|
FAQs
1. What are stem cells?
2. What diseases could be treated by stem cells?
3. Are stem cell therapies in use today?
4. What is therapeutic cloning? How is it different from reproductive cloning?
5. How Long Can Cord Blood Cells Be Stored?
6. When are Stem Cells Used?
7. Why is Cord Blood the Premier Source of Stem Cells?
8. How Is Umbilical Cord Blood Collected?
9. What is the difference between a public and private cord blood bank?
10. How Much Does It Cost (Sample Cost)?
11. What are my options regarding the disposition of my baby's umbilical cord blood?
12. Why should I have my baby's umbilical cord blood collected and preserved?
13.What does this mean for the other children in the family?
14.What makes cord blood stem cells unique?
15. When is the cord blood collected? Is the collection procedure risky or painful?
16. Who controls the use of the preserved cord blood stem cells?
17.Who can use the preserved cord blood stem cells?
18. Is there a cost to retrieve my newborn's cord blood if needed in the future?
19. What is the history of cord blood transplantation?
20.How successful are cord blood transplants?
21. How can cord blood be used?
22. How might cord blood transplants be used in the future?
1
. What are stem cells?
Stem cells are the body's “master” cells – they can renew themselves and create many types of cells. Because of these unique properties, there is hope that stem cell research may lead to treatments for debilitating diseases and expand our knowledge of human biology.
There are two basic types of stem cells: embryonic and adult. Embryonic stem cells (hESC) are pluripotent, meaning that they can give rise to any type of cell in the body. hESC are harvested during the blastocyst stage of embryonic development, four or five days after conception. A blastocyst is a hollow ball with an inner cell mass, which contains hESC. Extracting these cells destroys the embryo.
Adult stem cells are found in nearly every organ in the human body, and typically give rise to specific types of cells, usually that of their host tissue. Adult stem cells are therefore said to be less plastic than hESC, probably because they fulfil more of a repair and maintenance function, whereas hESC are the foundation cells of a living being.
Much of the basic research into these stem cells has been done in mice, but in 1998, scientists in the USA obtained the first human embryonic stem cells from an embryo made by in vitro fertilization. Before this, adult stem cells had been identified in human bone marrow and used clinically to treat cancers of the blood. These adult stem cells have also been the subject of intense research to see if they can repair damaged human tissues.
Researchers have discovered stem cells in cord blood, baby dental pulp, and amniotic fluid which are more plastic than the typical adult stem cell, but are not considered hESC because they are not pluripotent.
2. What diseases could be treated by stem cells?
Research may lead to the development of stem cell-based therapies for many debilitating chronic and degenerative diseases, including diabetes, heart disease, blindness, muscle-wasting diseases, spinal cord injury, Parkinson's disease, and stroke.
Stem cell-based therapies will be based on the abilities of stem cells to regenerate damaged cells. For example, creating insulin-producing cells for Type I diabetes patients, repairing damaged heart muscle, or restoring muscle tissue in people with muscular dystrophy.
However, there are many other potential applications for stem cell research. Stem cells could be used to create replacement tissue, such as skin for burn victims, or perhaps even entire organs. Drug companies may use stem cells to test drugs and identify which recipients might benefit most from the treatment. Studying stem cells with genetic defects, such as those leading to motor neuron disease, will enable scientists to learn more about the disease development and help in the discovery of new drugs to treat it. Similarly, by isolating and studying cancer stem cells, new therapies for a whole range of tumours may be found.
3. Are stem cell therapies in use today?
While the potential for stem cell therapies is great, there is much to be learned about the basic biology of stem cells and cell development before there can be any large-scale clinical trials involving stem cells.
However, stem cell therapy is in common use today in the form of bone marrow and cord blood transplants. Stem cells found in these tissues are used to treat blood-based cancers such as leukaemia, as well as some immune system or genetic disorders.
No one knows for certain when stem cell-based therapies will be a widely available treatment option for more human diseases. Scientists in some research areas, such as diabetes, spinal cord injury, corneal damage, bone repair and heart disease, may be closer to identifying ways of using stem cells. However, actual therapies may be several years away from use in the clinic, as new regulatory and ethical issues surrounding these treatments are resolved.
