stem cells. Smith's “Stem Cell Therapeutic and Research Act of 2005” (P.L. 109-129), authorized $265 million for stem cell therapy, umbilical cord blood and bone marrow treatments.
The bill, which was signed into law by President George W. Bush in December of 2005, authorizes $79 million for the collection of cord blood stem cells with the goal of building the nation’s public umbilical cord blood supply by adding 150,000 new units to the current inventory. The intention of the law is to collect a genetically diverse cross-section of cord blood units in an effort to make matches available to 90 percent of patients in need.
The law also created a national registry to match cord blood for those in need. All the cord blood banks participating in the inventory program will be linked into a search system that would allow transplant physicians to search for cord blood and bone marrow matches through a single access point.
“The Stem Cell Therapeutic and Research Act of 2005” is not only aimed at increasing the medical utilization rate for cord blood stem cells, but is also aimed at increasing cord blood stem cell research. All cord blood collected and deemed unsuitable for transplant is required to be donated for research.
[edit] See also
[edit] References
- ^ Cbr Systems, Inc. (2006). Common Misconceptions About Cord Blood Banking. Cord Blood Registry. Retrieved on September 20, 2006.
- ^ NIH data
- ^ Raymer, Elizabeth (October 14, 2005). New strategy will boost cord blood stem cells. University of Toronto. Retrieved on September 20, 2006.
- ^ Dr. Kurtzberg Info
[edit] External links
[edit] General information
- The March of Dimes - Umbilical Cord Blood
- National Cord Blood Program — Cord Blood Q&A
- GentleBirth.org — Umbilical cord issues
- Parents Guide to Cord Blood
- Cord Blood Blog
- Cord Blood Bank
- Stem Cell and Cord Blood information database
[edit] Free, public donation information
- CordBloodDonor.com — Learn about public banking options
- National Marrow Donor Program — Details on umbilical cord blood donation
- Family Cord Blood Services — Public Donation Option FAQs
- Future Health — Cord blood donation and information
- Cryobanks International — Accepts collections throughout the USA
- Alberta Cord Blood Bank — accepts collections throughout Canada
- Babies for Life Foundation — Public cord blood donation and education
[edit] Diseases treated with cord blood
- Diseases Treated with Umbilical Cord Blood — List of over 75 diseases currently treated
- National Cord Blood Program — Frequency of patients transplanted with cord blood by disease
- Cord Blood Center — The list of diseases treated with haematopoietic cells transplantation, including autologous cord blood, cord blood from a sibling, autologous bone marrow, and bone marrow from a donor
