6.77 MB | 16:52 Min
Dr. Elizabeth Shpall is the Director of the M.D. Anderson Cancer Center Cord Blood Bank, a public cord blood bank in Houston, TX, dedicated to collecting umbilical cord blood from consenting mothers and making the stem cells available to transplant facilities as an alternate option to bone marrow transplantation for patients lacking appropriate marrow donors. She is also a professor of medicine at the M.D. Anderson Cancer Center, one of the world’s most respected centers devoted exclusively to cancer patient care, research, education and prevention.
Barbara Dehn is a Registered Nurse Practitioner specializing in women’s health, and a spokesperson for Cord Blood Registry, a private cord blood bank, which preserves cord blood stem cells for more than 260,000 newborns throughout the world.
Welcome to your Pea in the Podcast, I’m Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy.
This week, we’re talking about cord blood banking.
We’ll talk about cord blood stem cells…
“Those stem cells, because they are only 9 months old, they are tremendously adaptable and they can turn into lots of different cells in the body.”
We’ll consider your options — private banking and cord blood donations…
“Give it to the humanity and, you know, you will probably save a life.”
And we’ll hear from a dad whose son was saved by cord blood…
“In 45 days, our son was out of the hospital, and he was basically cured.”
We’ll talk about how banking works, we’ll hear from the director of a public bank and more from the dad whose son was saved by cord blood all in this Pea in the Podcast.
Joseph was born a happy baby, but when he was a few months old, everything changed.
“His hands and feet were always swollen, and he always was in a lot of pain. He just was very listless and didn’t want to move and you could tell something was very different.”
Joseph’s dad says his son had sickle cell anemia and his prognosis wasn’t good.
“Some of the worst case scenarios, they don’t live very long at all. And we thought for sure that our son was going to be in that count, that he probably wouldn’t make it to his teenage years.”
Joseph’s family was heartbroken, but then they learned he might be helped by a stem cell transplant using the cells from the cord blood of his expected sibling. The cord blood was collected, the stem cells were harvested and they turned out to be a match for the desperately sick toddler. Joseph’s dad said doctors moved quickly to help the little boy.
“He went and had to go through 10 days of chemotherapy just to kill off his cells, and then they brought in the cord blood stem cells and just gave him a transplant. And then after about, actually about 30 days, everything was in place. In 45 days, our son was out of the hospital, and he was basically cured.”
A brilliantly happy ending and a perfect example of what stem cells collected from a baby’s umbilical cord and placenta can do. They can save lives.
But that doesn’t make a decision about whether or not to save your baby’s cord blood an easy one.
First, let’s sort through your options. Barbara Dehn is a Women’s Health Nurse Practitioner associated with Cord Blood Registry, a private cord blood bank.
“They can save their baby’s cord blood in a family bank so that that means they have access to that blood should the need ever arise for that child or for one of the siblings or potentially for the mom of the family. They also have the option of donating the cord blood to a public bank and in that case the blood is sent off, there’s what we call HLA typing that is done so they can put that data into the bone marrow registry for anyone who needs that blood and then, sadly, the last option is that it can just be discarded or thrown away.”
So let’s start with family banking. Companies like Cord Blood Registry will collect your baby’s cord blood for you, they’ll have it delivered to their facility, they will freeze it and store it for you forever if you keep paying the annual fee. It will be there in case one of your other children becomes ill with one of the diseases like leukemia or sickle cell anemia that is currently treated with cord blood stem cells.
Stem cells aren’t usually used to treat the person from whom they are taken, because they will likely contain the code for the illness they have in the DNA, since most of the diseases stem cells are used to treat are genetic. But Dehn says some parent’s choose to bank based on cord blood’s potential.
“Those stem cells, because they are only 9 months old, they are tremendously adaptable and they can turn into lots of different cells in the body. Now the studies are coming out every week that show that, boy, these cord blood stem cells can turn into living blood vessels, imagine that. They can turn into bone tissue, cartilage tissue, skin tissue, so it’s not just for the unthinkable tragedy of cancers, leukemias and sickle cell anemias, but there’s real potential to treat other illnesses or injuries that, in the past, we had no treatments for.“
Like diabetes or multiple sclerosis. And there’s promising work going on using stem cells for cerebral palsy and brain injuries due to loss of oxygen, but those breakthroughs are still in the future and some or all of them may not come to fruition. So if you bank based on potential, you’re taking a bit of a leap of faith, and it’s an expensive leap with collection costing sometimes between $500 and $2,000 and annual storage fees at more than $100, but for some that is a leap of faith that is well worth taking.
