Is Cord Blood the Same as Bone Marrow Can I Bank Babies Cord Blood
Should You Bank Your Baby's String Blood?
The stalk cells in this vital fluid could salvage someone's life, merely information technology probably won't exist your child's.
To bank or not to bank — that is the question I institute myself reckoning with around six months into my pregnancy, when advertisements for private cord blood banks seemed to be popping up everywhere. "Protect what matters most," a poster in my obstetrician's office said. "Build your family unit a healthy future," an advertisement on my Instagram feed prompted.
At the time, I had no idea what cord blood was, or why I'd desire to pay some visitor hundreds of dollars per year to hold onto it. Simply didn't I want to protect my family? I was forced to pay attention.
Cord claret, I learned, is the stem-cell-rich blood that flows through the umbilical cord and the placenta when your baby is in the womb. When providers cutting and clamp the umbilical cord later delivery, they can collect the remaining blood and ship information technology to a banking concern where it's plunged into a deep freeze. But while the Nutrient and Drug Administration has approved cord blood from a donor to treat a variety of claret and allowed system disorders like leukemia, lymphoma and sickle cell disease, some individual cord blood companies are advertising this valuable fluid as a blanket biological insurance policy against a host of other atmospheric condition, including autism, cerebral palsy, Alzheimer's and more.
The only problem: It's not approved to treat any of these ailments.
"These are really cool cells and they have a lot of potential backdrop," said Paul Knoepfler, a stem cell biologist at the University of California, Davis. But before positioning them as a treatment for anything across blood diseases, researchers need to prove that they are prophylactic and effective. "And that hasn't been done," he said.
Why cord blood is and so special
Swirling around string claret are millions of special kinds of claret stem cells known equally hematopoietic stalk cells, which tin develop into any type of blood cell in the human body. On a given 24-hour interval, the stem cells in your bone marrow make billions of new red and white claret cells to replenish old ones that have died. But if they brand mistakes, the result can be serious, even fatal. Leukemia, for case, results when the body produces also many abnormal white claret cells, which can crowd out healthy ones.
Before the 1980s, the only way to get a claret stem cell transplant for a disease like leukemia was to use bone marrow from a donor. But that can be a long and challenging process (os marrow is not collected until you find a perfect match) and tin come with serious risks for the recipient (and sometimes for the donor). Cord blood transplants, which come from your own cord blood or a donor'southward and which are administered similar to a blood transfusion, proved to exist faster (cord blood has already been nerveless and can exist administered right away), less risky and in many cases, merely as useful. They likewise became a boon for people of color, since bone marrow registries in the United States tend non to be racially and ethnically various, and string blood doesn't crave equally verbal a friction match every bit bone marrow.
How banking works
Subsequently collection, your baby'southward cord claret is shipped to either a public or a private claret bank, depending on which you choose.
Public cord blood donations price the donor nothing and are fabricated available to anyone (including scientists) through a national registry. With public cyberbanking, withal, y'all can't ever ask for your own babe's cord blood back if a family unit member needs information technology.
Private cyberbanking, on the other hand, costs money but is held for your baby or another family member (most likely a sibling) when or if they may demand it. Banks typically charge an initial collection fee of $1,000 to $2,000 per birth, followed past about $150 to $200 per year (storage costs can vary from bank to banking concern). Insurance doesn't cover private banking, but some cord blood banks offer financial help for families with immediate relatives who have a known blood disorder and would benefit from a stem jail cell transplant.
It'south of import to know that if your baby has a genetic blood disorder, similar sickle cell anemia, her ain cord blood probably won't exist helpful in treating her status because her blood will contain the aforementioned genetic defect that is making her sick (this is also true of bone marrow transplants). In such a case, she would likely need cord blood from some other healthy donor, like a sibling.
In theory, your baby's banked claret can be preserved indefinitely. But because public cord blood banks have only been around for about 30 years, it'due south hard to know for certain how long frozen cord blood remains viable.
The controversy over individual banking
Though public and private banks provide a similar service — the ability to store cord blood — their methods and standards can differ essentially.
The F.D.A. considers publicly banked string blood a "drug" and a "biological production" that is bailiwick to strict requirements and regulations. Public banks must meet high sterility standards, and the blood must exist disease- and contamination-free and take a minimum number of cells before it is banked.
Private banks, on the other manus, don't ever meet the same quality or viability standards, and mostly don't impose a lower limit on the number of cells that must be collected. This means at that place is not always a guarantee that the banked blood volition incorporate enough stalk cells for a successful transplant. One express study published in 2010 institute that fewer than half of privately banked units in the United states of america met the F.D.A.'southward criteria, with public banks faring better.
Private banks are also for-profit companies. In some cases, their marketing advertises string blood as a therapy for conditions like autism or cerebral palsy, when in fact such treatments take not been proven to work, said Alan Leahigh, chief executive officeholder of the String Blood Association, a nonprofit that supports cord claret banking, research and awareness.
