Cord Blood Banking

Cord blood banking is an emotive topic, there is a lot of different views on it and questions about the benefits and then there is the cost to consider.

Cord blood banking is where umbilical cord blood is collected at birth and is stored. It is done by using a needle inserted into the cord and drawing it out into a syringe. It is then stored in liquid nitrogen. In this cord blood is stem cells which can be used for stem cell transplant for the treatment of some diseases. Most of these diseases are rare, the one most referred to is leukemia.

But what are the facts and who do you listen to. There are a lot of web sites relating to this topic. The company in New Zealand who offers this service privately is www.cordbank.co.nz . They have a lot of information, but it also has to be considered that they are a private company who are making money, thus will benefit by promoting it to the public. On statement says "saving your baby's umbilical cord stem cells could save your baby's life". This statement is not incorrect but the 'could' word in the sentence should be highlighted as there are no guarantees that it will.

The News and Issues page at New Zealand Organisation for Rare Disorders has an article that states:

"A recent request by a private cord blood bank to the Minister of Health, seeking approval to change the restrictions on the use of the blood they store, has led to criticism of the private bank and the information it gives to parents."

There are also articles on the NZ Medical Association site: The one here Cord blood banking has the reply from Medical Director of Cordbank in New Zealand, in which she wishes to correct some inaccuracies she believes were in the papers concerning cord blood banking that appeared in the NZMJ (Vol 118 No 1208, 28 January 2005. URL: http://www.nzma.org.nz/journal/118-1208/1255/). Controversies related to private cord banks are further discussed in the accompanying article by Sullivan et al. (Sullivan M, Browett P, Patton N. Private umbilical cord blood banking: a biological insurance of dubious future benefit. URL: http://www.nzma.org.nz/journal/118-1208/1260).

Personally I found an article written in the Metro magazine called "Cold Comfort Farm" the most helpful. It was in the February 2005 issue by Matt Philip. In the article he interviews several health professionals. Peter Browett (haematologist and transplant physician and professor of molecular medicine) states that "but even if they're in the unlucky group not cured by chemotherapy, there are other equivalent or perhaps better transplant options than cord blood"

If you have a child who has leukaemia and another child is born in that family then the public health system may offer to collect cord blood free of charge if they believe it can be of use in the treatment of a sibling. With Cordbank's private company the blood is collected with the understanding it is only for the child in which is taken from. This is called autologous use. Universally most stem cell transplants come from another donor. In some countries they have public cord blood banks in which the public system stores (banks) cord blood, at this stage in New Zealand it is not available. Some research says in the case of common childhood leukaemia's the mutations that caused the disease are present at birth in the blood thus are you benefiting the child by giving them a transplant of stem cells that have possibly caused the disease in the first place.

According to American Academy of Pediatrics 14, 27: "Cord blood donation should be discouraged when cord blood stored in a bank is to be directed for later personal or family use, because most conditions that might be helped by cord blood stem cells already exist in the infant's cord blood (i.e. premalignant changes in stem cells). Physicians should be aware of the unsubstantiated claims of private cord blood banks that promise to insure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood."

If you decide you wish to have cord blood stored it needs to be arranged in advance of the birth. You also need to have someone willing to take the cord blood so talk to your lead maternity carer (LMC). In some cases it may not possible, for example if there is not enough blood left in the cord or in an emergency where they are looking after the mother or babies health and there is no time to take cord blood such as in post birth haemorrhage.

The guide provided by Cordbank is:

• Complete the contract. You can download from their site, or phone 0800 CORDBANK (0800 267 322) to have the contract mailed to you
• CordBank collection kit will be couriered to you
• Baby's umbilical cord blood is collected at birth
• Call courier who will deliver the kit to CordBank (Auckland)
• Blood is processed and stored at CordBank

Things to consider and questions you may want to have answered:

• What happens if they can not obtain enough cord blood at the delivery?
• What guarantees are there, do they know if there is any deterioration in the stem cells over time?
• What is the the probability that the average child will require a transplant of their own stem cells?
• How often has the autologous stem cells been used from the NZ private Cordbank and did it help with treatment of the health condition?

Costs are listed on their site at: http://www.cordbank.co.nz/whatDoesItCost.htm

I am not a specialist in this area; the information I have provided is from quotes and comments from articles I have read.