Should I bank my baby's cord blood?
"I'm having baby number three in April and my obstetrician gave me some info about cord blood banking. I can't remember hearing about it with Babies 1 and 2 (maybe it wasn't around then?) but now apparently you can have your newborn's cord blood collected and you can either donate it to a public bank or you can pay a private bank to store it for you indefinitely, in case you need it.
The cost to have it collected and privately stored is pretty steep though, at a few thousand dollars, so I wondered whether it really is worth doing? What is it used for and is it really worth the cost?
Hi Caitlin. Similarly to you, I wasn't aware of cord blood banking when I had my kids, although it has been available in Australia for a few years now. As you said though, there are two types of cord blood banking: Public banking – where the blood is donated and is available to anyone in the world who might need it, and: Private banking – where you retain ownership in the blood and it is stored exclusively for you. That type of banking comes at a cost.
I have sourced an answer to your query from Associate Professor Mark Kirkland, who is a stem cell researcher at the Institute of Technology and Research Innovation at Deakin University. He is also Medical Director at private cord blood bank Cell Care.
What is it?
According to Professor Kirkland, cord blood is special. "Cord blood is different to regular blood for several reasons," he says. "It's different because it isn't aged; it hasn't been exposed to the environment. That makes a difference because all cells in the body have an internal clock that ticks down. So when we collect cord blood, we are collecting cells at the early stages of life, when that clock is set at the earliest possible stage. The factory-default setting, if you like. Cord blood also has cells in it of a type that we don't see at any later stage of life and has immune cells which are totally unique."
What is it used for?
The current use for cord blood is for bone marrow diseases such as leukaemia. In the future, however, scientists are expecting that cord blood may well be used for a variety of other diseases, such as cerebral palsy and diabetes – two current areas of active investigation.
"The beauty of cord blood is that factory-default setting, particularly when it comes to the immune system" says Professor Kirkland. "The immune system develops throughout childhood. But of course if anything goes wrong during that period then at the moment you are stuck with it. A lot of diseases such as Type 1 diabetes, for example, occur where something goes wrong with the immune system, and the current thinking is that these cord blood cells represent the child's immune system prior to that. So the hope is that in the future it may be possible to use the cord blood cells to restore the immune system."
Is it worth the cost?
It does cost around $3,000 to have your baby's cord blood collected and stored for eighteen years (you can then opt to pay for further storage). Essentially it can be seen as an insurance policy; a medical "just in case" type of thing.
"It's a bit controversial, the idea of storing cord blood now, because these new applications for it are still under development an some people say well, how can you ask people to pay to store cord blood when most potential applications aren't proven yet?" Says Professor Kirkland. "But I often turn that question around and say, well, what are the chances that there won't be uses for these cells in thirty years time. And frankly the chances that there won't be uses for them are close to zero. And some of those uses will be things that we haven't even thought of yet."
"Parents can see it as being similar to an insurance policy. Diabetes affects 1 in 250 children; cerebral palsy is 1 in 500. A recent estimate said that the chances of needing a bone marrow transplant (which you can use cord blood for) throughout you life is around 1 in 400. Storing cord blood from one child can also potentially benefit a sibling; there is a 25% chance of cord blood from one child being a match for their sibling."
Of course if you do fall ill you can access cord blood from a public bank and generally the wait is only around two months. However the difference, according to Professor Kirkland, is in the quality of the match. "If you access cord blood from a public bank then it's coming from an unrelated donor and most unrelated donor transplants are a partial mismatch," he explains. "So to be technical, there are six main antigens and blood from a public bank might yield a four or five out of six match. With cord blood you can get away with not having a complete tissue match but the better the match, the better the outcome. If it's your own blood, it's a perfect match and even the benefit of using a sibling is that about 25% will be a complete match. It can be a seriously better outcome."
And while the technology and take up in Australia is still fairly new, it should be seen as a long-term proposition, with the current medical thinking being that cord blood will hopefully be available throughout life. "People have been storing cord blood for around 23 years; the last study that I looked at examined cord blood that had been stored for twenty years and there was no change to the blood," says Professor Kirkland. "So at this stage, as far as we know, you can store cord blood indefinitely."
"I suspect that in thirty or forty years it will be even more important to have stored your cord blood because of course by then you have forty or fifty years of aging on you and have access to blood which still has the characteristics of when you were born.
I think it's sensible. I am a bit biased of course, because I've been a stem cell researcher for twenty years and when you start reading the scientific papers about cord blood, every second paper is talking about the enormous therapeutic potential of cord blood cells.
If you think about where the technology will be in thirty years time... the potential is enormous."
EB Members: Have you banked cord blood? Would you consider it? Comment on Justine's blog.