By : MANVEET KAUR
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Storing a newborn’s umbilical cord as insurance against certain diseases that the child or family may be afflicted with in the future has lead to new services offered by blood banks. MANVEET KAUR speaks to medical specialists who clarify the benefits and limits involved.
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| Dr Foo Ban Nyen, executive chairman of CellSafe International |
BEFORE a baby is born, parents-to-be need to make all sorts of decisions for the benefit of their child’s wellbeing, ranging from what brand diapers to use to which paediatrician to consult.
These days, they are faced with another serious decision, one that may protect their child from a life-threatening illness. The decision: whether or not to take out a “biological insurance” for their children, so to speak.
This type of insurance is essentially a blood sample from the baby’s umbilical cord, which will be cryogenically stored at a blood bank. Cord blood, as it is known, contains stem cells that can be used in transplants to cure leukaemia, lymphoma, anaemia and other blood-diseases and may, someday, treat ailments from diabetes to Alzheimer’s.
These days, they are faced with another serious decision, one that may protect their child from a life-threatening illness. The decision: whether or not to take out a “biological insurance” for their children, so to speak.
This type of insurance is essentially a blood sample from the baby’s umbilical cord, which will be cryogenically stored at a blood bank. Cord blood, as it is known, contains stem cells that can be used in transplants to cure leukaemia, lymphoma, anaemia and other blood-diseases and may, someday, treat ailments from diabetes to Alzheimer’s.
According to Benen Foo Ban Nyen, executive chairman of CellSafe International, a private blood bank in the Klang Valley, stem cells are rare and difficult to harvest from the adult body, but they are found abundantly in the baby’s umbilical cord and placenta. “Umbilical cords are often discarded after birth, yet the blood is a rich source for stem cells,” he says.
Foo says there are three main reasons to save a baby’s cord blood: for the child, for family members and for presently undeveloped uses.
“There are well over 70 diseases that have been successfully treated using umbilical cord blood stem cells, and there are many diseases — from Parkinson’s, stroke, heart disease and spinal cord injuries to Alzheimer’s — in promising stages of research and development right now,” says Foo, whose company is one of the three private blood banks in Malaysia, along with StemLife and CyroCord.
As cord blood banking isn’t routine in hospital or home deliveries, you have to choose and plan beforehand. Foo says that it will be collected in a specific kit that parents must order ahead of time from them.
“Taking cord blood is very safe for the mother and baby,” explains Foo. “Collection takes place shortly after birth in both vaginal and cesarean (c-section) deliveries.”
Storing a newborn’s stem cells with a private company means the family has access to the cells whenever needed — as long as the company is in business and the cells are viable. A basic package for cord blood banking at CellSafe costs RM2,000, with an annual fee of RM250. Should you choose to stop paying your fees, your stem cells will be disposed of. A more comprehensive package, like the Platinum package, costs RM5,000.
But it almost seems too simple, doesn’t it? Save a byproduct of the birth process and potentially save a life. In practice, however, umbilical cord use, collection, and storage are still experimental and raise many controversial issues and questions. Should the blood be stored only for potential use by a family member or donated to a public bank? What is the likelihood of a family ever using its own sample?
Another concern is that the long-term viability of cryogenically frozen cord blood has yet to be firmly established.
Still, 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,” says haematologist Dr Goh Kim Yen. “It can be used to treat numerous hematologic, metabolic, and immunologic disorders.”
She says that studies have shown success in using cord blood stem cells in allogeneic transplants. Allogeneic transplants mean the tissue comes from a person other than the recipient — either a sibling, another relative, or a non-relative. Conversely, an autologous transplant means the patient uses his own tissue.
However, Dr Goh, who specialises in stem cell transplants, says that if a child develops certain blood diseases, his or her own frozen cord blood may not be the best choice of stem cell to carry out a transplant.
“The cord blood may have the same genetic flaws that caused the disease in the first place, so it may not be the best choice.”
Stem cell transplants are performed in both children and adults, she says.
The larger the size of the person, the more blood-forming stem cells that are needed for a successful transplant. The number of stem cells in a single unit of umbilical cord blood may not be adequate for engraftment in a large sized adult.
The American Academy of Pediatrics (AAP), in its most recent statement, says “private storage of cord blood as “biological insurance” is unwise” unless a family member might need a blood stem cell transplant.
For instance, Dr Goh explains, if someone in your family already has leukaemia, sickle cell anaemia, or other blood disorders, banking could make sense, either for the child or for another family member.
