BREAKING DOWN THE SCIENCE
What are stem cells?
Stem cells are considered the “master cells” of the body. These immature cells have the remarkable potential to develop into many different types of cells that make up our blood, tissue, organs, and immune system.1 Stem cells also act as an internal repair system by repeatedly dividing to replenish other cells as they die or are damaged.1
Where can you obtain stem cells come from?
Stem cells may be found in many places, including the bone marrow, cord blood and tissue, and placental blood and tissue.2 These stem cells are known as multipotent stem cells, which means they can give rise to multiple types of cells.3 The controversy around stem cell research was sparked by a different kind of stem cell, known as an embryonic stem cell.4 The stem cells collected from the cord and placenta are not embryonic and are non-controversial.
What are the different types of stem cells?
The two main types of stem cells are hematopoetic stem cells and mesenchymal stem cells.
Hematopoietic stem cells (HSCs):5
- Differentiate into any type of blood cell, including white and red blood cells and platelets
- Are found in umbilical cord blood, placental blood, bone marrow, and peripheral blood
- Have been used as medical treatment for over 25 years and for up to 80 different diseases, particularly for cancers of the blood6
Mesenchymal stem cells (MSCs):7
- Can differentiate into nerve cells as well as bone, cartilage, muscle, and fat
- Have anti-inflammatory and immunosuppressive properties that are believed to contribute to repair and regeneration of injured cells and tissue
- Are found in placental tissue
- Are found in umbilical cord tissue
- Are currently being researched for the treatment of diseases such as diabetes, heart disease, liver disease, stroke damage, and spinal cord injury8
What is a stem cell transplant?
A stem cell transplant is a type of medical treatment that offers the possibility of replacing diseased blood-forming cells (called hematopoietic stem cells) with healthy ones.9 Stem cell transplants can use stem cells that have been collected from cord blood, bone marrow, or peripheral (circulating) blood. But there are many advantages for certain people to have cord blood stem cell transplants.
Stem cells for transplantation can come from:
- The person having the procedure (“autologous transplants”)
- An unrelated matched donor (“unrelated allogeneic transplant”)
- A related matched donor (“related allogeneic transplant”)
Stem cell treatment for cancer
For people with leukemia, lymphoma, myeloma, myelodysplastic syndromes (MDS), and other blood cancers, a stem cell transplant will typically follow chemotherapy or radiation treatment.10 The procedure can also be beneficial for people with other inherited or acquired bone marrow or immune system disorders.
Stem cell transplant procedure
The stem cell transplant procedure itself has 4 key steps:9
- Stem cell collection, from either banked cord or placental blood, bone marrow, or PBSC
- Patient Preparation, including chemotherapy with or without radiation
- Transplantation, whereby the stem cells are put into the patient’s body through the veins
- Recovery, which can last weeks to months
What is cord blood banking?
Cord blood banking enables parents to save stem cells from the umbilical cord blood of their child immediately after birth. Families preserve these cells so that they are available for use in existing and future medical treatments.
What is placental stem cell banking, and why should I choose it?
With Lifebank, you can bank more stem cells—and more life-saving opportunities—by collecting from three stem-cell-rich sources: placental blood, cord blood, and placental tissue. Placental stem cell banking preserves potent stem cells from the blood of the placenta, and provides a greater number of stem cells for your family. Transplanting more stem cells has been shown to increase the probability of transplant success and survival.17,18,19 In the near future, having more cells available may also prove beneficial for new treatments in an emerging medical field called regenerative medicine.20,21,22 Placental stem cell banking gives you and your family the opportunity to take advantage of today’s medical treatments, should you need them, and tomorrow’s emerging medical advancements as they become reality.
What is placental tissue banking?
What is delayed cord clamping?
At birth, a baby is still attached to its mother by the umbilical cord, which is part of the placenta.23 Clamping the umbilical cord is the procedure typically used to separate the newborn baby from the placenta. For many years, it has been common practice to clamp the umbilical cord shortly after the baby is born (within 15 to 30 seconds) in order to help reduce the risk of maternal bleeding.1,23,24 Recently, however, the timing of cord clamping has been revisited.
