Cord Blood: Y/N?
- Kristian Wells
Being days away from becoming a parent I have entered the realm of provider and protector. My paternal instincts are kicking in and an ever-present sense of familial preservation and protection has arisen. Naturally, wanting the best for my unborn as he enters the harsh world, the topic of core blood banking set up base in my prefrontal cortex, awaiting a decision.
I did a little research and was sent the immaculately presented information pack (red flag 1) from a company claiming to be the largest and most experienced blood and tissue bank in Australia. Along with a 25 page, over simplified, verging on preachy 'Family Cord Banking' book (red flag 2), there was a double sided sheet with a success story on one side and a horror story entitled "Why didn't someone tell me about cord blood and tissue storage for my baby?", in true tabloid style flair. Then the obligatory, 'Like' us on Facebook card, a personalised congratulatory letter, a 'How to Enrol' card and a price guide. Being aware of the prices involved, I was still shocked to see it in print. The biggest red flag of all was that the only plans available were to either pay yearly at a rate ten times what you would pay for an 18 or 25 year plan, or chose the 18 or 25 year plans which had to be paid in full within 24 months.
Fast forward a week. Still sitting on the fence, my brain has however been niggling me with questions I need answered. Questions like: Why a rigid 24 months? Why such a high yearly rate in comparison? I was already guessing at answers but before I speculated, I wanted hard facts. Without sounding elitist, I also wanted something more scientific than the Family Cord Banking “bible” I had been presented with.
1. Why a rigid 24 months? Why such a high yearly rate in comparison?
The sceptic in me tells me they obviously want the money quickly for a reason, that their long-con is coming to an end. The optimist tells me that cryogenics is expensive as cells must be kept at a constant −196°C. They need to money up front to avoid overheads later on.
2. Why are they selling this so hard?
The brochures, the articles, the wonderful matte finish on the 400GSM weight folder, the follow up phone calls? It all reeks of desperation, a sinking ship. Optimist: a profitable business should care about presentation.
Then I get it. In Australia, we have been lucky for so long to have universal health care that we have taken health for granted. It is only lately that we have been pushed (and shoved) into private health cover, the government has threatened the infamous $7 GP visits, we have begun to put a dollar value on our health. But we’re new to all this and don’t like to speculate in matters of health so we grudgingly but dutifully dole out to private health care funds and over-priced specialists. Profitable Businesses. Do they really have our best interests at heart? OK I realise this has become a rant, let’s get back to facts.
A popular claim from these storage companies is, “To date, 30,000 transplants have been performed using these amazing healing cells,” which is an impressive figure. I followed the citation to an excellent article in Nature (yes, you need a subscription for the full article) where I found the vast majority of these transplants came from public banks, not private. What’s this? I was led to believe that my son’s stem cells were specific only to him. How can this be possible? Then I discover that if my son has a genetic disorder, this cannot be treated by his own stem cells as they contain the same disorder within their DNA. So what do the professionals think? The Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends informing parents of the pros and cons of public vs. private cord cell banking, and the Australian Medical Association recommends public banking for cord stem cells.
Still, the 24 month thing has me thinking. Why are they in such a rush? I discover the answer: iPSCs (Induced pluripotent stem cells). Core blood and stem cells are pluripotent. Pluripotent stem cells are often termed 'true' stem cells because they have the potential to differentiate into almost any cell in the body. This means that under the right circumstances, a pluripotent stem cell can produce almost all of the cells in the body. Yet after this embryonic development stage is over, the stem cells no longer have this unlimited potential to develop into all cell types. Their pluripotency is thus lost and they can only become certain types of cells. iPSCs can be derived directly from adult tissues, they not only bypass the need for cord blood cells, but can be made in a patient-matched manner, which means that each individual could have their own pluripotent stem cell line. These unlimited supplies of autologous cells could be used to generate transplants without the risk of immune rejection. iPSCs are readily being used in personalized drug discovery efforts and understanding the patient-specific basis of disease. In December of last year, researchers at the Center for iPS Cell Research and Application (CiRA), Kyoto University, have shown that induced pluripotent stem (iPS) cells can be used to correct genetic mutations. The technology is there, I’m guessing it will become wide spread in, oh ball-park figure here, 24 months?
Still, for the time being, the message is clear. Rather than discarding cord blood, it may as well go into banks where it can be used for treatments, along with research, but putting it into private banks is almost like discarding it. So if you’re about to have a baby, public banking is the way to go.