If you can’t afford — or are not interested in — privately banking your baby’s cord blood, you might consider donating it. Dr. Elizabeth Shpall directs the cord blood bank at MD Andersen Cancer Center in Houston, and she wishes you would.
“Saving it for yourself only makes sense if you have a child who has maybe a leukemia and you have a healthy cord where you would be able to use it. The vast majority of people will never have use for their own cord and therefore we are very much persuaded that the donation to a public bank makes the most sense for most normal, healthy people, and there in the bank can help those people who need it. And if someday you ever needed a cord, the inventory of cord blood is exploding so fast on the scene, there are so many more good, nice, healthy, well-matched units, that you would likely find that, in fact, our bias is that it makes more sense to donate to the public arena at this time.”
So if you donate your baby’s cord blood, who will it help? Well, kids with all kinds of diseases.
“There are some genetic diseases where cord is working fabulously well. There is one called Krabbe Disease in little kids where they are born with severe enzyme deficiencies and they are retarded and they die by usually 1 or 2 years. These kids are getting transplants now, very early, in the first few months of life and they are growing like normal kids, so that is hugely exciting. It’s been used successfully in sickle cell anemia and then several other genetic immunologic diseases, so it is becoming very, it’s being tested in a number of different settings. And then certainly for any of the diseases where stem cell transplantation is done, acute leukemia, chronic leukemia, lymphoma, myeloma, it is being used.”
Dr. Shpall agrees with Dehn, there is great potential with cord blood stem cells to treat many other disorders.
“Well, we’re working in so many different areas where we think so, we certainly hope so, but I think today I would not want to promise anything yet.”
One drawback of public banking that you do not face if you bank privately is if you ever need that cord blood for any reason, you can’t go to the bank and say, ‘Hey, remember me? I’d like to make a withdrawal.’ Dr. Shpall says that doesn’t mean you’re totally out in the cold, though.
“What it does is it builds up an inventory of people of your HLA type, and that if you ever needed a transplant, there would be more units there available like that, if not that one itself, that could be given to a patient so you know so that is does help the community of people who have the same HLA type as you.”
This is especially important for minorities.
“African American, Hispanics, Asians, and Jews — none of those ethnic groups are very well represented in the marrow donor program. So where we can often find, if you’re a white Caucasian we can find a donor for you usually in the registry there’s 7 million registered donors, but if you’re any of those 4 categories that I mentioned, sometimes we never find a donor and that is where cord blood is targeting minority population. So here 98% of our units are from Hispanic patients, and we are finding Hispanic cords now when our patients have leukemia that we never found before. It’s very gratifying.”
Women’s Health Nurse Practitioner Barbara Dehn agrees minorities and multi-ethnic families really need to consider cord blood banking.
“If parents are in a relationship and they’re pregnant with a baby, and their partner is from a very different part of the world than they are, please seriously consider banking your baby’s cord blood because, God forbid, you ever need to find a perfect bone marrow match, it is very difficult if mom and dad come from different parts of the world. But at least if you bank that cord blood, it’s kind of like biologic insurance and you know that that’s a match for your child.”
Okay, so you want to privately bank and keep your baby’s cord blood for your family, what do you do? For more information on both private and public banking, the Parent’s Guide to Cord Blood website has provided expectant parents with unbiased information about cord blood stem cells and cord blood banks.
Barbara Dehn is affiliated with Cord Blood Registry and she says this is what happens when it is time to have your baby…
“You’ll be bringing a kit to the hospital with you. When you bring the kit to the hospital, you let the caregivers know and they take some blood from mom, which they have to do anyway so they just take a little extra. After the baby is born and the cord is clamped and cut, then the cord blood is obtained from the part of the cord that’s attached to the placenta. So no blood is removed from the baby, so it is completed safe. So the baby is never, ever put into any harm or any danger and that umbilical cord was just going to be thrown away anyway, we just want to get those cells from it. So the midwife or the physician would obtain the sample, put it in the containers, they call a courier, which is printed on the box, and then the courier comes and picks it up and it is sent off to the lab.”