Delayed cord clamping (at least 30 to 60 seconds after birth) allows continued blood ﬂow between the placenta, the umbilical cord, and the baby.23,25 Recent research has found that this can offer benefits to the baby. For instance, delayed cord clamping can improve iron stores in the first few months of life, possibly benefiting the baby’s later development.24 The benefits are even more pronounced in pre-term babies.26
In light of the mounting research in favor of delayed cord clamping, the American College of Obstetricians and Gynecologists now recommends a delay in umbilical cord clamping for at least 30 to 60 seconds after birth.27 Of course, the decision of whether or not to delay cord clamping should ultimately be made by the parents after discussing all the possible pros and cons with their doctor.
Is it possible to delay cord clamping if I also want to bank my baby’s cord blood?
There’s a lot of recent discussion about delayed cord clamping vs. cord blood banking. The concern is that a delay in clamping the umbilical cord leaves less blood in the cord and placenta, resulting in fewer stem cells in your collection.
The point of delayed cord clamping is to allow some of the stem-cell-rich blood from the umbilical cord to flow into the newborn baby. This is most likely to happen within the first 30 to 60 seconds after birth.23 Research has found that delaying cord clamping by 20 seconds or more leads to a significant decrease (several hundred million cells fewer) in the recovered cell count.28 However, even though there is less cord blood, and therefore fewer stem cells, with delayed cord clamping, you can still collect a meaningful, albeit smaller, number of stem cells.
If you decide on delayed cord clamping with advice from your doctor, then there’s even more reason to consider placental blood banking in addition to your cord blood collection. Banking placental blood increases the total number of stem cells collected. Lifebank offers expectant parents the opportunity to collect stem cells from the placental blood.
Ultimately, the decision of whether or not to delay cord clamping should be made by the parents after discussing all the possible pros and cons with their doctor.
CHOOSING YOUR BLOOD BANK
Why would I bank stem cells if my family has no history of blood diseases?
Every 2 minutes a child is diagnosed with cancer.11 Many families have no prior history of the disease, which may require treatment with stem cell transplants. In addition, stem cells are actively being studied in an emerging medical field called regenerative medicine. So your family could potentially benefit from future stem cell-related treatments.
How much does cord blood banking cost?
Lifebank has a range of pricing options across our banking services to meet your family’s individual needs. The cost of cord blood banking with Lifebank starts at $1,495 for enrollment, collection and processing, and the first year of storage. Thereafter, storage fees start at $125 a year (when prepaid for 25 years).
Our comprehensive banking options allow your family to take advantage of more of the benefits of both today’s and tomorrow’s stem‑cell‑based medical treatments. Adding placental blood, placental tissue, or cord blood tissue to your cord blood collection will be reflected in the associated costs. Learn more about our comprehensive banking services and their associated prices.
Ways to help manage the cost
To help your family manage the cost of cord blood banking and our other banking services, Lifebank offers several cost-saving programs, including:
- Lifebank Gift Registry: Receive contributions from friends and family members toward the cost of banking
- Refer a Friend and Save: Ask us about our referral programs
- Bank Again at a Discount: Call for a discount on enrollment when you bank with us a second (or third!) time
How are stem cells processed?
When considering the cost of cord blood banking, it can be helpful to understand just where your money will go. Lifebank uses state-of-the-art collection, processing, and storage methods to help ensure that your baby’s stem cells are preserved for the long term, giving you immediate access if you should need them. Lifebank’s heparin-free collection process uses an FDA-recommended cell-protecting solution called citrate phosphate dextrose (CPD), which allows cells to maintain their integrity in the time between collection and processing.
Lifebank removes red blood cells, which have no therapeutic benefit and can lead to transplant complications13, from cord blood through a customized process called “red blood cell depletion”.
Our process ensures that the cord blood units are 99% pure* on average.4 Our trained technicians manually separate red blood cells from stem cells, giving your collection the personalized attention it deserves. Other cord blood banks use an automated process and may have purity levels as low as 71%.15,16
*Purity is defined as the absence of red blood cells in cord blood.
Is cord blood banking worth it?
When expectant parents are considering the pros and cons of cord blood banking, the cost of private banking is often a source of concern. With enrollment, collection, processing, and storage fees, it’s understandable to wonder, “Is cord blood banking worth it?”—especially at a time when the regular costs of having and taking care of a new baby are looming.
Cord blood banking can be thought of as “biological insurance” for your child and your family’s future health. Your child or a family member has a 1 in 200 chance of needing a stem cell transplant during their lifetime.12 Paying $123 to $150 a year for cord blood banking with Lifebank (in addition to a collection fee) is a lot less than the cost of other insurance policies we don’t hesitate to buy, such as life, health, property, or car insurance.