According to most experts, the odds that a child will ever use his or her own stored cord blood are small. A 2005 editorial in the journal Obstetrics and Gynecology states that the chances are about one in 2,700.
Other estimates range widely. Advertising from one private cord blood bank puts the odds at 1 in 27. The American Academy of Pediatrics suggests it’s more like 1 in 200,000.
Indisputably, there are very few documented cases of a child receiving his or her own banked cord blood as treatment. The US Institute of Medicine says that there may only have been as few as 14 of these procedures ever performed. One reason is that the conditions cord blood stem cells could help treat just aren’t that common.
“The diseases in children that we can treat with their own cord blood stem cells are limited,” says Dr Goh.
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. Whatever you do, don’t let yourself be pushed into a choice.
“I think it’s fine if a parent makes an informed decision to do this and the decision is entirely a personal one after weighing its pros and cons,” says Dr Goh.
Foo says there are three main reasons to save a baby’s cord blood: for the child, for family members and for presently undeveloped uses.
“There are well over 70 diseases that have been successfully treated using umbilical cord blood stem cells, and there are many diseases — from Parkinson’s, stroke, heart disease and spinal cord injuries to Alzheimer’s — in promising stages of research and development right now,” says Foo, whose company is one of the three private blood banks in Malaysia, along with StemLife and CyroCord.
As cord blood banking isn’t routine in hospital or home deliveries, you have to choose and plan beforehand. Foo says that it will be collected in a specific kit that parents must order ahead of time from them.
“Taking cord blood is very safe for the mother and baby,” explains Foo. “Collection takes place shortly after birth in both vaginal and cesarean (c-section) deliveries.”
Storing a newborn’s stem cells with a private company means the family has access to the cells whenever needed — as long as the company is in business and the cells are viable. A basic package for cord blood banking at CellSafe costs RM2,000, with an annual fee of RM250. Should you choose to stop paying your fees, your stem cells will be disposed of. A more comprehensive package, like the Platinum package, costs RM5,000.
But it almost seems too simple, doesn’t it? Save a byproduct of the birth process and potentially save a life. In practice, however, umbilical cord use, collection, and storage are still experimental and raise many controversial issues and questions. Should the blood be stored only for potential use by a family member or donated to a public bank? What is the likelihood of a family ever using its own sample?
Another concern is that the long-term viability of cryogenically frozen cord blood has yet to be firmly established.
Still, 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,” says haematologist Dr Goh Kim Yen. “It can be used to treat numerous hematologic, metabolic, and immunologic disorders.”
She says that studies have shown success in using cord blood stem cells in allogeneic transplants. Allogeneic transplants mean the tissue comes from a person other than the recipient — either a sibling, another relative, or a non-relative. Conversely, an autologous transplant means the patient uses his own tissue.
However, Dr Goh, who specialises in stem cell transplants, says that if a child develops certain blood diseases, his or her own frozen cord blood may not be the best choice of stem cell to carry out a transplant.
“The cord blood may have the same genetic flaws that caused the disease in the first place, so it may not be the best choice.”
Stem cell transplants are performed in both children and adults, she says.
The larger the size of the person, the more blood-forming stem cells that are needed for a successful transplant. The number of stem cells in a single unit of umbilical cord blood may not be adequate for engraftment in a large sized adult.
The American Academy of Pediatrics (AAP), in its most recent statement, says “private storage of cord blood as “biological insurance” is unwise” unless a family member might need a blood stem cell transplant.
For instance, Dr Goh explains, if someone in your family already has leukaemia, sickle cell anaemia, or other blood disorders, banking could make sense, either for the child or for another family member.
According to most experts, the odds that a child will ever use his or her own stored cord blood are small. A 2005 editorial in the journal Obstetrics and Gynecology states that the chances are about one in 2,700.
Other estimates range widely. Advertising from one private cord blood bank puts the odds at 1 in 27. The American Academy of Pediatrics suggests it’s more like 1 in 200,000.
Indisputably, there are very few documented cases of a child receiving his or her own banked cord blood as treatment. The US Institute of Medicine says that there may only have been as few as 14 of these procedures ever performed. One reason is that the conditions cord blood stem cells could help treat just aren’t that common.
“The diseases in children that we can treat with their own cord blood stem cells are limited,” says Dr Goh.
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. Whatever you do, don’t let yourself be pushed into a choice.
“I think it’s fine if a parent makes an informed decision to do this and the decision is entirely a personal one after weighing its pros and cons,” says Dr Goh.
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