Sunday, April 23, 2006

Discussion with husband : Cord Blood Banking

I brought this up to my husband last night about Stem Cord Banking. I was surprised that he didn't know anything about this or heard about it. Well, the first time I heard about it was in 2002 when StemCord was set up in Singapore. However at that time it wasn't common to store Stem Cord and I do not really understand much of it and then I "bomb", next minute the important cells from my little girl's umbilical cord is thrown away.And not forgetting the placenta too( should have asked gynae to smear the placenta on my face!).

So this time, I've brought this up to my husband. With the reasons that we did not do any banking for our first born and if we kept this for the second born, it will help him/her and his/her sibling. And this is the last chance as I'm not planning to have anymore children. So it's now or never.........

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These are extracted from StemCord website on their FAQs :
1. What is in umbilical cord blood that is so important?
2. What are blood stem cells?
3. Why blood stem cells useful and valuable?
4. What are the advantages of storing blood stem cells from cord blood?
5. What is cord blood banking?
6. Who is suitable for cord blood banking?
7. How is cord blood collected and stored?
8. Are there any risks to mother or the baby?
9. Ethical issues
10. How long can stem cells be stored?
11. Why do families choose to collect and store their baby's cord blood?
12. Can I bank my baby's cord blood with a public cord blood bank?
13. Wow do we know that the stem cells processed and stored at StemCord are still viable?
14. Are we sure that these cryopreserved stem cells will work when we need to use them years later?


UMBILICAL CORD BLOOD
Following the birth of a baby, the umbilical cord usually is discarded along with the placenta. However, it is now known that blood retrieved from the umbilical cord is a rich source of stem cells. Stem cells are immature, pluripotent cells that can produce all other blood cells, including blood-clotting platelets and red and white blood cells. Like donated bone marrow, umbilical cord blood can be used to treat various genetic disorders that affect the blood and immune system, leukemia and certain cancers, and some inherited disorders of body chemistry. To date, more than 45 disorders can be treated with stem cells from umbilical cord blood.


WHAT ARE BLOOD STEM CELLS?
Blood stem cells are the “grandfather” of blood cells. They produce blood cells such as white blood cells, red blood cells and platelets which are essential for normal life. Blood stem cells are usually found in the bone marrow and in the peripheral blood circulation (smaller quantities). In the 1980s, the umbilical cord blood was noted to contain large amounts of blood stem cells also


WHY BLOOD STEM CELLS ARE USEFUL AND VALUABLE?
Blood stem cells are crucial for stem cell transplants (SCT). SCT is a very important treatment option for many blood disorders and cancers. Without blood stem cells, a patient will not have this option and may not have a chance of a cure. Because of this, various public blood stem cell banks have been set up across the world to provide potential blood stem cell donors. These public stem cell banks are in the form of bone marrow registries or public cord blood banks

In private cord blood banks, an individual can keep his/her own blood stem cells. These stored blood stem cells may provide a treatment option for him/her in the future.


WHAT ARE THE ADVANTAGES OF STORING BLOOD STEM CELLS FROM CORD BLOOD?
1. Blood stem cells from cord blood are easier to harvest . The harvesting process does not entail any risk to both mother and child. Harvesting blood stem cells from the bone marrow requires general anaesthesia, which entails some health risk. Bone marrow harvesting also involves some pain, as oppose to no pain at all with cord blood harvesting.
2. Stem cell transplants using cord blood has less Graft Versus Host Disease (GVHD) and hence has lower risks to the recipient . This is due to the “less matured” nature of the blood stem cells in cord blood in comparison to those from bone marrow and peripheral blood.
3.Because of lower GVHD risk, cord blood transplants can be attempted even if there is no perfect HLA matching.
4. In private cord blood banking, the stored blood stem cells are kept for the individual. But in view of the above, the stored cord blood stem cells can potentially be used for other family members .
5. The stored cord blood stem cells are always readily available. This is a potential advantage as we do not waste precious time searching for potential blood stem cell donors. In some conditions, e.g. Aplastic Anemia, the time to a stem cell transplant is critical and having some blood stem cells readily available is very important.
6. Cord blood is less likely to contain certain infectious agents , like some viruses such as cytomegalovirus that can pose a risk to transplant recipients.
7. Some studies suggest that cord blood may have a greater ability to generate new blood cells than bone marrow. Ounce for ounce, there are nearly 10 times as many blood-producing cells in cord blood. This fact suggests that a smaller number of cord blood cells are needed for a successful transplantation.


WHAT IS CORD BLOOD BANKING?
Cord blood banking is the collection and storage of blood taken from the umbilical cord after the baby is delivered. Cord blood is one of the richest sources of stem cells. Stem cells are unique primitive cells that have the capability of differentiating into a variety of cell types of the body. Currently, there is a lot of research being done, looking into using these stem cells for treatment of many other illnesses.


WHO IS SUITABLE FOR CORD BLOOD BANKING?
Storing cord blood is suitable for everyone unless it is a difficult or complicated pregnancy. Your obstetrician will be able to advise you accordingly. Storing these valuable cells for your newborn baby will provide them into a form of “biological insurance”.

Cord blood banking is particularly useful and advisable for the following :


1. Family history of blood disorder and cancers
Potentially may offer an extra treatment option in the form of stem cell transplant.
2. Small family size, single child family, late pregnancies (>35 yrs old), difficult pregnancies or sub fertile couples.
In this situations, the child may be the only child and hence will not have any donor, should he/she develop any diseases that require a stem cell transplant.
3. Mixed Marriages (from different races)
In this situation, it is very unlikely to be able to get a donor from the public stem cell banks as the genetic constitution will be very different. It is similar to people with rare blood groups.
4. The First Born
It is advisable to collect for the first born as we will never know if subsequent pregnancies will be successful. As such, if the first born becomes the only child, he will not have any siblings to depend on for blood stem cells, should he require any.


