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What is umbilical cord blood?

Umbilical cord blood, or simply cord blood, is the blood left in the umbilical cord and placenta after the baby is born and the cord is cut. Usually, along with the umbilical cord and placenta, this blood is discarded as medical waste as it was thought to have no use. How wrong we were: recent advances in medical science have shown how IMPORTANT umbilical cord blood is. For one, it is a very rich source of stem cells (for this purpose, the blood has to be collected within 10 minutes of the birth). And stem cells, if you’ve been living under a rock these past few years, are currently one of the greatest hopes of mankind in overcoming otherwise untreatable diseases, such as those affecting the blood and immune system, or certain genetic disorders that are just so tricky to cure.

But wait, what are stem cells?

Stem cells are unspecialized cells that produce all blood cells. Think of them as blank “seed” cells that are programmed to eventually differentiate into specialized cells, as needed by the body. Therefore, stem cells can become (depending on need) platelets (which clot the blood to stop bleeding), red blood cells (transport oxygen to the cells), and white blood cells (the “soldiers” of our immune system that fights off disease).

How awesome are stem cells from umbilical cord blood?

To date, about 70 medical disorders have been treated with stem cells taken from cord blood—that’s how awesome! To put it simply: it SAVES LIVES!

People undergoing chemotherapy or radiation therapy (such as those with cancer) end up having their stem cells destroyed. This is a very dangerous condition, so they receive a stem cell transplant, taken from a donor (traditionally collected from the donor’s bone marrow—very painful!—or normal blood), and injected usually through a large vein in the chest. The transplanted cells find their way into the patient’s bone marrow, in which it is hoped that the stem cells will replicate and produce new blood cells in order to rebuild the person’s blood and immune system.

Stem cell transplants can save lives of people with serious diseases, such as leukemia (cancer of the white blood cells) and other cancers, or those with serious blood disorders (aplastic anemia). Recently, it has been found that umbilical cord blood stem cells can also be used in the treatment of brain injury, cerebral palsy, type 1 diabetes, and heart disorders. For children requiring such a stem cell transplant, umbilical cord blood is used; for adults, bone marrow transplant is used. However, with increasing knowledge and efficiency regarding umbilical cord stem cells transplant, adults are increasingly receiving this transplant as well.

Why are cord blood stem cells so important?

Although stem cells can also be taken from the bone marrow and normal blood, cord blood stem cells offer a number of advantages. Such as the following:

1. It is safe and easy to collect umbilical cord stem cells. It poses no risk to both the mother and baby, as the umbilical cord blood anyway would have been discarded. On the other hand, collecting stem cells from bone marrow is very painful and is actually already a form of surgery: it uses general or spinal anesthesia, and it poses a small risk of serious complications. Plus, it is so darned painful. The same thing with getting stem cells from normal blood: the donor gets several injections to stimulate the release of stem cells into the blood, and this sometimes causes bone pain and serious complications. All these things are not a problem with umbilical cord blood stem cells.
2. More matches: For a bone-marrow transplant to succeed, there must be a nearly perfect match of certain tissue proteins (called human leukocyte antigens or HLAs) between the donor and the recipient. Family members, such as siblings, are most likely to be a tissue match. However, only about 30 percent of individuals requiring a stem-cell transplant have a relative that is an appropriate tissue match. When stem cells from cord blood are used, the donor cells appear more likely to “take” or engraft, even when there are partial tissue mismatches. This means that more individuals may be able to find an appropriate match using cord blood.
3. Faster availability: Many individuals who do not have an appropriately matched family member can find a matched donor through national bone-marrow and cord-blood registries. It often takes at least two months to locate an appropriate bone- marrow donor compared to about two weeks for a cord-blood unit. The banked cord-blood cells also are available almost immediately. This can be crucial for patients with severe disorders who might die before an appropriate bone marrow donor can be found and complete the donation process.
4. More ethnic diversity: Members of non-white ethnic and racial groups often find it more difficult to find a match through a bone-marrow registry because there are fewer registered potential donors from non-white groups. The increasing use of cord-blood cells may make timely treatment available for more of these individuals.
5. Reduced risk of graft vs. host disease (GVHD): GVHD is a potentially fatal complication, in which donor cells attack the recipient’s tissues. This complication appears to occur less frequently with cord blood than with bone marrow, possibly because cord-blood cells are immature and may lack the ability to attack the recipient. A 2000 study found that children who received a cord-blood transplant from a closely matched sibling were 59 percent less likely to develop GVHD than children who received a bone marrow transplant from a closely matched sibling.
6. Fewer infections: Cord blood is less likely to contain viruses that can pose a risk to transplant recipients.

Moreover, some studies suggest that cord blood may have a greater ability to generate new blood cells than bone marrow. This suggests that a smaller number of cord-blood cells are needed for a successful transplantation.

Are there disadvantages in umbilical cord blood stem cells?

The biggest disadvantage is that although rich in stem cells, the umbilical cord contains only a small volume of blood. This means that the unit has a smaller number of stem cells than may be collected from bone marrow. As a result, there may not be enough stem cells to treat some older children or adults. (Doctors are studying the effectiveness of combining more than one cord-blood unit or expanding the number of stem cells in a unit before transplantation to attempt to solve this problem.)

Stem cells from cord blood may take longer to “take” and start producing blood cells than bone-marrow stem cells. This may be due, at least in part, to the smaller volume of stem cells from cord blood. Individuals may be at increased risk of infection until the transplanted stem cells produce sufficient disease-fighting white blood cells.

Umbilical cord blood banking: parents have a choice

Parents can now choose to store their newborn baby’s cord blood at a private cord-blood bank in case their baby or a family member ever needs it. Or parents can donate the cord blood to a public cord-blood bank so that any genetically matched individual needing treatment has access to it. Prospective parents who are considering these options should have as much information as possible to make an informed decision. Some states require health care providers to discuss options for umbilical cord-blood banking with their patients.

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