FAQs - Cord Blood Stem Cells

To help you make an informed decision, we have compiled some of the most commonly asked questions.

What is in umbilical cord blood that is so important?
Umbilical cord blood is also known as placental blood. Your baby’s umbilical cord blood a rich source of stem cells, which are immature, pluripotent cells that can produce all other blood cells, including platelets and red and white blood cells. Umbilical cord blood can be used to treat various genetic disorders that affect the blood and immune system, leukemia and certain solid tumours and some inherited disorders.
Why are blood stem cells useful and valuable?
Blood stem cells, most often found deep in the bone marrow and in the peripheral blood circulation, are the factory of the blood system. They are crucial for stem cell transplants (SCT). SCT is a very important treatment option for many blood disorders and cancers. Without blood stem cells, a patient will not have this option and may not have a chance of a cure. Hence, various blood stem cell banks have been set up across the world to provide potential blood stem cell donors. These stem cell banks are in the form of bone marrow registries and cord blood banks.
What types of diseases can be treated with stem cell transplants?
To date, more than 70 diseases can be treated involving stem cell transplantation. Research is being conducted using stem cells for treatment in cellular repair and regeneration and emerging applications of stem cells are listed under Future of Stem Cells.
What are the advantages of using blood stem cells from cord blood compared to those from the bone marrow?

Painless and Risk-free Collection
Blood stem cells from cord blood are easier to harvest. The harvesting process does not entail any risk to both mother and child. Harvesting blood stem cells from the bone marrow requires general anaesthesia, which entails some health risk. Bone marrow harvesting also involves some pain, as opposed to no pain at all with cord blood harvesting.

Readily Available
The stored cord blood stem cells are always readily available. This is a potential advantage as we do not waste precious time searching for potential blood stem cell donors. In some conditions, e.g. Aplastic Anemia, the time to a stem cell transplant is critical and having some blood stem cells readily available is very important and can minimise disease progression.

Benefits of Cord Blood Stem Cells
Cord blood is less likely to contain certain infectious agents like some viruses such as cytomegalovirus that can pose a risk to transplant recipients. Some studies suggest that cord blood may have a greater ability to generate new blood cells than bone marrow. Ounce for ounce, there are nearly 10 times as many blood-producing cells in cord blood. This fact suggests that a smaller number of cord blood cells are needed for a successful transplantation.

Easier to Match
Stem cell transplants using cord blood has less Graft Versus Host Disease (GVHD) and is therefore less risky for the recipient. This is because cord blood stem cells are less mature than those from the bone marrow and peripheral blood, and can successfully be used even when there is only a half-match. Due to lower GVHD risk, cord blood transplants can be attempted even if there is no perfect HLA matching. In private cord blood banking, the stored blood stem cells are kept for the individual. In view of the above, the stored cord blood stem cells can potentially be used for other family members.

What is HLA-matching?
The Human Leukocyte Antigens need to be perfectly matched in usual stem cell transplants. These antigens are present in white cells and are responsible for rejection or Graft Versus Host Disease (GVHD). Matching refers to the proteins called Human Leukocyte Antigens (HLA) that appear on the surface of white blood cells and other tissues in the body. These six HLA points, or loci, determine tissue compatibility between a patient and a donor. Although a perfect match would be best, studies have shown that cord blood transplants can be successful, even when only four of the six loci match. With cord blood, the immune cells are less mature than those in bone marrow, and therefore siblings are twice as likely to be able to use each other's cord blood, compared to bone marrow.
What is Graft vs Host Disease (GVHD)?
GVHD is one of the most common and life threatening side effects of a stem cell/bone marrow transplant. It is the leading cause of death in stem cell transplant patients. GVHD occurs when the transplanted stem cells recognise the recipient's body as foreign, and "reject" it. Cord blood transplants have had a noticeable lack of GVHD because the stem cells from the donor do not need to match the recipient as closely as with bone marrow.
What are the limitations of cord blood stem cells in treating illnesses?
Cord blood stem cells (and stem cells in general) are used primarily to treat blood disorders and cancers. Its future potential uses will only be limited by our imagination.
What is the future for cord blood transplants?
Cord blood has been used in thousands of transplants for children and adults around the world. Research has demonstrated that cord blood stem cells can differentiate into other types of cells in the body. The regenerative qualities of stem cells have been brought to the forefront in the field of cellular repair. Stem cells have been labeled an important biological resource and researchers are conducting more and more studies to unlock the potential of umbilical cord blood stem cells in future applications for diseases like Alzheimer's, brain injury, cerebral palsy, corneal regeneration, diabetes, juvenile diabetes, heart and liver disease, muscular dystrophy, Parkinson's disease, spinal cord injury, and stroke.

New uses for cord blood stem cells are being discovered rapidly. However, banking cord blood does not guarantee that the cells will provide a cure or be applicable for every situation. The treating physician will determine the ultimate use. The use of cord blood stem cells for emerging treatments is experimental. Please consult your physician. 

Are there any ethical Issues relating to cord blood transplant?
Unlike using stem cells taken from embryos, there are no ethical issues involved in the collection or usage of stem cells from cord blood. If cells from this source are not stored, the blood is discarded and hence valuable stem cells will be lost. Collection of these unique cells will only be possible and available at time of birth of the child.

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