Umbilical Cord As Spare Parts Warehouse? Controversies On Private Blood Banking

Main Category: Stem Cell Research
Also Included In: Blood / Hematology;  Biology / Biochemistry;  Conferences
Article Date: 11 Jun 2007 - 0:00 PDT

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Blood from the umbilical cord is considered to be a valuable "biological raw material" today that can help to cure illness. An increasing number of parents have private blood banks freeze the stem cells from the blood in their child's umbilical cord and spare no expense to do so. But experts at the Congress of the European Hematology Association in Vienna say that the benefits of this supposedly preventive measure is controversial. Putting cord blood in public banks, on the other hand, is an act of solidarity that could provide stem cells to affected patients who need them. Possible future options may be hybrid public-private blood banks.

A growing number of private firms are entering the lucrative market for "biological self-sufficiency." They offer parents of newborns a special service, namely, freezing stem cells from the blood in their children's umbilical cords for 20 years. They promise cures for possible diseases through the transplantation of the person's own cells and claim that cord blood will be able to cure degenerative joint diseases or diabetes in the future a genuine form of "biological life insurance."

These promises of cures have had a definite effect: "More than 600,000 people around the world have already deposited cord blood in private blood banks," explained Professor Willem E. Fibbe from Leiden University Medical Center in the Netherlands at the 12th Congress of the European Hematology Association (EHA), held in Vienna from June 7 to 10. "That is a substantially larger number than have contributed to public donor stem cell banks."

Cord blood does indeed have interesting medical properties. "Cord blood has an exceptional number of stem cells," explained Professor Fibbe. Blood stem cells are adult stem cells and thus not taken from embryos. They are normally in bone marrow, where they undergo multiple divisions and mature into various types of cells in the blood stream.

Solidarity blood banks versus self-supply

Cells from donated cord blood, i.e. not the patient's own cord blood, are already being successfully transplanted today, especially in people with leukemia or lymphoma. Stem cells from cord blood are considered to be a suitable alternative in cases where conventional bone marrow transplantation is not possible. Searches for matching donor preparations can be conducted in public cord blood banks for these patients through a global network.

This is the main difference between public and private cord blood depositaries. Public blood banks operate on a solidarity principle. Whoever serves as a donor provides the blood to an unknown patient in the future. No costs are incurred by the recipient. In private cord blood banks, the reserves are not available to the general public, only to the donors and their families. To take this preventive step for their child, parents today are willing to bear costs ranging from 1,500 to several thousand euros depending on the private bank involved.

Investment into the future?

It is, however, controversial how valid such an investment may be, the full biological potential of this unique source of stem cells still remaining to be fully explored. "Based on current research, this type of prevention has no proven benefits and building up a private store of cord blood is not expedient", Professor Fibbe noted. "At this stage, it is usually more sensible to make your cord blood available to a donor blood bank, helping patients who are in critical need of a cord blood transplant."

Scientists are convinced though that there is future potential. "Umbilical cord blood represents important perspectives for the future of hematopoietic stem cell therapy and potentially regenerative medicine", Professor Fibbe noted. This potential will be realized as the therapeutic value of cord blood becomes increasingly known and the uses of cord blood continue to expand.

But there are some concerns about inappropriate marketing of promises beyond the capabilities of present-day medicine to parents. Professor Fibbe therefore urged that prospective customers of private cord blood banks be given completely straightforward and objective information about the actual possibilities and uncertainties involved in autologous stem cell transplantation to be able to weigh all the facts.

Hybrid banks as possible option

A possible development may emerge in public-private hybrid banks where donated cord blood accessible to all potential patients would be stored as well as private deposits. "Opening the possibility of combining public and private functions is an option to be discussed", Professor Fibbe said. In Spain a hybrid solution has already been created. It requires that the unit will be donated if required for allogeneic transplantation.

"Public blood bank operators are able to guarantee continuity and also maintain uniform quality standards, which is crucial for a number of reasons in this context," the expert underlined. "Common high quality standards for both, the public and private side of blood banks would help cord blood therapies to reach their full potential."

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