Umbilical Cord Blood Banking: Why? What? How?

chillibreeze writer — Namitha Kumar

Six-year-old Ritisha’s parents were devastated when she was diagnosed with Chronic Myeloblastic Leukemia (CML). A bone marrow transplant from her older sibling Rakesh was ruled out as the HLA typing did not match. It was then that her hematologist at CMC, Vellore came up with the idea of a cord blood transplant. Though the chances were slim due to the small number of cord blood banks in India, the doctor and her parents decided to give it a shot.

It was a one in a thousand chance, but it worked! Fortunately for Ritisha, an unrelated donor with five Human Leukocyte Antigen (HLA) matches was found and she successfully received a cord blood transplant. Today, Ritisha is going on eight and the cancer shows no sign of returning.

So what is cord blood?
Cord blood is the blood drawn from the umbilical cord and placenta after a baby is born. The afterbirth was considered a medical waste until the powerful uses of cord blood were discovered. Cord blood contains stem cells which can be frozen, stored, and later used for stem cell transplants and regenerative medicine. These miraculous stem cells can grow into blood as well as other types of cells. Since cord blood stem cells are much more primitive than bone marrow stem cells, they have several advantages. Most importantly, they have the remarkable ability to differentiate into other cells and self-regenerate.

Why cord blood?
Cord blood stem cells have a definite advantage over bone marrow stem cells. Firstly, finding a match for a bone marrow transplant can be difficult and sometimes impossible. Besides, bone marrow stem cells require the donor to undergo an invasive technique. Cord blood cells don’t have to be as closely matched to the patient as adult stem cells from the bone marrow. Cord blood stem cells can be harvested without any risk to the mother and baby. Blood is drawn from the umbilical cord after birth and the cord is clamped and cut. The cells are viable for a few days at room temperature giving sufficient time to be delivered to a storage bank. Once processed and cryogenically frozen, the cells remain viable for decades.

History of Umbilical cord blood banking
Umbilical cord blood was approved for use by the US FDA and other authorities in the late 1980s. The first umbilical cord blood transfusion cured a blood cancer patient in 1988. Over 1, 000 cord blood transfusions in the US have cured children with leukemia with little or no side effects. Since the cord blood cells are primitive, it does not carry HLA antigens on the surface thereby reducing the chance of rejection by the receiver.

As many as 70 diseases have been known to be cured by cord blood transplants, including cancers like Acute and Chronic Myelogenous Leukemia and Acute Lymphoblastic Leukemia, blood disorders like Thalassemia and Sickle Cell Anemia, and musculoskeletal disorders like osteoporosis.

The future holds even more potential. Autologous cord blood transplant can help the body repair itself. This is known as regenerative medicine. Children who have had their cord blood stored will have more medical options in future. At present, clinical trials using autologous cord blood cells are being conducted to cure Cerebral Palsy and Type I Diabetes.

Cord blood banks
Since 70% of the people receiving cord blood transplants do not have a matching donor within their family, unrelated registries become important. This brings in the role of cord blood banks. In India, the prospect of cord blood cell preservation is gaining momentum. Because cord blood stem cells is seen as an insurance against future life threatening diseases, more and more urban couples do not mind paying to bank their baby’s cord blood.

Cord blood research and preservation was first initiated at the Cancer Research Institute, Tata Memorial Centre, Mumbai in 1990. The first private cord blood bank was established in 1992. Since then, other such facilities that have opened up, including Cryobanks International that operates in tandem with Cryobanks USA. The facility in Gurgaon is one of the best in India.

Reliance Life Sciences has also come up with Relicord in Mumbai. These cryobanks allow for private banking where the cord blood is stored exclusively for the donor and his/her family. There is also a public registry where cord blood donations are made. These are open to the public and anyone requiring cord blood stem cells can register and if a match is found the stem cells are given.

Affordability
Private banking of cord blood cells has not gained too much popularity either in India or globally. The major deterrent is the cost factor. In addition to a large initial processing and banking fee, one also has to pay an annual storage fee. In the US, first-year fees can range from $595 to $1,835, depending on which private bank is chosen. Annual storage fees are usually about $95.

Given the uses and advantages of cord blood stem cells, we need more not-for-profit cord blood banks in India. India also needs more research in this direction. Recognizing the need for such research, in 2005 the Ministry of Health approved a grant of Rs. 5 crore to upgrade stem cell research at the Mumbai-based National Institute for Research in Reproductive Health under the Indian Council of Medical Research (ICMR).

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Chillibreeze's disclaimer: This is a contributed article and was published on Chillibreeze in May, 2010. The views and opinions expressed in this article are those of the author(s) and do not reflect the views of Chillibreeze as a company. Chillibreeze has a strict anti-plagiarism policy. Please contact us to report any copyright issues related to this article. The relevance of the facts and figures cited (if any) could change after a period of time.

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—About our writer:

Namitha is a Communicative English lecturee at a college in Bangalore. She has 7 years experience in content creation and graphics. She enjoys creative writing and dabbles in poetry and play writing. She is interested in media and cultural studies. She also enjoys watching alternative films and listening to eclectic music. She believes in the 'live and let live philosophy' and calls herself a radical feminist. Given a chance, Namitha would love to act in alternative films!

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