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 the cord has been cut. Doctors have identified that cord blood, like bone marrow, is a rich source of stem cells, which can be used in medical treatments. A variety of cell types exist in cord blood including hematopoietic stem cells (HSC), mesenchymal stem cells (MSC) and embryonic-like stem cells (ESC). Cord blood is routinely discarded after birth, but a process known as cord blood banking allows families to save this valuable resource for potential future medical use.

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What are stem cells?

Stem cells are the body's "master" cells because they can regenerate and turn into the cells that form all other tissues, organs, and systems in the body. The first discovery of stem cells was in bone marrow, and they were used to regenerate blood and immune cells for patients who had received chemotherapy for cancer. In the late 1980's, doctors found success using cord blood stem cells to treat diseases that had previously been treated with bone marrow transplantation. Stem cells used for medical treatments can be obtained from bone marrow, peripheral (circulating) blood, or cord blood.

Now a part of medical treatments for four decades, different types of stem cells are being used in a wide range of treatments. Today, the ability of cord blood stem cells to repair damaged cells and tissues in the body has opened new possibilities for treating and curing some of the most serious diseases and injuries.

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Are cord blood stem cells different than other stem cells?

Yes. When compared to adult stem cells, cord blood stem cells are biologically unique and are advantageous due to their higher rates of proliferation, immunological immaturity, and reduced exposure to viruses and aging. In comparison to embryonic stem cells, cord blood cells are proven safe in the human body and have been used effectively for decades in medical treatment.

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

Cord blood banking is an once-in-a-lifetime opportunity for parents to save the stems cells found in the blood of their newborn's umbilical cord. Cord blood banking is safe for both the mother and the newborn since the cord blood is collected after the baby is born and the umbilical cord has been clamped and cut. Once the cord blood has been collected, it is sent to a laboratory for processing and storage in liquid nitrogen vapor.

There are two types of cord blood banks: public donation banks, and private family banks.
  • In a public bank, cord blood is donated anonymously for potential use by a patient in need. Donors must meet eligibility requirements, and give birth in participating hospitals in order to donate to a public bank.
  • In a private family bank, the cord blood is collected and stored for exclusive use by the baby and family members, should a need arise in the future.

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How is cord blood used in medical treatments?

Cord blood stem cells may be used in two areas of disease and injury treatment: transplant medicine and regenerative medicine.

    Transplant Medicine
    Cord blood stem cells may be used to treat nearly 80 serious diseases. First found in bone marrow, stem cells have been used for decades in lifesaving treatments for diseases including leukemia, other cancers, and blood disorders. In transplant medicine, a patient generally will undergo chemotherapy and then receive an infusion of cord blood stem cells to regenerate a healthy blood and immune system.
    Regenerative Medicine
    Regenerative medicine focuses on using stem cells to repair damaged tissues and organs, which may help your baby in case of disease or injury. Doctors believe that the stem cells may travel to the site of injury and begin repair or release substances that promote healing.

    This emerging field of medicine is directed at treatments for conditions such as brain injury and juvenile diabetes. There are many other areas that are in development:
ALS (Lou Gehrig's disease) Brain injury Cerebral palsy
Congenital heart defects Hearing loss Heart disease
Juvenile diabetes Liver disease Orthopedic injury
Spinal cord injury Stroke/Infant stroke  
    "This revolutionary technology (regenerative medicine) has the potential to develop therapies for previously untreatable diseases and conditions. Examples of diseases regenerative medicine can cure include diabetes, heart disease, renal failure, osteoporosis, and spinal cord injuries."
    -U.S. Department of Health and Human Services

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Who can use the newborn's cord blood stem cells?

For Transplant Medicine:

    The baby will be a perfect match for the cord blood stem cells and may use them for a variety of emerging treatments in regenerative medicine (such as brain injury or juvenile diabetes), and transplant medicine (certain cancers and blood disorders).

