Umbilical cord blood(UCB) and Placenta were discarded after the delivery of the baby till not so long ago until the uses of UCB came into light. Umbilical cord blood is found to be life-saving as it is rich in hematopoietic Stem cells. These stem cells have the property of self-renewal as well as the ability to differentiate into lymphoid and myeloid cell lineages. The cord blood is a rich source of mesenchymal cells which are known to suppress Graft versus Host disease (GVHD). UCB has native T cells with minimal recognition of foreign antigens. All these properties of UCB can be used for the treatment of multiple malignant, hematological, and genetic disorders.
What is Umbilical cord blood banking?
UCB can be collected after the delivery of the baby and after clamping the cord. UCB is collected from the umbilical vein into a sterile closed system collection bag containing an anticoagulant solution.
Transportation and Storage:
The Sterile collection bag is then transported to the cord blood bank, where it is tested, processed, and cryopreserved. UCB can be preserved and stored for over 15 to 25 years with efficient recovery of stem cells.
Cord blood collection is not advisable in Twin Gestation, Prematurity, or any other complicated Pregnancy.
Should Parents consider Umbilical cord banking?
Often parents are anxious and vulnerable to the marketing strategies of Private blood banks. Parents’ sense of protection towards their children is exploited to the maximum by these companies with misleading and luring advertisements. Parents are not given accurate information regarding the utility of stored tissue.
Private banking is highly recommended when there is an existing family member or sibling or biological parents suffering from a condition that is proven to be cured by allogeneic stem cell transplantation like leukemia, hemoglobinopathies( ex: Thalassemia, Sickle cell anemia) and Bone marrow failure, etc
So, UCB can be helpful for siblings or close family members, and not for the baby you’ve collected it from(Except in cases like high-risk Solid tumors).
Autologous(baby’s stem cells) stem cells are used in high-risk solid tumors. However even in such cases stem cells can be harvested later on in life from the patient’s bone marrow or peripheral blood, which provided similar results as UCB.
Stem cell transplant using an individual’s cord blood cannot be used for treating diseases of genetic origin and metabolic disorders as these cords stem cells harbor the same genetic mutation, resulting in disease.
In hematological malignancies, allogenic(stem cells taken from a different individual of the same species) stem cells are preferred over autologous stem cells due to the proven therapeutic effect of graft-versus-leukemia reaction, which occurs only in allogeneic stem cell transplantation.
- Readily available if and when required
- Lower risk of Graft versus Host Disease
- UCB stored from a healthy sibling cannot be used, if it is not HLA-matched with the recipient
- Storing for family members other than siblings or biological parents are unlikely to be useful.
- A single UCB unit may not be sufficient in an adult as the cell dose per kg body weight may not be sufficient
- The likelihood of the stored blood being used for HSCT is very small, probably as low as 0.005 to 0.04% in the first 20 yrs of life
Which company/banks should the baby’s UCB be stored in?
The UCB should be stored only in the UCB banks that are licensed by CDSCO. Regarding which licensed UCB banks to be chosen, it is solely one’s judgment to decide which company is the best.
Public Cord Blood Banks
Umbilical cord blood units stored in public banks are available for patients in need worldwide. A patient from any corner of the world can access the cord blood units in a public bank through a search performed by various registries worldwide if they get HLA-matched. The donors are Not Charged for the storage process. The recipients who will be using the cord blood units for their treatment will be Charged.
In India currently, there is only one Public Cord Blood bank named “JEEVAN” located in Tamil Nadu. Sadly, that too has stopped taking new units of cord blood for storage since 2018 due to a lack of funds! They store the UCB for absolutely zero fees and if anyone requires the cord blood cells they provide it to them with a fee of approximately 3 lakh INR.
Private Cord Blood Banks
UCB is stored privately for a particular family which opts for cord blood storage and can be utilized by the family as the need arise. The family will be charged for the storage. If and when the need arises, it’ll not be Charged for utilization. Charges vary from one company to another. Approximately, the company charges about 50,000-1,00,000 INR for storage.
One of the studies conducted by Sun J, Allison J, et al concluded that “Quality parameters of privately banked CBUs are inferior to those stored in public banks. If the efficacy of autologous CB is established clinically, the quality of autologous units should be held to the same standards as those stored in public banks.”
Some of the CDSO licensed Private Cord blood banks in India (as per 2021 reports) are mentioned below:
Name of the Bank Location
Cryoviva India Gurugram
Cordlike India Kolkatta
Cryo Stemcell Bengaluru
Cryovault Biotech Bengaluru
Stemplus Sangli, Maharashtra
Stemcyte India Gujarat
My Opinion : If there is a sibling or biological parent suffering from hemoglobinopathies, leukemia or bone marrow failure syndrome, storing UCB in a Private bank would be helpful.