Hematopoietic stem cells (stem cells that make our blood cells) are found in bone marrow, peripheral blood and umbilical cord blood and each source has been extensively used in bone marrow transplantations since 1957, 1981 and 1988 respectively, thus not a new exercise. The novelty lies in the realization, insight and possibility to store one’s family’s own stem cells for future ailments. These hematopoietic stem cells can repopulate a damaged bone marrow after chemotherapy, radiation or disease and differentiate to create blood-forming cells, including white blood cells, red blood cells, and platelets as well as a new immune system. Stem cells obtained from the cord MUST not be confused with animal stem cells of any source, stem cells from other parts of the body or embryonic stem cells that are only produced in the laboratory and that are strictly and rightfully controlled by National Drug Agencies around teh World.

So, the 25K US$ question (virtually) to be answered is: where do you find stem cells when you need them if you do not have any? Despite the large and increasing number of stored samples, approximately 50–70% of the patients without stored stem cells and in need of a transplant are still unable to find a suitable adult donor in a timely manner. Your doctor will initiate the search for a match which due to tissue type diversity will inevitably start in your own family. One in four (25%) is the chance that one of your biological siblings will match you, that probability increasing with increasing number of siblings compared to 1 in 50,000 to 100,000 among unrelated persons. If there is no match, then a public bank will be contacted and you will need to prepare the above mentioned 1,000,000 Baht for an eventual match as that is the cost of donated stem cells (varies between 25,000-50,000 $US as most adults need 2 samples). If you do not have the means to buy you don’t get them but then again you may also perish if no match is found or it is not found in time. This problem is more compelling in patients belonging to ethnic and racial minorities who, because of larger tissue type diversity and some reluctance to volunteer as adult donors, have an even lower probability of identifying an unrelated adult donor. What is relevant for all of us in this globalized world is mixed ethnicity persons (possibly our grandchildren!) will in the future face an impossible task in finding matching stem cells.

So in those that did get a bone marrow transplant, where did they find the stem cells? In many transplantation series the percentages reported on the origin of stem cells (own, sibling or stranger) offer surprises as in adult bone marrow transplantation almost 87% obtained the life-saving stem cells from themselves or the immediate family (own in 68%, siblings in 19%) and only in 13% an unrelated donor from a public bank was involved while similar trends were seen in children (65% in total, own in 42%, siblings in 23%; only in 35% of the cases an unrelated donor was involved). These percentages along with the 1 in 217 lifetime probability of needing a hematopoietic stem cell transplant make us understand that we should store for ourselves and our families! Priceless is the knowledge that one has their own family stem cells stored when a disease strikes as swift procurement of stem cells is important since delay in the time to transplant can adversely affect survival and neurological outcome, particularly in high-risk malignancies and congenital neurodegenerative disorders while the psychological impact on a waiting family is substantial.

Costs are minimal and worth the investment! Current prices are less than 2K US$ for collection and lifetime storage depending on the provider of choice and promotions (slightly less than 26 US$ per year amortized over the projected life expectancy of 77 years of a newborn today). The opinions of the American Medical Association and the American College of Obstetricians and Gynecologists (ACOG) state that expectant parents must be informed of their cord blood storing options and that the probability of needing cord blood stem cells is 1 in 2,700 before age 20 (compare to probability of dying in a traffic accident at 1 in 6,000 per year). Moreover, 20 US states in which more that 2/3 of the total US births are occurring, have recently enacted legislation on cord blood education!

Recent reports from the US and other parts of the world show that own cord blood and peripheral blood stem cells can cure more diseases than just blood diseases such as diabetes type 1 and 2, have amazing effects on animal models of Alzheimer’s disease and other Central Nervous System ailments, spinal cord injury and retinal disease models, heart muscle regeneration, and cerebral palsy (114 at Duke’s Medical Center in the US and 1 of THAI StemLife in Thailand and Asia. These unique cases have generated worldwide interest and been reported in numerous prestigious international stem cell Congresses.

Cord blood stem cells offer astounding promise and hope that will revolutionize and change the way we practice medicine in the years to come. Aged, damaged, or lost cells could regenerate and tissues/organs can be repaired by autologous cell-replacement therapies. Yet incurable genetic and degenerative disorders in the human body can be reversed and even cured by the use of cord blood stem cells. Let us not deprive our children of this once in a lifetime circumstance to partake in the new applications and opportunities that will ultimately derive from this gift of Life. Expectant parents as custodians of the cord blood should be properly informed of their options with regard to cord blood banking or a refusal may well violate the child’s human rights with legal implications to providers.

July 2007, Coriell reported “More than 8,000 cord blood transplants have been performed worldwide since 1988. ”

Quoted from a Thermogenesis press release October 9, 2007:
“Cord blood stem cells have been transplanted more than 11,000 times to treat patients with life threatening diseases, including leukemia, lymphoma and more than 60 different genetic disorders. Further, recent peer-reviewed scientific articles indicate stem cells residing in cord blood can also differentiate into other tissues of the body, including the brain, gone cartilage and muscle, indicating potential broader application of cord blood stem cells in future clinical use. With approximately four million births per year in the Untied States alone, cord blood represents a large, natural resource for use in the treatment of malignant and genetic diseases in which sourcing does not involve donor risk. Cord blood is saved when a baby is born, processed and cryogenically stored for future use. Following the first successful cord blood transplant performed in 1988, awareness of the potential therapeutic value of cord blood stem cells has increased and collection and storage has grown rapidly.”

Generally the common understanding is that there are over 40 conditions currently treatable with cord blood stem cells. See Parent’s to Guide Cord Blood

I’m going through the debate right now of whether to bank private or public. I think I’ll go public but I’m Canadian and so am more comfortable with the whole concept of a public health care system than most in the U.S. are yet.

–Lee

Most of European cord blood bank’s discuss and dream about mix model. This model is very good! That bussines looks like “responsible and respect”. Unless even it will be run – private storage have better future. imho

There is no question – to store CB or not, only question that “would you donate for public register or store for potential personal use?” Here, each parent, knowing all of real information (all pros and cons), make decision about “worth investment”.

The main argument of Dr. Sullivan is calculation of probability of potential use of CB unit, which should NOT include current ongoing clinical trials (not multicentral and not randomized), because we don’t know how they going to finish in few years. But I’m pretty sure, some of them in few years will increase probability dramatically.

So, knowing what’s going on in this dynamic field, I’d spend 1000-2000$ + 100-200$ annually for personal storage. Also I really like new “hybrid” model, which can solve some controversies.