Posted in Pre-Parenting

Cord Blood Banks: Intro to Pros/Cons and Comparisons

Whether to do a Free Public Cord Bank or Paid Private Cord Bank for your baby’s umbilical cord blood comes up during prenatal care (and should be decided before delivery to guarantee access to desired collection kits).   Here’s a scientific, unbiased review of what it entails:

Free Public Cord banks usually collect only umbilical cord blood. Paid Private Cord Banks vary by company and offer up to 3 different tissue collection/storage: umbilical cord blood, umbilical cord tissue, and placental banking.  Umbilical cord blood contains hematopoietic stem cells that can become any blood cell (red blood cell, white blood cell, etc)-and could help treat blood diseases like leukemia among other things.  The umbilical cord tissue itself also contains mesenchymal cells, which can be isolated and turn into a broader range of cells, which is much more experimental undergoing early testing. (These cell types are slightly different from the “embryonic stem cells” often in the news that can become any cell type- but umbilical collection is less controversial as these limited stem cells are essentially trash if not collected, and do not harm the infant as they are collected after cord clamping from tissue that would otherwise be discarded.) Some private cord banks advertise placental banking– which contains mesenchymal stem cells, doesn’t have standard accreditation for collection methods, and doesn’t add additional advantage since cord tissue mesenchymal cells can be triggered to divide to make additional copies– so at this point appears less relevant.  

The American Academy of Pediatrics (AAP) recommends free public cord banking for all (rather than private banking).  For anyone who needs stem cell treatments, a public bank is the likely source of those cells (rather than a private bank of your own cells- since your cells likely have the same genetic error that caused your disease).   I will include their citations below, but the AAP also summarizes its stance well here:

  • “Public cord blood banks serve patients worldwide by matching individuals in need. Private banks store the cord blood for the donor family’s potential self use, although there is little evidence supporting this use unless a family shares a known genetic defect.
  • Donation to a public cord blood bank is free. Private cord blood banks charge a placement fee of $1,350 to $2,300 and an annual maintenance fee of $100-$175.
  • Public cord blood banks are highly regulated by oversight accrediting institutions. Private cord blood banks may not meet stringent requirements, which can cause cord blood to be of lesser quality.
  • The rate that cord blood stems cells are utilized from a public bank is 30 times higher compared with private cord blood banks. Yet more cord blood donations from ethnic/minority populations are needed to meet increasing need.”

Official AAP Summary: https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Encourages-Use-of-Public-Cord-Blood-Banks.aspx  

Detailed Nov 2017 Statement by AAP: http://pediatrics.aappublications.org/content/140/5/e20172695

Non-Medical Summary of AAP Stance: https://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Should-We-Store-Our-Newborns-Cord-Blood.aspx

However, private stem cell banking might be recommended to you by your doctor if you have a rare genetic condition or atypical/unclear diagnosis (neurologic, autoimmune, or other) in yourself or your family that might change the cost/benefit analysis towards private banking (sometimes you may do a private stem cell bank of one child to help another family member as well).   Furthermore, those with more disposable income may consider private stem cell banking a biologic “safe deposit box” that could be useful to that infant or another family member in the future based on their own cost/benefit analysis.  

I’d reiterate that there are very few negatives to public cord banking– if you’re unsure I recommend you go with a public cord bank. Ask your doctor or hospital in advance if they affiliiate public bank, or find out more information to do a mail in donation here in case they do not: https://parentsguidecordblood.org/en/donationspot  or more general public donation information: https://parentsguidecordblood.org/en/donate-cord-blood)  

Picking a Private Cord Bank:

I had a medical reason my doctor recommended that I consider private stem cell banking, so I researched it further…and even being a doctor myself I struggled to wade through the primarily biased company information that surfaced in most Google searches.  (This is an unpaid, unbiased article: I don’t get any kickbacks for any private stem cell companies, nor does this constitute medical advice.) This article is meant to share what I’ve learned to help inform others: if you’ve found other useful links feel free to share with me in the Contact Us page!

Below I attempted to list reputable sources of stem cell science to inform your own cost/benefit analysis of private cord banking for yourself and your family.  This informative non-profit started by an astrophysicist who lost his child to leukemia is a good place to start: https://parentsguidecordblood.org/  Distilling that and other websites, I have references for common questions in the process below:

What diseases can be treated by stem cells?

Umbilical cord blood (hematopoetic) stem cell based treatments are mostly for blood cell cancers (leukemia and related diseases).  Treatment is done via allogenic transplant– meaning the patient is NOT the person who donated the cells; the autologous (self-transplant) supported via private cord donation does NOT occur for most diseases.  (Most private stem cell banks advertise that 80 diseases can be treated, but gloss over the fact your infant is not likely to benefit from their own stem cells in that case.)  This nonprofit link has a very detailed, unbiased chart of what is being treated currently and experimentally via stem cells (the “Autologous” Column of the first charts are what is especially relevant for private umbilical cord blood banking; whereas “Allogeneic” categories are typically from a public stem cell bank):

https://parentsguidecordblood.org/en/diseases

Umbilical TISSUE (mesenchymal) cells are even more experimental than the blood stem cells, and are not used for standard treatments.  Research is investigating their use for a range of diseases along side cord blood referenced at links below.

What areas of research suggest future potential treatments?

Self (autologous) and other (allogeneic) umbilical cord blood treatments are undergoing experimental testing for a range of diseases here (lower in the page at Diseases and Disorders that have been in Clinical Trials with Cord Blood or Cord Tissue Cells) :  

https://parentsguidecordblood.org/en/diseases

Umbilical TISSUE (mesenchymal) cells are even more experimental than the blood stem cells, and are not used for standard treatments, and only researched for non-self (allogeneic) transfers thus far (which is different than the autologous transplant most private blood banks would advertise for your newborn):

https://parentsguidecordblood.org/en/diseases

How do you assess/compare the value of private stem cell banks?

  • Accreditation
  • Availability of cell type storage you desire, and collection options
  • Company viability and long-term durability, storage facility location (free from national disasters, with backup systems etc) and reliability: Better Business Bureau reviews, etc  
  • Number of cell samples stored and number of transplants
  • Pricing (and any hidden fees)
  • Shipping, collection and storage methods
  • Affiliated labs, research, etc
  • Other guarantees

If there is more interest in those topics, I’d be happy to include much more on each of those areas above- please Contact Us if you’d like to hear more.  

I published this article in the meantime to inform/provide a framework for those curious or who might be on a timeline to decide for this topic before delivery!  Many sources say by week 28-34 is recommended to decide/research your wishes.  For private cord banking you need your desired company’s collection kit in hand to bring to the hospital in order to be sure to collect the stem cells (and often have to pay a $100-200 deposit before, which may or may not be refundable if you don’t collect).  If you look into this late like me–many companies will Express mail/Overnight this kit, often if at no cost to you if it is later in pregnancy; however, most hospitals don’t have private cord kits on hand or only limited offerings.  Companies happily staff their phones to answer questions since they want your business- so feel free to call and compare several to find what you want.

This unbiased government website provides more information on the timeline and process of cord collection (particularly for a free public bank): https://bloodcell.transplant.hrsa.gov/cord/options/donating/index.html

 

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