4. What is therapeutic cloning? How is it different from reproductive cloning?
Therapeutic cloning, also known as somatic cell nuclear transfer (SCNT), consists of several steps. Firstly, a donor egg must be obtained from a female. The genetic material is then extracted from the egg. A somatic cell from an adult body – often, a skin cell – is obtained from another donor. The genetic material is extracted from the somatic cell, and injected into the egg, which is then stimulated to begin embryonic growth.
Once the embryo has grown to the blastocyst stage four to five days later, the inner cell mass is extracted, yielding embryonic stem cells which are genetically identical to the somatic cell donor. This procedure has been successfully completed with many species, and was recently claimed by scientists in South Korea to have been achieved in human cells. However, this work has now been discredited, following reports in the press of irregularities in the human egg donation process, and subsequent resignation of the lead scientist amid allegations of fraud.
The Korean episode has cast further doubt and concern over SCNT which has already been banned in many countries. The UK has established a rigorous regulatory framework, which is managed by the Human Fertilization and Embryology Authority (HFEA). This agency has worked closely to understand and inform public opinion in the UK, and as a result, SCNT is permitted within strictly regulated ethical and scientific guidelines.
Therapeutic cloning is supported by many scientists for research purposes. For example, hEs cells from cloned embryos with genetic abnormalities, may be valuable tools for drug discovery for genetic diseases, as well as understanding the disease processes. Two UK research teams are currently licensed by the HFEA to carry out such research and make hES cells from cloned embryos bearing the gene defects which lead to motor neuron disease
If researchers wanted to produce another living being, they would have implanted the blastocyst into a uterus and allowed the pregnancy to evolve. This is known as reproductive cloning, and has been carried out in other species with some success. In 1996, scientists at the Roslin Institute in Edinburgh cloned an adult sheep to produce Dolly. Cloned pigs, cows, cats, horses, monkeys and mice have also been reported in the scientific press.
Reproductive cloning is an extremely complex process. It took 277 attempts to create Dolly, in a process riddled with miscarriages and genetic defects. It is uncertain whether this could ever be achieved with humans in an ethical and safe manner, without long-term side effects to both the donors and the cloned being.
Reproductive cloning in humans has been banned in most countries and is generally denounced by scientists.
5. How Long Can Cord Blood Cells Be Stored?
While the science is still fairly new, according to published research (Transplantation, 1998:65 (9): 1275-1278), blood-forming stem cells stored up to 15 years can be used in transplants. In fact, most research indicates that stem cells slow-rate frozen and stored in liquid nitrogen are viable for an indefinite period.
6. When are Stem Cells Used?
Patients suffering from a malignant disease, such as leukemia, may undergo treatment with radiation or chemotherapy to destroy the cancer cells in their body. Radiation and chemotherapy treatments are often successful in destroying the cancer cells. However, they may also destroy the patient’s healthy cells and bone marrow in the process.
Bone marrow is essential for the production of blood cells. If the bone marrow is destroyed, either from a malignant, non-malignant or genetic disorder, a stem cell transplant becomes necessary. Transplanted stem cells re-populate the bone marrow, which replenishes the body’s supply of red blood cells.
Every year, a growing number of patients are diagnosed with diseases that can be treated by bone marrow transplantation. The problem with this option is the lack of availability for an exact Human Leukocyte Antigen (HLA) type match, which determines whether a patient has a suitable donor for stem cell transplant. Almost 50% of these patients are unable to find a donor using donor registries. It is even more difficult for African Americans, Hispanics, Native Americans and other ethnic minorities or those with mixed ethnicities to locate donors.
Using a family member’s stored stem cells offers patients in need a higher probability of finding an exact or acceptable match for their transplantation needs. The probability that the stem cells will be an exact HLA type blood match is as follows: 1/1 for the child the stem cells were collected from, 1/2 for the mother and father of the child, and 1/4 for a sibling of the child, whose stem cells are saved. In addition, stem cell transplantation from umbilical cord blood is less likely to cause “graft vs. host disease”—an immune attack on the recipient by cells from a donor—and other complications relating to the body rejecting foreign cells rather than a stem cell transplantation derived from a bone marrow donor.
7.Why is Cord Blood the Premier Source of Stem Cells?
