JULY BLOG

CORD AWARENESS

What is cord blood?

Cord blood contains the same powerful stem cells that help the baby develop organs, blood, tissue and an immune system during pregnancy.   After the baby is born or even after delayed cord clamping, there is blood left over in the umbilical cord that can be collected and saved, or 'banked.'  Cord blood contains hematopoietic progenitor cells or blood-forming stem cells.  At birth, cord blood can be collected or recovered from the umbilical cord.

Cord blood is the blood in the placental blood vessels and umbilical cord that connects the unborn baby to the mother's womb.  The umbilical cord fluid is loaded with stem cells, which can treat cancer, blood diseases such as anemia and some immune system disorders.   Stem cells from cord blood rarely carry infectious diseases and are half as likely to be rejected as adult stem cells.

Expecting a baby can be a very exciting and very confusing time.  One choice parents face is whether to donate, bank or discard their baby's cord blood.  Did you know that the Food and Drug Administration, FDA, regulates cord blood?  Here is information about regulations in place to help ensure the safety of cord blood for transplantation.

What are hematopoietic progenitor cells?

Hematopoietic progenitor cells, HPC’s, are found in bone marrow, peripheral blood and cord blood.  These stem cells are routinely used to treat patients with cancers such as leukemia or lymphoma and other disorders of the blood and immune systems.

Why Bank Cord Blood?

Umbilical cord blood stem cells have the unique ability to help rebuild a healthy immune system damaged by disease.  Cord blood has been used in transplant medicine for nearly 30 years and can be used in the treatment of nearly 80 different diseases.  Over the last few years,

cord blood use has expanded beyond transplant medicine into clinical research trials for conditions like autism and brain injuries. 

What Is Cord Blood Used For Today?

Researchers have been using cord blood in clinical trials for regenerative medicine for conditions like autism and cerebral palsy over the last few years.   In using cord blood in regenerative medicine, researchers are hopeful that cells will regenerate or help repair damage by disease, genetics, or injury by stimulating the body's own repair mechanisms.  Cord blood has been used in transplant medicine for thirty years.   Over 35,000 patients of all ages have received stem cell transplants from cord blood.  Cord blood can be used in the treatment of nearly 80 diseases, including:

• Cancers
• Blood Disorders 
• Bone Marrow Failure Syndromes
• Metabolic Disorders 
• Immune Disorders 

How is cord blood collected?

The fluid is easy to collect and has 10 times more stem cells than those collected from bone marrow.  The process is safe, painless and will not interfere with birth plans or bonding time with your new baby.  After the baby is born, the umbilical cord is clamped and cut.  The remaining blood drains into a collection bag.   The benefit of cord blood is an invaluable medical resource.  The cells in cord blood haven't been exposed to potentially harmful factors impacting stem cells collected later in life, saving the pristine cells moments after the baby is born.

How are patients and donated cord blood units “matched” so that a unit of cord blood can be used for a patient’s transplant?

Human leukocyte antigen, HLA typing is used to match patients and donors for cord blood transplants.  HLA’s are proteins found on most cells in the body.  The immune system uses these proteins as markers to recognize which cells belong in their body and which do not.  A close match between the patient’s and the donor's HLA markers can reduce the risk the patient’s immune cells will attack the donor's cells or that the donor's immune cells will attack the patient’s body after the transplant.

How are HPCs from cord blood different than HPCs from other sources?

Evidence shows that cord blood HPC’s may not require as exact a match as HPCs from bone marrow or the bloodstream because the antigens in cord blood are less mature.  This suggests transplants involving compatible HPC’s from cord blood may less likely cause adverse reactions because donor’s cells are less likely to see the patient’s cells as foreign bodies and attack them!

What are the options for cord blood banking?

Cord blood can be donated to a public cord blood bank to be stored for potential future use by anyone who may need it.  Alternatively, parents may arrange for the cord blood to be stored in a private cord bank, for use if later needed for treatment of the child from whom it was recovered or for use in first- or second-degree relatives.  You may also wish to consult your health care provider about the options.  Information on cord blood donation options may be found on the Health Resources and Services Administration (HRSA) web site. 

