After a baby is born and the umbilical cord is cut, some blood remains in the blood vessels of the placenta and the portion of the umbilical cord that remains attached to it. After birth, the baby no longer needs this extra blood. This blood is called placental blood or umbilical cord blood: "cord blood" for short.
Cord blood contains all the normal elements of blood - red blood cells, white blood cells, platelets and plasma. But it is also rich in hematopoietic (blood-forming) stem cells, similar to those found in bone marrow. This is why cord blood can be used for transplantation as an alternative to bone marrow.
Cord blood is being used increasingly on an experimental basis as a source of stem cells, as an alternative to bone marrow. Most cord blood transplants have been performed in patients with blood and immune system diseases. Cord Blood transplants have also been performed for patients with genetic or metabolic diseases. More than 80 different diseases have been treated to date with unrelated cord blood transplants.
[Click here to see a list of diseases treated with cord blood from the NYBC's National Cord Blood Program (PDF)]
If you're expecting a baby, you might have thought about umbilical cord blood - along with the many other ways you can hope to make life safe for your child.
Expectant parents do all kinds of things for safety's sake. They plug up empty electrical sockets, childproof their cabinets, pore over car seat research, and measure the space between the bars of hand-me-down cribs -- all months before their son or daughter is born.
Cord blood transplants do not require a perfect match.
Studies have shown that cord blood transplants can be performed in cases that the donor and the recipient are partially matched. In contrast, bone marrow grafts require 8/8 matching in most cases.
Because partially matched cord blood transplants can be performed, cord blood increases the patient’s chance to find a suitable donor. With cord blood, a relatively small donor pool can effectively support most patients' needs. We have estimated, for example, that a national inventory of 150,000 cord blood units would provide acceptable matches for at least 80-90% of United States patients.
Some are now choosing a procedure that, they feel, could further protect their children from harm: umbilical cord blood banking.
The procedure takes blood from the umbilical cord at birth and stores it for a fee in a private blood bank. (Public banks are another option - see below.) Because this blood is rich in stem cells -- cells that have the ability to transform into just about any human cell -- it could someday be used as treatment if your child ever became ill with certain diseases. It might also be useful for a sick sibling or relative. Banking cord blood is a way of preserving potentially life-saving cells that usually get thrown away after birth.
But is banking worth it for most people? The banks argue that it's a form of "insurance" in case your children ever get sick. However, many medical associations -- like the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists -- don't support the practice for most people. They say that possible benefits are too remote to justify the costs.
"I don't tell any of my patients not to do it, but I point out that the odds that they will ever use the stored cord blood are very low," says Stephen Feig, professor of pediatrics at UCLA. "It's a very expensive insurance policy."
So the important thing is to make an informed choice. You need to know the benefits and costs of cord blood banking before you make any decisions.
Why Is Cord Blood Worth Saving?
Stem cells are immature cells that can both reproduce themselves and have the potential to turn into other types of cells. There are several types. The ones in umbilical cord blood and bone marrow are called hematopoietic progenitor cells (HPCs).
Some people (usually children and, sometimes, adults of small size) with certain diseases -- like leukemia, lymphoma, sickle cell anemia, and others - can be injected with these HPC stem cells to replenish their blood supply with new, healthy cells. The stem cells can also help the body recover from some cancer treatments like chemotherapy or radiation.
No one debates that cord blood cells can be lifesaving. "Cord blood is a proven, effective source of blood-forming stem cells for people with certain diseases," Feig tells WebMD.
According to the Institute of Medicine, HPCs have saved more than 20,000 lives in the U.S. in recent years, although the majority are from bone marrow transplants rather than cord blood. There have only been about 6,000 reported cord blood transplants.
sources: nationalcordbloodprogram.org & webmd
