Stem cells from umbilical cord blood – donate or store?

Giving birth to a healthy  baby  is a small miracle for both moms and dads. And all parents want their child to remain healthy in the future. For several years it has been possible  to take stem cells from the umbilical cord blood at birth  and have them frozen for later use or donate them. But does that make sense? Why cells from umbilical cord blood? And what can stem cells be used for? We have put together the most important information for you.

What are stem cells?

Stem cells are cells that have the ability to develop into different types and shapes of cells through cell division – they are the raw material of other body cells, so to speak. Depending on where they come from, a distinction is made between embryonic and adult stem cells.

  • Embryonic stem cells are the precursors of all body cells – every human being develops from them. They are found in the so-called blastocysts, an early stage of the embryo shortly after fertilization of the egg cell.
  • Adult stem cells, i.e. adult stem cells, are found in many human body tissues, but mainly in the bone marrow. The stem cells from the umbilical cord also belong to the adult stem cells.

What is the difference between embryonic and adult stem cells?

Embryonic stem cells can divide indefinitely and develop into any cell type. They are the basic building block from which an embryo grows.

In contrast, it is the task of adult stem cells to provide cells as a replacement for damaged or dead cells. They thus ensure the constant renewal of cells throughout the body, but can no longer develop into all cell types. Adult stem cells are already committed to certain cell types, such as the formation of skin cells. Although skin stem cells can develop into various forms of skin tissue, they cannot, for example, replace nerve cells. This would require a different type of stem cell.

What are stem cells used for in medicine?

Damaged cells can also be artificially replaced with new ones. This is used in medicine to treat certain diseases, such as  blood cancer  (leukaemia). Diseased tissues can be renewed or replaced in this way. This treatment method is called stem cell therapy.

Stem cells are required for these forms of therapy. Although embryonic stem cells are particularly versatile, their extraction requires the killing of a fertilized egg cell – this procedure is therefore prohibited in Germany for ethical reasons. However, a method has been developed to modify adult stem cells in the laboratory so that they have the properties of embryonic stem cells. One then speaks of induced pluripotent stem cells.

Adult stem cells, on the other hand, can be obtained from ethically completely harmless stem cell donations, but are less versatile. An alternative to this are adult stem cells from umbilical cord blood, so-called neonatal stem cells.

What is special about stem cells from umbilical cord blood?

Umbilical cord blood mainly contains stem cells, from which various blood cells can emerge, the so-called hematopoietic stem cells. Stem cells from umbilical cord blood are particularly popular for stem cell therapy for the following reasons:

  • Since the stem cells from the umbilical cord blood are particularly young and efficient, they multiply quickly.
  • In addition, they seem to be better tolerated due to their immaturity, which means that the recipient of the donation relatively rarely has a rejection reaction. 
  • Normally, stem cells age over time and are damaged by environmental influences. The risk of such cell damage from the environment is almost zero with stem cells from the umbilical cord. 
  • In addition, these neonatal stem cells can be transplanted even if the tissue characteristics of the donor and recipient do not match perfectly. 
  • In addition, their collection from umbilical cord blood is ethically completely harmless. 

What can stem cells from umbilical cord blood be used for?

According to the current state of knowledge, stem cells from umbilical cord blood can be used, among other things, for the treatment of blood diseases, in particular various types of leukemia. Because the blood stem cells contained in the umbilical cord blood can develop into different blood cell types: red and  white blood cells  as well as platelets.

In addition, it is also possible to treat congenital or acquired defects in the immune system using blood stem cells. By transferring the stem cells, the so-called transplantation, the blood formation and the  immune system  of a patient can be completely renewed.

The stem cells do not have to be fresh for this – they can also be frozen and stored using a special process if they are needed at a later date.

How is the umbilical cord blood collected?

Once the child is born, the umbilical cord has done its job. It is usually discarded after the baby cuts its cord. 

At this point, however, the umbilical cord still contains blood that is rich in stem cells. This umbilical cord blood can be taken in the delivery room shortly after the birth. To do this, the umbilical vein is punctured – i.e. the blood is removed via the puncture with a hollow needle – and the blood flows into a special collection vessel.

