Stem cell banking

They’re being researched as a possible cure to conditions as varied as cerebral palsy, traumatic brain injury, hearing loss and type 1 diabetes, and cord blood stem cells are already used to treat more than 80 blood-related diseases such as leukaemia, multiple myeloma and sickle cell anaemia. Stem cells can also be used as an alternative to a bone marrow transplant. While it’s perfectly possible to harvest stem cells from your body later in life, cord blood stem cells are considered to be better quality because they haven’t been exposed to ageing, pollutants or disease. “There are currently 4 000 trials involving stem cells worldwide, with more than 200 of these trials using umbilical cord blood stem cells. Some of the most exciting research is taking place with autism, spinal cord injury and diabetes,” says Dr Yvonne Holt of Next Biosciences.

WHY BANK BABY’S CORD BLOOD AND TISSUE?

Cord blood stem cells are a guaranteed perfect match to your child’s immune system and pose no risk of rejection when transplanted. These stem cells also have a one in four chance of being a suitable match for a sibling. It’s a medical insurance policy should your child fall ill and need a transplant. If you have to rely on a bone marrow stem cell donor, your chances of finding a match are 1 in 100 000. Sadly, these odds plummet to 1 in 400 000 for mixed race and ethnic minorities, who are badly under-represented on stem cell registries. The cost of finding a matching donor can be crippling when you face a minimum sum of R250 000.

WHEN TO DECIDE

Expectant parents are encouraged to start thinking about stem cell banking at around 20 weeks. This gives them enough time to do their homework and properly educate themselves about all the options. However, the application process is fairly quick, and the collection kit can be delivered within three to five days of your successful application and initial payment. Netcells also have emergency collection kits available at all major hospitals should the baby decide to come early and you have not received the kit in time.

HOW THEY’RE COLLECTED

Collecting stem cells during the birth is a relatively straightforward process that poses no risk to either the mother or the baby. Your stem cell storage company will provide you with a collection kit that you take with you to the hospital at the time of the birth to hand to your gynaecologist or midwife. Immediately after the baby’s delivery, the umbilical cord is clamped, and the cord is cut. At this point, your gynaecologist or midwife will collect the sample. The needle attached to the sterile collection bag is inserted into the vein in the umbilical cord. The placental blood or umbilical cord blood then flows into the collection bag. If you are also collecting umbilical cord tissue, your gynaecologist or midwife will collect a piece of the umbilical cord and put it into a specially designed kit. After the birth, your doctor will hand the kit back to you, and the stem cell storage company will collect the kit from your bedside. If you’re having twins or triplets, you’ll need a collection kit for each child, but all the locally operating companies offer discounts for these collections.

CAN IT GO WRONG?

Like any medical procedure, sometimes the harvesting doesn’t go smoothly, and in the event of a medical emergency during the birth, the attending doctor’s priorities are the health and safety of the mother and baby, in which case they may not even attempt to collect cord blood during the birth. In the event of the cord blood and/or cord tissue not being harvested during the birth, or if the cord blood sample is too small to store successfully (particularly with prem births), the cord blood bank usually refunds almost the whole fee.

IF YOUR CHILD IS BORN OF A MIXED-RACE PARTNERSHIP, YOUR CHANCES OF FINDING A MATCH FROM A STEM CELL BANK ARE SIGNIFICANTLY REDUCED, SO BANKING THEIR STEM CELLS IS ALSO ADVISED.

BETTER CHANCES FOR ETHNIC MATCHES

The SA Bone Marrow Registry (SABMR) has joined forces with Netcells, the largest private cord blood bank in Africa, which will be making cord blood available to patients in need of a bone-marrow transplant.

Since the ’90s, advances in umbilical-cord-blood technology have made cord-blood transplants a viable alternative to conventional bone-marrow or stem cell transplants, but up until now, access has been a challenge. South Africa doesn’t have a public cord-blood bank. The partnership between SABMR and Netcells will make it easier for especially black patients to find matches. “Currently, there is only a 1 in 100 000 chance of finding a bone-marrow stem-cell donor match for patients of European descent. The odds drop even further for patients of other races due to the low donor numbers from these groups,” says SABMR deputy director Jane Ward. ”Finding donor matches for patients of mixed ethnic race is even more challenging.

“South Africa has one of the most culturally diverse groups of people, which translates into an extensive genetic diversity. Most bone-marrow registries around the world, including us, struggle to increase the donor pool among ethnic populations, and when volunteers do sign up, there is an added risk that they are unavailable when they’re needed.”

This is where access to cord blood comes in, as one of three sources of blood-forming cells used in transplants. Netcells’ community stem cell bank offers subsidised fees in an effort to boost cord blood banking among parents. After the storage period expires, Netcells will make existing cord blood units available to the SABMR, with the parents’ consent, of course.

This will provide local (and overseas) patients with a better chance of finding a matched donor.

So, if you opt for the community stem cell bank, the fees are reduced, and the cord blood unit can be used by the family or by another who might need it.

It works on a first-come-first-serve basis and will go to the person who needs it the most.

In private cord blood banking, parents pay the full price to have their baby’s cord unit banked for his or her own use in the future or for use by a family member.

In essence, the family owns the cord blood and can decide how they would like to use it.

Worldwide, more than 40 000 cord blood stem cell transplants have been performed – 23 of which were facilitated by the SABMR in South Africa. ●