Umbilical cord blood stem cells are controversy-free and offer advantages over other types of stem cells. While your baby’s own stem cells are a perfect match (100%), there is a good probability of a match for siblings, parents and or grandparents. While stem cells have been in the news more and more these days, few understand that there are different types of stem cells:
Adult Stem Cells: Adult stem cells are found in bone marrow (the vehicle carrying these stem cells) and require invasive surgery to acquire. Also, finding a matching donor for a bone marrow transplant via a public bank can be difficult and sometimes impossible.
Embryonic Stem Cells: Derived from an embryo (sperm meets the egg) are highly controversial and often in the news and at the heart of many moral and ethical debates.
Umbilical Cord Blood Stem Cells: Umbilical cord blood offers a perfectly natural, controversy-free method of acquiring stem cells. (The Vatican approves of cord blood banking.) Cord blood stem cells offer many advantages over other stem cells. They are collected in a risk-free, 5-minute procedure at the time of birth that is painless for both mother and baby. Also, stem cells from cord blood are better than stem cells from bone marrow because they are less prone to “graft vs. host disease” (GVHD – an immune system attack by donor cells against the recipient) and other complications relating to the recipient body rejecting foreign cells. Most importantly, banked cord blood is available when you and your family need it most, allowing treatment to begin almost immediately, without time spent searching for a match. Plus, cord blood stem cells are a perfect match for the baby and can potentially be used to treat other family members.
8.How Is Umbilical Cord Blood Collected?
Cord blood collection is simple and poses no risk to you or your baby. Immediately after your baby's delivery, the umbilical cord is clamped and the baby is separated from the cord. At this point, the needle attached to the collection bag is inserted into the vein in the umbilical cord. The placental blood/umbilical cord blood, drawn by gravity, then flows into the collection bag. The bag comes equipped with an anti-coagulant to keep the blood from clotting before it reaches our laboratory. Unlike traditional bone marrow collection, which usually requires general anesthesia and recovery, the process of collecting cord blood is non-invasive, painless and generally takes just three to five minutes to complete. NECBB will supply you with a cord blood collection kit prior to your baby's delivery date. You simply bring the kit to the hospital for the physician or midwife to collect the cord blood after you deliver.
9. What is the difference between a public and private cord blood bank?
When deciding what to do with your cord blood you have three choices: donate to a public bank, contract with a private bank or discard it as medical waste. A public bank (non-profit) like the American Red Cross takes in donations for use of the greater public. A private bank (for-profit) offers you the opportunity to bank exclusively for you and your family making the stem cells available when you need them most, allowing treatment to begin almost immediately, without time spent searching for a match. Plus, cord blood stem cells are a perfect match for the baby and can potentially be used to treat other family members.
10.How Much Does It Cost (Sample Cost)?
The costs for our services are as follows:
Initial Enrollment Fee $250.00
Administrative costs associated with establishing your family’s account, including your cord blood collection kit. The enrollment fee is a non-refundable deposit.
Processing and Banking Fee $1,300.00
Due at the time your baby’s cord blood arrives at your lab, this fee includes all costs associated with the shipping and processing of your baby’s cord blood, and includes the following services:.
Follow up materials to your caregiver, notifying them of your decision to preserve your baby’s cord blood
Annual Storage Fee $124.00
This fee maintains your baby’s stem cells at our on-site cryogenic storage facility.
Total First-Year Fees $1,674.00
Our Four–Month, Interest-Free Payment Plan!
Prepay and Save $580!
You can prepay the initial 20 years of storage with a one-time payment of $3,450 (a $580 savings when compares to our standard plan)
11. What are my options regarding the disposition of my baby's umbilical cord blood?
Expectant parents can:
Collect and preserve the cells for the potential future medical benefit of the family
Donate the blood for research or use by an unrelated third party
Allow the hospital to discard the newborn's blood
12. Why should I have my baby's umbilical cord blood collected and preserved?
Your baby's cord blood is rich in stem cells, which are special cells normally found in our bone marrow. Stem cells are the master cells responsible for producing all of the mature cells in our blood and immune system. They form the white cells that fight infection, the red cells that carry oxygen, the platelets that promote clotting and the cells of our immune systems. Because cord blood has a high incidence of these stem cells, they can easily be collected and cryopreserved in case they are needed later in life. Stem cell treatments and transplants have already been used for such wide-ranging diseases and conditions as cancer and leukemia, sickle cell disease, various forms of anemia and severe combined immunodeficiency (SCID's). Experimentation for expanded uses of stem cells holds great promise. Often, matched stem cells, which are necessary for transplant, are difficult to obtain, due to strict matching requirements. However, cells taken from your newborn are a guaranteed match for your baby for his or her lifetime. Additionally, they have at least a 1-in-4 chance of matching a sibling. Banking them at birth may provide future opportunities for medical treatments that may not
13.What does this mean for the other children in the family?