If you want to donate your baby’s cord blood, Dr. Shpall says you also start by talking to your OB, who can help you find out if there is a public bank in your area. Contact the bank, and they’ll take it from there. This is what happens with Dr. Shpall’s bank in Houston…
“We screen patients like we do for blood donation, and when they are found to be eligible, we get their consent, we consent them to donate the cord, we test their blood and the cord blood to make sure it’s not infected, we need to look at the chart and make sure that there is no history there that we would be worried about in terms of transmission of diseases or cancers. And once all of that is cleared, we basically, they sign a consent form that says they agree to donate to the bank, we then negotiate with whoever is delivering the baby. I have collectors on all of the labor floors and labor decks and they are there to help, to stand by and either do the collection or help the obstetrician to do it with the placenta in utero. So the baby is delivered, handed off, the cord is cut and so there is no risk to baby or mom and at that point we collect the cord into a bag, a collection bag like a blood bag. We then take it to MD Andersen’s stem cell laboratory where we test it and freeze it, and we put all of the information from the testing into a database that is worldwide and when somebody needs a cord for transplant, we search our database and if we find a match, we basically release it to whoever it is either in Houston or out.”
When you’re deciding between public or private banking, Barbara Dehn says the decision may be made for you if there is no public bank in your area.
“There aren’t a lot of public cord blood banks that accept donations. So even for me, I live in Northern California, we only have one public bank here, and it is in an area where most parents cannot donate their baby’s blood. Now for family banking, it doesn’t where in the world you are. No matter where in the world you are, if you’re close to an airport, you can family bank as long as you can get that to an airport within a couple of hours.”
But Shpall encourages you to look into donation if you are interested, because more public banks are opening up all the time.
“There are probably 52 or so world-wide, really big ones, and more every day. They are just exploding on the scene.”
And the National Marrow Donor Program, which is a non-profit organization that maintains the largest listing of umbilical cord blood units available for transplantation in the US, says if your baby needs cord blood, they have a 75% chance of finding a good match in the nation’s public banks.
Still don’t know whether you’d rather bank your child’s cord blood for yourself or donate? Dr. Elizabeth Shpall echoes the position of the American Academy of Pediatrics.
“If you have already one child with leukemia or other similar disease, then it makes sense to bank it for your family. Otherwise, if you have no in the first degree relatives, if you have no disease, you’re not going to use it, give it to humanity and, you know, you’ll probably save a life.”
So if a child in the family has an illness like leukemia, lymphoma, aplastic anemia immune deficiency, sickle cell anemia, or thalassemia, that could potentially be cured with a cord blood transplant, the AAP says you should really think about banking privately.
But whether you bank privately or publicly, Women’s Health Nurse Practitioner Barbara Dehn encourages you not to throw the cord blood away.
“I was a pediatric ICU nurse, and I took care of a lot of children who were waiting for bone marrow matches, and sadly many of those children never found a bone marrow match. So the idea that parents would either store the baby’s cord blood for their own use or donate it, is a wonderful option because right now only 3% of cord blood stem cell samples are being stored or family banked, so we’d love to see more get out there into the system.”
Because, as Dr. Shpall says, you might save a life. Like Joseph’s…
“He was only 2 years old when he had his cord blood transplant and, you know, that was 5 years ago and now our son, Joseph, is a happy, healthy, little 7-year-old and we are so proud of him now.”
We hope you’ve enjoyed this Pea in the Podcast: Cord Blood Banking. Please visit our website PeaInThePodcast.com for more information about our experts, to find links and transcripts and to register to get tailored week-by-week shows for each week and stage of your pregnancy. It’s everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I’m Bonnie Petrie, thanks for listening.
A Special Thanks To…
Joseph in Texas for sharing his son’s cord blood stem cell success story with us for this podcast.