HOW IS CORD BLOOD COLLECTED AND STORED?
Cord blood is collected after the baby is delivered and the umbilical cord is clamped and cut. Cord blood collection is a procedure that usually takes less than five minutes and can be performed in vaginal or caesarean deliveries and for multiple births. StemCord offers both the syringe or bag collection method, which gives your doctor a choice to use the method he or she prefers. With the syringe, the collection is similar to drawing blood for a blood test. After your baby has been born and the cord has been clamped and cut, the blood will be drawn from the umbilical cord before it is discarded. The bag collection method is similar, only gravity is used to drain the umbilical cord blood into the collection bag. Everything your doctor needs is contained in the kit you receive upon enrollment.

After collection, the blood is transported to the laboratory. It will be then processed by a special method and then stored in liquid nitrogen tanks at -180oC. Regardless of how the cord blood is collected (syringe or bag), we store the sample in multiple cryovials that are specifically designed for long-term cryogenic storage and have a long history of proven dependability and flexibility for future use. Stem cell technology is evolving rapidly, we believe that storage in multiple vials provides our clients with a significant future benefit because the cells may potentially be used for more than one treatment. We have a double-containment system, which is designed to eliminate the potential risk of cross-contamination during long-term storage. This system provides the most secure, long-term cryogenic storage available. The ability to cryosheath the vial as well as the risk of bag breakage in liquid nitrogen are the primary reasons we store the cells in cryovials instead of blood bags.


ARE THERE ANY RISKS TO THE MOTHER OR BABY?
There are no risks to both mother and baby as cord blood is collected only after baby is delivered and the cord is clamped and cut. The volume of blood collected is small and negligible and hence does not “bleed” the mother.


ETHICAL ISSUES
Unlike using stem cells taken from embryos, there are no ethical issues involved in the collection or usage of stem cells from cord blood. If cells from this source are not stored, the blood is discarded and hence valuable stem cells will be lost. Collection of these unique cells will only be possible and available at time of birth of the child.


HOW LONG CAN STEM CELLS BE STORED?
Researchers believe that stem cells can be stored for indefinite period of time. In terms of published literature, cryopreserved stem cells had been proven to remain viable after 15 years of storage.


WHY DO FAMILIES CHOOSE TO COLLECT AND STORE THEIR BABY'S CORD BLOOD?
Once-in-a-Lifetime Opportunity – Only at Birth

Expectant parents are storing cord blood for their families, not only as a potential life-saving resource for current uses of stem cells, but also for their future potential. Some families have more defined risk factors, but most often, parents bank for the security in knowing the health benefits stem cells may someday offer their children themselves, or other family members.

Recent clinical studies support the unique suitability of cord blood stem cells for a number of developing technologies. Doctors are especially enthusiastic about the potential use of cord blood stem cells in the emerging fields of gene therapy and cellular repair. When you bank your baby's cord blood stem cells, you are saving what may be a key component to potential future medical treatments and cures.


CAN I BANK MY BABY'S CORD BLOOD WITH A PUBLIC CORD BLOOD BANK?
With the cord blood donated to a public bank, if it has not been used for research or by someone else, a family might be able to retrieve their donated sample. It is important for parents to understand that not all donated samples are banked. This same discipline applies to a normal blood donation drive that not everybody is suitable for blood donation. A rejection from the public banks could be based on family medical history, maternal medical history, collection volume, and examination of the maternal blood sample.

If autologous cells are not available, or cannot be used, stem cells from a relative (preferably a sibling) are usually the next best treatment option. Unrelated cord blood puts the patient at a much greater risk of developing potentially fatal GVHD. Related cord blood also reduces the risk that the transplant sample may harbor genetic problems that could cause disease in the recipient because of the family's prior knowledge of their genetic history.

Cord blood cells, being less mature than adult stem cells, have a higher likelihood of being a suitable HLA match between siblings as compared to only a slim chance for bone marrow. Public banks can ensure an adequate sample for transplant but not the best or most preferred sample. Families that personally bank their baby's cord blood stem cells have the assurance and security of the closest match for either child or family member, without fear of not finding a match.


HOW DO WE KNOW THAT THE STEM CELLS PROCESSED AND STORED AT STEMCORD ARE STILL VIABLE?
Right from the beginning, StemCord had put in place many quality checks and work processes to maintain the viability of these cryopreserved stem cells. These measures are in strict accordance with the standards of the American Association of Blood Banks and had been certified by the licensing unit of the Ministry of Health.


ARE WE SURE THAT THESE CRYOPRESERVED STEM CELLS WILL WORK WHEN WE NEED TO USE THEM YEARS LATER?
StemCord is proud to announce that it had contributed and helped in the care of patients with cancers from the lymphatics, marrow, nose, soft tissue and ovary. Blood stem cells had been collected from the blood or bone marrow of these patients. These units were processed and stored at –180 degrees Celsius in StemCord Laboratory. They were subsequently used in conventional Stem Cell Transplants for these patients. We are happy to announce that all patients had engrafted. Their engraftment had varied from 9 to 29 days. This data is consistent with international norms for patients with similar age and clinical features.

This engraftment data is the ultimate proof that StemCord's processing & storage of stem cells (irrespective from bone marrow, peripheral blood or umbilical cord blood) works.

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So, anyway on this. This is what I found out.

StemCord
Cordlife
Public Bank

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