How does FDA regulate cord blood stored for personal or family use? 

Cord blood stored for personal use and use in first- or second-degree relatives meeting criteria of “drug” under the Food, Drug & Cosmetic Act and “biological product” under Section 351 of the Public Health Service Act.  Cord blood in this category must meet additional requirements and be licensed under a biologics license application, does not require approval before use.  Private cord banks must comply with other FDA requirements, including establishment registration and listing, donor screening and testing for infectious diseases (except when used for the original donor), reporting and labeling requirements, and compliance with current good tissue practice regulations. 

Stored cord blood can't always be used, even if the person develops a disease later on.  If a disease is caused by a genetic mutation, it will also be in the stem cells.  Current research indicates stored blood may only be useful for 15 years.

The American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics don’t recommend routine cord blood storage.  They state private banks should only be used when there’s a sibling with a medical condition who could benefit from the stem cells.  Families are encouraged to donate stem cells to a public bank to help others.

Where can I get more information about donating baby cord blood?

To make your baby's cord blood available for use by anyone who needs a cord blood transplant, you may donate it to a public cord blood bank.  Information on donating cord blood to a public cord blood bank is also found on the HRSA web site.

Who can use your baby's cord blood?

There is confusion who can use cord blood stem cells in treatment — the baby they were collected from or a sibling!!  The short answer is both, but depends on the condition being treated or ultimately the treating physician's decision!

• Your Baby - may be able to use his or her own cord blood in the treatment of certain non-genetic diseases and cancers, like neuroblastoma.  Participation in certain clinical trials such as autism and cerebral palsy, require children to have access to their own cord blood.
• A Sibling - in need of a stem cells donor may be able to use baby cord blood.  Treatments using cord blood from a family member are about twice as successful as those from a non-relative.

What about cord tissue?

Cord tissue is not quite ready for prime time yet, but excitement is growing around its potential to help conditions affecting cartilage, muscle and nerve cells continues to grow.   Researchers are focusing on a wide range of potential treatment areas, including Parkinson’s disease, Alzheimer’s, liver fibrosis, lung cancer, and sports injuries.   Since 2007, there have been 150 clinical trials using cord tissue stem cells.

There is a high likelihood that immediate biological family members could benefit from the baby’s cord tissue stem cells with parents having a 100% likelihood of compatibility and with siblings at 75% and grandparents at 25%.   

Other Areas Of Regenerative Medicine Using Cord Blood In Research

• Brain Injury - Stroke  and  Hypoxic-Ischemic Encephalopathy (HI) 
• Cardiac - Hypoplastic Left Heart Syndrome  (HLHS) 
• Hearing -  Acquired Hearing Loss 
• Autoimmune Deficiencies - Type 1 Diabetes 

Diseases Treated

• Leukemia is a cancer of the blood immune system, where the cells are called leukocytes or white cells
• Myelodysplastic Syndromes are also called pre-leukemia  
• Lymphoma is a cancer of the leukocytes that circulate in the blood and lymph
• Other Disorders of Blood Cell Proliferation  
• Transplants for Inherited Disorders of the Immune System & Other Organs  
• Transplants for Inherited Metabolic Disorders
• Solid tumors not originating in the blood or immune system
• Neurologic Disorder
• Auto-Immune Disorders
• Cardiovascular
• Diabetic
• Genetic and/or Metabolic Disorders
• Orthopedic

To learn more about cord blood banking, visit Parent's Guide to Cord Blood Foundation at https://parentsguidecordblood.org/en/diseases

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PROFESSIONAL

• https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/cord-blood-banking-information-consumers
• https://www.viacord.com/why-bank/cord-blood/
• https://www.viacord.com/why-bank/benefits-of-cord-blood/
• https://www.webmd.com/parenting/baby/should-you-bank-your-babys-cord-blood#1
• https://www.viacord.com/why-bank/cord-blood/
• https://www.viacord.com/treatments-and-research/treatable-diseases-today/
• https://www.viacord.com/treatments-and-research/regenerative-medicine/
• https://parentsguidecordblood.org/en/diseases