ViaCord, one of the nation'due south largest private banks, states on its website that "special properties of cord blood stem cells" may help those with autism, in part by encouraging their brain cells to repair and by boosting their immune system. As evidence for that claim, they reference a 2017 clinical trial of 25 children with autism who were given cord blood transfusions.
The trial did propose that the therapy might be safe. Simply it was non designed to determine whether information technology worked, said Dr. Joanne Kurtzberg, a pediatric hematologist-oncologist at Knuckles Academy Medical Center and president of the Cord Blood Association, who led the trial.
Dr. Kurtzberg has also led two subsequent Phase 2 clinical trials — one on the efficacy of cord claret transfusions as a handling for autism, and another on cerebral palsy. In both cases, while the results accept been encouraging, they are nevertheless preliminary; information technology would take larger, Phase three trials in more patients to prove that a treatment is truly safe and effective.
"I think that some of the companies yous're referring to leverage and take reward of our studies in a way that is premature," Dr. Kurtzberg said about individual string blood banks.
Some private string blood banks are likewise floating vague possibilities of regenerative stalk cell medicine as a cure for center affliction, Alzheimer'due south, diabetes and other weather. Not 1 of these therapies has fabricated it past a Stage 2 trial, or is approved by the F.D.A.
Morey Kraus, chief scientific officer at ViaCord, said that he understands that more than research on string blood is needed for use in unapproved conditions, just that fifty-fifty if the enquiry doesn't pan out, parents will have been glad they had the option of cyberbanking and trying information technology as a therapy.
Not everyone agrees: "The information advise in that location might exist a piffling help in that location, simply I find it not at all convincing," said Dr. Steven Joffe, a pediatric oncologist and bioethicist at the University of Pennsylvania Perelman School of Medicine. The cost of private banking "would be hard to justify at this indicate," he said, unless someone in the family has a known blood disorder that might require a stem cell transplant.
According to Dr. Knoepfler, string blood stem cells should non exist thought of as "some kind of panacea" for all diseases. "People are in desperate situations," he said, "they're looking for promise, and giving them false hope has definite downsides."
A difficult choice
At the terminate of the mean solar day, is information technology worth information technology to bank your babe's string claret? As with many medical matters, the answer is complicated.
The American Academy of Pediatrics and The American College of Obstetricians and Gynecologists say that in that location'southward non plenty evidence to recommend routine private string blood banking, except in unique circumstances: If a showtime- or 2nd-caste relative is in need of a stem cell transplant (because of a blood disorder like leukemia) or if someone in your family has a known genetic disorder, like sickle prison cell disease.
Only fifty-fifty in those instances, private banking is nonetheless a chance: At that place's not always a guarantee that your banked claret will contain plenty stalk cells to exist usable. And if that same genetic status happened to be passed on to your infant, the stalk cells would be unusable, a fact which private banks do not always make clear.
If your family doesn't accept a genetic illness or blood disorder, the odds of using your baby's ain blood are vanishingly pocket-size — particularly if you're saving it just for your infant. Co-ordinate to data posted on the website of Cryo-Jail cell, one of the country's oldest and largest private banks, near units they release go to clinical trials or family unit members of the newborn. They are almost never used to care for a blood disorder in the child itself.
The A.A.P. and ACOG, however, encourage families to consider public banking — non because it might benefit them specifically, but because it might exist a lifesaver for someone else.
How to decide
Whether you lot ultimately choose to bank your infant'due south string claret, it'south all-time to start thinking about it during your second trimester, then that you have enough time to ask yourself the relevant questions and discuss them with your family unit and provider. Is there a adept chance that someone in your immediate family will demand a stalk cell transplant? Is it of import to you to donate string blood? Is your hospital gear up to accept donations? Are y'all willing to pay for a service your infant or family may never apply?
If you make up one's mind to depository financial institution privately, notify your banking concern of option so that they can mail you a kit. Information technology normally takes a few days, but most private banks volition also rush a drove kit or deliver it directly to the hospital if you make a last-minute decision.
If you decide to go public, altruistic cord blood costs nothing and requires minimal planning. You'll even so need to make sure that your hospital of option is gear up to accept public donations — there are currently 16 public cord blood banks in the United States, and most 147 hospitals that can accept public donations.
Either way, it's a personal decision, and what works for someone else's family unit may not be correct for yours. "I do non call up a family should e'er feel like information technology's imperative to bank their kid's string claret, similar if they don't, they've denied their child access to some lifesaving therapy," said Dr. Kurtzberg.
If you take the fiscal means and understand the cells may never exist useful for annihilation, she said, then get ahead. Or else, donate them to a public bank where they're much more than probable to save someone'south life.
Dana Najjar is a journalist and software developer living in Brooklyn.
Source: https://www.nytimes.com/2020/12/18/parenting/pregnancy/cord-blood-banking.html
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