Consider your family history
The case for whether cord blood banking is worth it becomes even stronger if there’s already a family history of one of the diseases currently treatable with cord blood, including leukemia, lymphomas, sickle cell anemia, and immune deficiency diseases, among others. With a family history of one of these diseases, your family’s chances of needing a stem cell transplant at some point in the future are higher than the general population’s.
Planning for more than one child?
You may find the idea of cord blood banking particularly reassuring if you have or plan to have more than one child. Your baby’s cord blood stem cells can be used for siblings and other family members. Your baby’s stem cells have a 25% chance of being a perfect genetic match and a 50% chance of being a partial genetic match for your baby’s brother or sister. So you’re not just banking for your baby’s benefit, but truly for your whole family.
Plan for the future
Like other insurance, cord blood banking provides security, in this case against a number of life-threatening diseases – and that can be considered priceless. By adding placental blood, placental tissue, and cord tissue to your cord blood collection, you’re increasing the odds of your family being able to take advantage of future medical advancements as they become available, including regenerative medicine.
If I donate to a public bank, can I access my collection if I need it?
Once a family makes a donation, assuming it meets collection standards, the stem cells become available for any potential matching patient or for research. There’s no way to guarantee access to your child’s stem cells (a perfect genetic match) at a later date.
If someone from my family needed a transplant, couldn’t we use stem cells from a public bank?
It’s possible, but public banks rely on donations and cannot guarantee that a good genetic match will be available. Unfortunately, many patients who need stem cell transplants don’t receive them because they are unable to find a suitable match from a public bank.29
Private stem cell banking ensures that you have immediate access to an adequate number of stem cells that are a perfect genetic match for your child.* In addition, your baby’s stem cells have a much greater likelihood of providing a good match for other close blood relatives, such as a first-degree relative (parent, sibling, or child).
*For some diseases and genetic conditions, children will not be able to use their own stem cells and would require a stem cell transplant from a sibling or unrelated donor.
How and when should I enroll with Lifebank to save my baby’s stem cells?
The sooner, the better! As soon as you enroll to take advantage of this once-in-a-lifetime opportunity, we will mail you your collection kit so you have it well in advance of your baby’s birth.
Is the collection process safe?
Absolutely! The entire process is performed by your own healthcare provider, is non-invasive, and only takes about 5 minutes. Once your baby is born and the umbilical cord has been cut, your healthcare provider will collect blood from the portion of the cord still attached to the placenta. If you are banking placental stem cells, the entire placenta will be collected separately and placed into a special bag. The collection kit will then be transported by medical courier to the Lifebank laboratories for processing and preservation. The stem cells will be cryopreserved in a vapor-phase liquid nitrogen storage tank that is continuously monitored 24 hours a day, 7 days a week until the time when your family may need them. Learn more about the collection process.
REFERENCES & NOTES
- National Institutes of Health. Stem cell basics: 1. Introduction. Available at: https://stemcells.nih.gov/info/basics/1.htm. Accessed Jan. 11, 2017.
- National Institutes of Health. Stem cell basics: frequently asked questions (FAQs). Available at: https://stemcells.nih.gov/info/faqs.htm. Accessed Jan. 19, 2017.
- Weiss M and Troyer DL. Stem Cells in the Umbilical Cord. Stem Cell Rev. 2006; 2(2):155–162.
- Rubinstein P, Rosenfield RE, Adamson JW, Stevens CE. Stored Placental Blood for Unrelated Bone Marrow Reconstitution. Blood. 1993; 81(7):1679-1690.
- National Institutes of Health. Regenerative Medicine: 2. Bone Marrow (Hematopoietic) Stem Cells. Available at: https://stemcells.nih.gov/info/Regenerative_Medicine/2006Chapter2.htm. Accessed Jan. 19, 2017.
- Moise K Jr. Umbilical cord stem cells. Obstet Gynecol. 2005;106(6):1393-1407.
- Via AG, Frizziero A, Oliva F. Biological properties of mesenchymal stem cells from different sources. Muscles, Ligaments and Tendons Journal 2012; 2(3):154-162.
- National Institutes of Health. Mesenchymal Stem Cells. ClinicalTrials.gov. Available at: https://clinicaltrials.gov/ct2/results?term=mesenchymal+stem+cells&Search=Search. Accessed Jan. 19, 2017.