This cord blood collection process is completely painless and risk-free for both mother and baby.

What can you do with umbilical cord blood?

After collection, the blood is either sent to a stem cell bank or to a private company that stores the blood. In both cases, the cord blood is processed and the cells are frozen at -196°C in liquid nitrogen for a period of ten to over fifty years.

In principle, parents have the option of donating the umbilical cord blood or having it stored for their own use:

  • Donation:  With the donation of the umbilical cord blood, the stem cells obtained from it benefit all people who are dependent on a transplant due to a blood disease. This procedure is also known as allogeneic transplantation (external donation). For this purpose, the cells are stored in so-called stem cell banks. The donors of the umbilical cord blood do not have to incur any costs. The costs for removal, processing and storage are partially or completely covered by the stem cell bank. 
  • Personal use:  With the storage of the umbilical cord blood exclusively for personal use, the autologous donation, you keep the option open to fall back on the child’s own stem cells. These can be used later, if necessary, for the treatment of certain diseases of the blood or the child’s immune system. So-called stem cell depots are offered by private companies. They are associated with costs that are based, among other things, on the duration of storage.
  • Directed donation:  This is a cord blood donation where the recipient is already determined. This could be a first-degree sibling suffering from leukemia or another blood disorder.

Parents-to-be should contact their doctor in good time if they are interested in storing umbilical cord blood. Open questions can be clarified in a consultation. It should also be taken into account that a donation is only possible in a clinic that has staff trained for removal. Therefore, the decision to donate also determines the selection of the maternity clinic.

Does it make sense to store umbilical cord blood?

This question can not be answered on a general basis. So far, most experiences have been made with donated cells, i.e. with the transfer of umbilical cord stem cells to another person. The allogeneic transplantation of stem cells from umbilical cord blood is now an established procedure, especially in children.

It has been shown in the past that good results can be achieved using a transplant from foreign umbilical cord stem cells. This is possible because stem cells from umbilical cord blood have the advantage that donor and recipient do not have to be a complete genetic match.

So far there is only little data on the use of stem cells from the umbilical cord blood for personal use – partly because the process is quite new. An advantage of your own stem cells is that they do not cause any intolerance reactions. They can be used to treat blood disorders later in the child’s life and are then readily available.

But: If the child develops blood cancer, their own stem cell transplants usually cannot help either. Because these often contain the cancer-causing cells from birth. Then the use of donor cells makes sense.

Who can donate cord blood?

In principle, every healthy mother, as long as she is of legal age, can donate her baby’s umbilical cord blood. To do this, she must go to a maternity hospital, where the collection of umbilical cord blood is possible. Lists of possible clinics are often obtained from the providers of an umbilical cord blood donation, i.e. the stem cell banks.

How can I donate or store umbilical cord blood?

Once the decision has been made that the umbilical cord blood should be donated or stored, the following steps are necessary:

  • Choosing a clinic where the collection of umbilical cord blood is possible.
  • Deciding on a supplier who prepares and freezes the stem cells from the umbilical cord blood. This can be a public stem cell bank or a private company. 
  • Placing the order and completing the formalities for storage, such as filling out forms.
  • Delivery of a collection set to the parents (depending on the provider), which must be taken to the clinic for delivery.
  • Collection of the umbilical cord blood shortly after birth, completely painless and without risks for mother and child.
  • Transport of the blood to the contracted provider for further use.

What does the storage of umbilical cord blood cost?

The costs for storing stem cells from umbilical cord blood can vary greatly. This depends on the following questions:

  • Is it a donation, storage for personal use or a combination of both?
  • Which provider is selected, a private or a public one?
  • How long should the cells be stored?

Some providers only charge if the stem cells have been successfully processed and are suitable for storage. Others offer the storage of umbilical cord tissue in addition to the storage of umbilical cord blood. This option also affects the price. In addition to a one-time payment, there may also be annual fees for storage, which in turn depend on the duration of storage.

It is therefore absolutely advisable to obtain information directly from the providers and to compare the conditions due to the variety of offers and the different prices. Get comprehensive advice on storing or donating stem cells from the umbilical cord blood and carefully weigh the pros and cons.

 

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