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| |    Cord-Blood Banking by Elisa Ross, MD reviewed by Marjorie Greenfield, M.D. Up until recently, the umbilical cord--along with the blood that remained in it after a baby was born and the cord cut--was simply discarded by the hospital. Then, in the late 1980s, researchers discovered that cord blood possessed unusual properties that made it useful in the treatment of patients with some cancers and other illnesses. While the actual process of collecting cord blood is straightforward, many parents are not even aware that this option now exists, much less familiar with all the issues involved. The case for saving your baby's cord blood The blood running back and forth between your baby and the placenta is full of immature cells called stem cells. Unlike embryonic stem cells, which have the ability to develop into any type of body cell, cord-blood stem cells already are locked into a certain, vital function: making all the different components of the blood, such as platelets, white blood cells, and red blood cells-serving, in effect, like bone marrow. When transfused into a patient whose own blood cells have faulty genetic coding or have been destroyed by chemotherapy or other cancer treatments, the cord-blood cells can implant themselves in the bone marrow and generate legions of new, healthy cells. These days, cord-blood transplants most commonly are used in cancer patients when a donor can't be found for a bone-marrow transplant. The treatment is particularly effective in young patients-the Colorado University Cord Blood Bank reports a 70 percent success rate in children, but only 20 to 40 percent in adults. Researchers envision improving those odds and see many future applications as well, such as curing sickle cell disease and other blood-related genetic illnesses. So there is a possibility that your child, or someone else, may need these super-healthy and versatile cells one day. The drawbacks Aside from not knowing about this medical option, the main reason most people do not save their baby's stem cells is cost. In a private blood bank, the initial costs run from $275 to $1,500. Most also charge a yearly storage fee of $50 to $95. The advantage of using a private bank is that your sample is saved for only you to use. An alternative to private banking Public cord-blood banks are an alternative. These cost no money to use, but your sample is not specifically saved for you. Another person with a more immediate need may use it. If the time should come that you need stem cells, yours may still be available, or you may use donations from other people without charge. You also can direct your sample to go to a relative with an immediate need if the blood type matches. Anyone else needing to use stem cells from a public bank who has not been a donor must pay for it, sometimes tens of thousands of dollars. Will my family benefit from saving stem cells? Right now, situations in which stem cells would be helpful are quite rare. As mentioned earlier, stem-cell transplants are most commonly used for rare genetic conditions and for some types of cancer, including leukemia and lymphoma. And even with these present uses, many questions remain. In cancer treatment, for example, some researchers are concerned about the wisdom of transplanting back into the child the same cells that already showed a propensity to become malignant. Doctors also aren't sure if the number of cells taken at the time of birth would be enough to treat a full-grown 16-year-old. It is also not completely clear how active the cells would be after years of being stored. The treatment is so new and rare, we just don't have the data yet to resolve these important issues. What do the experts say? The American Academy of Pediatrics encourages "philanthropic" blood banking in public banks, but only for families with a current or potential need. Blood-bank proponents encourage any kind of banking, pointing out that research is getting closer and closer to many diverse, live-saving applications. How do I decide? Each family must weigh the pros and cons for themselves. Some families say that any cost is worth their peace of mind. Others say that in the face of uncertainty about the effectiveness of the treatment, they will use their resources elsewhere. Some choose the middle ground of donating publicly, knowing that their sample might benefit another family, if not themselves. For more information, ask your doctor or nurse, and be sure to check out our article on the technical aspects of cord-blood banking.
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