    To date, most medical therapies using cord blood stem cells within the family have benefited biological siblings of the newborn,

      Because the cells in cord blood are 'naïve' and young, they may be used more frequently between family members. It is more likely that siblings will be able to use each other's cord blood for treating cancers or genetic diseases compared to using their sibling's bone marrow.

    The mother should be able to use the cells due to the compatibility that occurs during gestation.

    Additionally, any immediate family member who is a suitable match may be able to use the baby's cord blood stem cells for transplant medicine.

For Regenerative Medicine:

    Regenerative medicine treatments require the use of the child's own stem cells.

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What diseases are treated with cord blood stem cells?

The most common disease treated with cord blood stem cell transplant is leukemia. However, nearly 80 serious diseases have been treated with cord blood stem cells in transplant medicine and the use of these stem cells in regenerative medicine is growing rapidly. Click here for the full list.

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

The science of stem cell therapy is expanding rapidly, so it is difficult to accurately calculate the odds that a family will use the cord blood or benefit from new treatments.

According to published estimates, the odds that your child or a family member will need to use stem cells for currently available transplant treatments are 1 in 217 by age 70.

Family history is not the only indicator of need, because most forms of leukemia are not hereditary and the causes for many cancers and diseases are unknown. In fact many serious diseases treatable with cord blood are not hereditary and occur without warning. In some cases, certain types of cancers are growing at alarming rates. Recent reports indicate that one in 630 children will get cancer by age fifteen.

Published odds of use for transplant medicine do not consider the increasing applications and promising cord blood therapies that are in development to treat brain injury, cerebral palsy, hearing loss, heart disease, diabetes, and spinal cord injury. Continued progress in stem cell treatments would greatly increase the likelihood of use by your baby throughout life. These breakthroughs in stem cell technology have lead to estimates that 1 in 3 could benefit from regenerative medicine in his or her lifetime.

References:
-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.
-Lichtenstein, P., et al. Environmental and Heritable Responders in the Causation of Cancer. New England Journal of Medicine. 2000;343(2):78-85
-Greenwood H, Singer P, Downey G, et al. Regenerative Medicine and the Developing World. 2006; 3(9):e381.
-Harris DT, Badowski M, Ahmad N, Gaballa MA. The potential of cord blood stem cells for use in regenerative medicine. Expert Opin Biol Ther. 2007;7(9):1311-1322.

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How long can the stem cells be stored?

Current data reflects that cord blood cells that have been stored for fifteen years have the same composition as they did at the time of storage. All science involving cryogenic storage of cells also indicates that the cells should remain viable indefinitely.

Reference:
Pasquini MC, Logan BR, Verter F, Horowitz MM, Nietfeld JJ. The Likelihood of Hematopoietic Stem Cell Transplantation (HCT) in the United States: Implications for Umbilical Cord Blood Storage. Blood 2005; 106(11): 1330.

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Does having more stem cells matter for treatment outcomes?

Yes. In traditional transplant medicine, having more cells available for treatment may help the patient recover faster, experience fewer complications, and ultimately, increase the chance for survival. A doctor will use all of the stem cells in transplant in order to give the patient the best chance for rapid regeneration of their blood and immune system.

In Regenerative Medicine, a higher number of cells may offer the ability to have multiple treatments.

Reference:
-Lichtenstein, P., et al. Environmental and Heritable Responseors in the Causation of Cancer. New England Journal of Medicine. 2000; 343(2):78-85
-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 in result attack it. 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.

Using one's own stem cells, called 'autologous' transplant, has no risk of GvHD since the cells are your own. 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 compatability 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. Although a perfect 6 out of 6 match is best, studies have shown that cord blood transplants can be successful, even when only three of six HLA match. With cord blood, the newborn immune cells are less mature than adult cells in bone marrow, and as a result, siblings have up to a 75% chance of using each other's cord blood, compared to only 25% with bone marrow.

Reference:
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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New uses for cord blood stem cells are being discovered rapidly; however, banking cord blood does not guarantee that the cells will provide a cure or be applicable for every situation. Ultimate use will be determined by the treating physician. Use in regenerative medicine is still considered experimental.