Baby Stem Cells - Cord Blood & Tissue

 

About Cord Blood
Stem Cells

Scientific and Medical Overview of Cord Blood Stem Cells

Umbilical cord blood is rich in haematopoietic (blood) stem cells which means they have the ability to evolve into all the specific cell types in the blood and immune system and are therefore used to treated blood and blood related diseases.

Haematopoietic stem cells (HSCs) are a standard treatment for the following blood diseases:

  • Leukemias (Leukemia is a cancer of the blood immune system, whose cells are called leukocytes or white cells)
  • Myelodysplastic Syndromes (Myelodysplasia is sometimes called pre-leukemia)
  • Lymphomas (Lymphoma is a cancer of the leukocytes that circulate in the blood and lymph vessels)
  • Anemia (Anemia’s are deficiencies or malformations of red cells)
  • Inherited Platelet Abnormalities (Platelets are small blood cells needed for clotting)
  • Myeloproliferative Disorders
  • Inherited Immune System Disorders
  • Metabolic Disorders
  • Other cancers (Not originating in the blood system)

For some diseases HSCs are the only therapy and for others, they are employed when front-line therapies have failed or the disease is very aggressive.

Cord blood also contain a very small amount of mesenchymal stem cells.

Who Can Use the Stem Cells?

Stem cells represent a perfect match for the child whose cord blood stem cells have been stored, with no risk of rejection. There is also an excellent possibility that the stem cells will be a suitable match for family members and/or close relatives:

  • a sibling (1 in 4 chance)
  • a parent (1 in 8 chance)
  • a grandparent (1 in 32 chance)

Haematopoetic stem cells can be retrieved from 3 types of donors

  • The patient themselves (autologous)
  • A related donor (allogeneic)
  • An unrelated donor (allogeneic)

Autologous transplantation

Autologous transplantation means that the donor and the recipient is the same person. This type of transplantation refers to the situation where the child’s own stem cells are used for treatment. It needs to be noted that autologous transplantation cannot be used in the treatment of inherited disorders. The reason being that the genes that code for the inherited disorder are carried in every cell i.e. they will also be found in the person’s own stem cells. So, we cannot return cells containing genes for an inherited disorder back into the person after we have treated them for the disorder. In that case, an allogenic donor will be used. Traditionally, autologous transplantation was not done for acute leukemia’s in children. However, views on this subject are changing and autologous transplantations are being tried in childhood leukemia. “First report of autologous cord blood transplantation in the treatment of a child with leukemia.”

Allogeneic transplantation

This type of transplant is a transplant between two genetically non-identical individuals. These individuals may be related family members or completely unrelated. Allogeneic transplants (allograft) may be used in the treatment of inherited and non-inherited disorders. Before doing an allograft, the recipient needs to find a matching donor.

HLA matching necessary for transplants

Prior to allogeneic stem cell transplantation, HLA type matching needs to take place. A 6/6 HLA match is necessary for bone marrow and peripheral blood stem cell transplants. Due to the “immature immunity” of umbilical cord blood only a 3-4/6 HLA match is necessary. The implications of this are: The chances of finding a donor are significantly increased, with a 1:4 chance of a sibling being a match and 1:8 chance for parents. Adult patients can receive a combination of multiple, mismatched cord blood units. There is less chance of Graft Versus Host Disease with cord blood than with bone marrow transplants, because cord blood stem cells have immature immune systems.

The amount of stem cells necessary for transplantation

Currently, the average number of stem cells collected from an umbilical cord blood collection unit will treat up to a 50kg person. The optimal dose is about 10 million nucleated cells (CD45+) per kilogram of body weight. As stated above, multiple, mismatched cord blood units can be used simultaneously in a transplant for an individual over 50kg in weight. The use of cord blood for adults is being enhanced by expanding the number of stem cells in vitro. Companies are developing techniques to grow stem cells in a laboratory environment and these are being used in clinical trials.

Chances of Needing the Stem Cells?

Hopefully they will never be needed and should be regarded as an extra form of medical insurance. The diseases that stem cells can currently treat are not common and therefore, the chances of using the cells are thankfully rare. Studies in the United States have been done to calculate the lifetime probability (age 0-70) that an individual will undergo a stem cell transplant. They reported that 1:435 people will receive their own stem cells for treatment; 1:400 persons will receive someone else’s stem cells; and the combined total number of stem cell transplants will be 1:217 persons.

With all the current research being undertaken, it is likely that retrievals will increase in the future, as more diseases become treatable through stem cell therapy.

Reasons to Consider Storing your Baby’s Cord Blood Stem Cells

  • Family history of certain illnesses especially haematological (blood) cancers, inherited blood disorders and inherited immune deficiencies.
  • Sibling with disease treatable by stem cell transplant.
  • Families of African origin and mixed race marriages, as it is extremely difficult to find suitable donors, as they are seriously under-represented in public banks.
  • Form of medical insurance, to give you extra peace-of-mind. You hope you never need them, but if you do, they are available.
  • Question of affordability. As with all things, cost is important. Storing you baby’s stem cells is not cheap and if you can afford, you should definitely consider it. If you do speak to your doctor and there is a negative response, it is because some doctors are of the opinion that this is a waste of money, because the chances of needing the stem cells are low. You must however remember that as medical science progresses, more and more diseases will become treatable with stem cells.

Medical Opinions and Useful Links

South African Society of Obstetricians and Gynaecologists (SASOG)

SASOG released an Opinion Paper on Cord Blood Banking in 2006, which was written by Prof Guidozzi. Netcells endorses this Paper. www.sasog.co.za

Parents’ Guide Cord Blood

This website was written by Dr Frances Verter, in memory of her daughter Shai who died from leukaemia. Read specifically Shai’s story, under the About Us section. Dr Verter has written this website in order to give unbiased advice to parents who are considering storing their baby’s cord blood. This website contains medical facts and opinions about stem cells, useful information about private cord blood banks around the world and what questions you should be asking. www.parentsguidecordblood.com