- U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA). Learn About Transplantation as a Treatment Option. Available at: https://bloodcell.transplant.hrsa.gov/transplant/understanding_tx/index.html#Treatment. Accessed on Jan. 18, 2017.
- The Leukemia & Lymphoma Society. Cord Blood Stem Cell Transplantation. 2007. Available at https://www.lls.org/sites/default/files/file_assets/cordbloodstemcelltransplantation.pdf. Accessed on Jan. 18, 2017.
- St. Baldrick’s Foundation. New Data Shows a Child Is Diagnosed With Cancer Every 2 Minutes. Available at: http://www.stbaldricks.org/blog/post/new-data-shows-a-child-is-diagnosed-with-cancer-every-2-minutes/. Accessed Jan. 11, 2017.
- Nietfeld J. Lifetime probabilities of hematopoietic stem cells transplantation in the U.S. Biol Blood Marrow Transplant. 2008;14(3):316–322.
- Parent’s Guide to Cord Blood Foundation. Why red blood cells should be removed before cord blood storage. Available at: https://parentsguidecordblood.org/en/news/why-red-blood-cells-should-be-removed-cord-blood-storage. Accessed Jan. 19, 2016.
- Data on file, LifebankUSA; 2010.
- Henderson C, Wofford J, Fortune F, Regan D. Evaluation of Processing Technologies for Umbilical Cord Blood (UCB). Poster presented at: ISCT Annual Meeting; May 2010; Philadelphia, PA.
- Dobrila L, Chapman J, Marr D, Kumar V, Coelho P, Rubinstein P. ThermoGenesis AXP AutoXpress™ Platform and BioArchive™ System for Automated Cord Blood Banking. Poster presented at: XXIXth International Congress of the International Society of Blood Transfusion; September 2006; Cape Town, South Africa.
- Gluckman E, Rocha V. Donor selection for unrelated cord blood transplants. Curr Opin Immunol. 2006; 18(5):565-570.
- Schoemans H, Theunissen K, Maertens J, Boogaerts M, Verfaillie C, Wagner J. Adult umbilical cord blood transplantation: a comprehensive review. Bone Marrow Transpl. 2006;38(2):83-93.
- Kamani N, Spellman S, Hurley CK, et al. State of the Art Review: HLA Matching and Outcome of Unrelated Donor Umbilical Cord Blood Transplants. Biol Blood Marrow Tr. 2008; 14(1):1-6.
- Richardson SM, Hoyland JA, Mobasheri R, Csaki C, Shakibaei M, Mobasheri A. Mesenchymal Stem Cells in Regenerative Medicine: Opportunities and Challenges for Articular Cartilage and Intervertebral Disc Tissue Engineering. J Cell Physiol. 2010; 222(1):23-32.
- Yen BL, Huang H-I, Chien C-C, et al. Isolation of multipotent cells from human term placenta. Stem Cells. 2005; 23(1):3-9.
- daSilva Meirelles L, Caplan AI, Nardi NB. In search of the in vivo identity of mesenchymal stem cells. Stem Cells. 2008; 26(9):2287-2299.
- Rabe H, Diaz-Rossello JL, Duley L, Dowswell T. Effect of timing of umbilical cord clamping and strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev. 2012;8(CD003248).
- McDonald SJ, Middleton P, Dowswell T, Morris PS. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev. 2008;2(CD004074).
- Allan DS, Scrivens N, Lawless T, Mostert K, Oppenheimer L, Walker M, Petraszko T, Elmoazzen H. Delayed clamping of the umbilical cord after delivery and implications for public cord blood banking. Transfusion 2016;56(3);662-665.
- Sommers R, Stonestreet BS, Oh W, Laptook A, Yanowitz TD, Raker C, Mercer J. Hemodynamic Effects of Delayed Cord Clamping in Premature Infants. Pediatrics. 2012;129(3):e667–e672.
- Delayed umbilical cord clamping after birth. Committee Opinion No. 684. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;129:e5–10.
- Parent’s Guide to Cord Blood Foundation. Timing of Umbilical Cord Clamping and Impact on Cord Blood Volume Collected for Banking. Available at http://parentsguidecordblood.org/en/news/timing-umbilical-cord-clamping-and-impact-cord-blood-volume-collected-banking. Accessed on Jan. 19, 2017.
- The Bone Marrow Foundation. Become a bone marrow/stem cell donor. Available at: http://bonemarrow.org/help/become-a-donor/. Accessed Jan. 11, 2017.