Outcome data show that, if needed in the future, there is a greater chance for success in a stem cell transplant between siblings than with unrelated donors and recipients. Moreover, there is less chance for severe graft-versus-host disease (GVHD) following transplantation. Approximately 60% of all pregnant women already have one or more children in the family. If you fall into this category, we strongly suggest you consider this important procedure. Many first time mothers are also planning to have additional children. While preserved specimens do not guarantee a match or a cure for every disease, new, evolving stem cell technologies are likely to increase the utilization of preserved specimens in the future.
14.What makes cord blood stem cells unique?
Cord blood stem cells have a number of significant advantages over other sources of stem cells (i.e., bone marrow):
cord blood has a high rate of engraftment,
is more tolerant of tissue mismatches,
results in a lower rate of severe graft-vs-host disease (a major complication in stem cell transplants),
and is rarely contaminated with latent viruses.
In addition, cord blood is "privileged" or unexposed to most diseases, which can make bone marrow from an adult more difficult to use in transplantation. But most importantly, cord blood from your baby is a perfect match for your child, in the unlikely event it should ever be needed, and a 1-in-4 chance of matching a current or future sibling. It is important to note that a perfect match may not imply that the cells would be useful to treat certain diseases of the donor.
15. When is the cord blood collected? Is the collection procedure risky or painful?
Cord blood is collected from the umbilical cord immediately after the birth of the baby, and can be performed with either vaginal or cesarean section deliveries. The collection can only take place at the time of delivery, and, since a collection kit is necessary, advance arrangements must be made. There is absolutely no pain or risk to the mother or child during the collection process since the blood is harvested from the cord once it has been clamped and cut.
16. Who controls the use of the preserved cord blood stem cells?
Until the child is of legal age, the parents, as the child's guardians, have control over the stem cells. No stem cells will be released without the parents' consent initially, and later the child's consent, once they reach legal age.
17.Who can use the preserved cord blood stem cells?
The preserved cord blood stem cells are, of course, available as a perfect match for the child from whose umbilical cord they were collected. Because there is a 1-in-4 chance of a perfect match with a sibling, parents may choose to make the cord blood available to siblings or potentially other family members who may need them. That decision is theirs alone.
18. Is there a cost to retrieve my newborn's cord blood if needed in the future?
Since you own the preserved specimen, there is no charge for retrieval. The specimen would be transported in a special container to the transplant location in order to maintain cryogenic temperatures.
19. What is the history of cord blood transplantation?
Umbilical cord blood was first used for transplantation in 1988, in France, for a patient with Fanconi's anemia; a disease-free sibling was the donor. Since that time, cord blood has been increasingly used as a substitute for bone marrow in thousands of successful transplants.
20.How successful are cord blood transplants?
Cord blood transplants have been demonstrated to be at least as successful as bone marrow in the cases in which they have been used. By comparison, cord blood has other advantages over bone marrow, including ease of collection and better tolerance of HLA mismatches.
21. How can cord blood be used?
Cord blood stem cells may be used in place of bone marrow or other sources of stem cells for transplantation and has already been used to treat numerous types of malignancies including certain leukemia's, Hodgkin's disease and other types of lymphoma. It has also been used for the treatment of a variety of anemia's, inherited metabolic disorders and deficiencies of the immune system. The majority of cord blood transplants to date have been performed in patients less than 18 years old and have been sibling or allogeneic (unrelated third party) transplants.
22. How might cord blood transplants be used in the future?
The nature of treatments for many diseases has changed radically over the past several years. Just a few years ago, gene therapy was unheard of. As the causes of more diseases are determined, more therapies will become available, and it is projected that cord blood transplantation will continue to play a vital role in these therapies. Current promising research is being conducted on the use of umbilical cord blood stem cells for the treatment of cardiac and neurological diseases, to name a few.
|
