Most of us know family members or acquaintances who suffer from leukemia, lymphoma and other types of cancer who do not respond to initial treatment or have high-risk features. These patients and others with blood disorders such as severe sickle cell anemia, thalassemia and aplastic anemia, as well as some primary immunodeficiency diseases and certain metabolic disorders, can be cured by hematopoietic stem cell transplantation.
Hematopoietic stem cells are found in bone marrow, peripheral blood and umbilical cord blood. They are very primitive cells that have the unique ability to develop through complex signaling processes into various components of blood and immune system. Replacing the diseased blood forming and immune cells with these new cells then leads to cure.
Since the components of these cells that determine acceptance or rejection of the graft are inherited, siblings, if available, are checked first. However, about 70 percent of patients who need transplant will not find a donor in their family. For these patients, finding hematopoietic stem cells from a matched unrelated donor is their only option.
Thanks to families who donate the umbilical cord blood of their newborn child, many more patients now have a second chance at beating their disease. In a sense, the families donating umbilical cords, which are usually discarded as part of afterbirth, are extending the joy of their child’s birth to another family whose loved one would not survive without this gift. Not surprisingly, the United States Congress, in a bid to help more patients find a donor, included support for umbilical cord blood transplant and research in the Stem Cell Research and Reauthorization Act of 2010.
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Umbilical Cord Blood May Be the Best Option for Some Patients
Umbilical cord blood is tested and cryopreserved after donation, which makes it readily available. This may provide the best chance of survival for a patient who has a rapidly progressing disease. For such patients, waiting four to six weeks for a donor to be identified, medically cleared and to have cells harvested before shipment to the treating physician may mean losing the battle.
The success of hematopoietic stem cell transplantation from bone marrow and peripheral blood donors is linked to how closely they match the patient. However, those receiving umbilical cord stem cells will do well with a less stringent match. This makes it possible for patients with rare markers related to their racial or ethnic descent to find a suitable unrelated umbilical cord.
Can Every Mother Donate her Child’s Cord Blood?
All mothers who are older than 18 years can donate their child’s cord blood. However, some mothers may be unable to donate if they do not meet eligibility criteria that are designed to ensure a safe product. You can determine your eligibility using guidelines on the National Marrow Donor Program at bethematch.org/Support-the-Cause/Donate-cord-blood/Learn-if-you-can-donate-cord-blood/.
Remember, the blood is drawn from the cord and placenta after your baby is born and therefore has no effect to your baby. Your personal information is also protected by law.
What to Do if You Decide to Donate
If you are an expectant mother, check if you are eligible to donate and talk with your doctor or midwife early. Your options are:
▪ Donate to a public cord blood bank to be made available to patients who need a stem cell transplant or for research. There is no cost to parents who elect to donate the umbilical cord blood of their baby. However, not all hospitals are set up to collect umbilical cord blood for storage in public cord blood banks, so make sure you ask before delivery.
▪ Store in a private cord blood bank for anticipated need by a family member. These centers are available in many states to collect and store your cord blood product for a fee.
▪ Direct a donation for a family member who has a medical need. Families with a member diagnosed with a condition that may be treated with stem cell transplantation can choose to save their baby’s cord blood for directed donation. Collecting and storing cord blood for directed donation is offered at little or no cost to eligible families.
Donating your baby’s umbilical cord blood is a big decision. For more information, visit bloodcell.transplant.hrsa.gov/CORD/ and bethematch.org/Support-the-Cause/Donate-cord-blood/Cord-blood-is-changing-lives/.
Martin Andreansky, M.D., Ph.D., is assistant professor of clinical pediatrics and Director of the Pediatric Bone Morrow Transplant Program and Edward D. Ziga, M.D., MPH, is an assistant professor of clinical pediatrics at UHealth – University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.