Umbilical cord stem cell banking for future medical use
post by Synaptic · 2011-11-13T01:41:43.149Z · LW · GW · Legacy · 4 commentsContents
4 comments
I had not heard of this until recently, and I doubt I am alone. I will quote from this source, which looks OK (there is also this).
What is the idea?
[D]uring the 1970s, researchers discovered that umbilical cord blood could supply the same kinds of blood-forming (hematopoietic) stem cells as a bone marrow donor. And so, umbilical cord blood began to be collected and stored.
How the cells are collected:
After a vaginal delivery, the umbilical cord is clamped on both sides and cut. In most cases, an experienced obstetrician or nurse collects the cord blood before the placenta is delivered. One side of the umbilical cord is unclamped, and a small tube is passed into the umbilical vein to collect the blood. After blood has been collected from the cord, needles are placed on the side of the surface of the placenta that was connected to the fetus to collect more blood and cells from the large blood vessels that fed the fetus.
How the cells are stored:
After cord-blood collection has taken place, the blood is placed into bags or syringes and is usually taken by courier to the cord-blood bank. Once there, the sample is given an identifying number. Then the stem cells are separated from the rest of the blood and are stored cryogenically (frozen in liquid nitrogen) in a collection facility, also known as a cord-blood bank.
How the cells can be used:
Then, if needed, blood-forming stem cells can be thawed and used in either autologous procedures (when someone receives his or her own umbilical cord blood in a transplant) or allogeneic procedures (when a person receives umbilical cord blood donated from someone else — a sibling, close relative, or anonymous donor).
The major upside:
The primary reason that parents consider banking their newborn's cord blood is because they have a child or close relative with or a family medical history of diseases that can be treated with bone marrow transplants.
The monetary cost:
The expense of collecting and storing the cord blood can be a deciding factor for many families. At a commercial cord-blood bank, you'll pay approximately $1,000-$2,000 to store a sample of cord blood, in addition to an approximately $100 yearly maintenance fee. You might also pay an additional fee of several hundred dollars for the cord-blood collection kit, courier service to the cord-blood bank, and initial processing.
Is it useful as "biological insurance"? Some say no:
Some doctors and organizations, such as the American Academy of Pediatrics (AAP), have expressed concern that cord-blood banks may capitalize on the fears of vulnerable new parents by providing misleading information about the statistics of bone marrow transplants.... The AAP doesn't recommend cord-blood banking for families who don't have a history of disease. That's because research has not yet determined the likelihood that a child would ever need his or her own stem cells, nor has it confirmed that transplantation using self-donated cells rather than cells from a relative or stranger is safer or more effective. According to the AAP, "private storage of cord blood as 'biological insurance' is unwise. However, banking should be considered if there is a family member with a current or potential need to undergo a stem cell transplantation."
Some say yes:
Other doctors and researchers support saving umbilical cord blood as a source of blood-forming stem cells in every delivery — mainly because of the promise that stem-cell research holds for the future. Most people would have little use for stem cells now, but research into the use of stem cells for treatment of disease is ongoing — and the future looks promising.
Three questions for LW:
1) Based on the above and/or outside information, would you recommend this procedure for two parents in their mid-20s living in the US with a middle class income whose babies will have no known risks for disease?
2) This seems like a good analogy for brain preservation using cryogenic nitrogen. Why do you think that umbilical cord stem cell banking is FDA regulated whereas brain preservation procedures are not?
3) Instead of privately banking them, it is possible to donate umbilical cord stem cells to public banks, for the benefit of others. Similarly, it is possible to donate one's postmortem brain (and organs) to the public, for the benefit of others. In both cases, there is the third option to do neither. In making these decisions, how do you weigh your own interests against those of others?
4 comments
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comment by daenerys · 2011-11-13T02:54:57.737Z · LW(p) · GW(p)
"Middle class" is hard to define, so I used the median household income in 2004, where the head of household was 25-29 years old- $41700 (here's my source ), which I'll round to $42k.
In 2010 the average age of the transplant recipient was 39. (I did some work with the numbers available here ). I decided to use average, though I can see why you might want to use a different method.
If you assume a $1500 initial cost and $100/year the total cost to store it for 39 years is 5400, or about 13% of their annual income. Even if it was used when the child was only 10 years old, it would still cost $2500, or 6% of their annual income (another way to think of it is 3 weeks' salary).
Also, the initial cost is already occuring at a time when a young couple is being hit pretty hard financially. They are used to their income supporting 2 people, and now it has to support 3 people (one of which is super-expensive!)
I would advise not to do the procedure in the scenario you gave. I do think it is a great idea to donate them to public banks though. In a public bank it is near certain to be of use somehow, whereas if you just store it, the chances of it actually being useful are slim.
Question- What happens to the stem cells when the person storing them dies? Are they then donate to a public stem cell bank?
comment by ahartell · 2011-11-13T02:55:35.936Z · LW(p) · GW(p)
1) Yes. I wish my umbilical cord had been banked, not that I am currently unhealthy. By the time the child is 50-60 years old, I expect advances will have been made which allow stem cells to greatly ameliorate problems associated with being that age, though it's possible that by that time there will be some other easier way of getting stem cells.
Is this a minority position?
ETA: Daenerys' comment makes a lot of sense. I was considering $100 to be trivial when compared to the possible benefits but it looks like that may not be the case.
Replies from: wedrifid, Luke_A_Somers↑ comment by Luke_A_Somers · 2011-11-13T06:21:29.956Z · LW(p) · GW(p)
though it's possible that by that time there will be some other easier way of getting stem cells.
By 50-60 years? Good heavens yes. The question for us was whether it would be available in 5 or 15 years (though of course on the 5 year horizon, FDA approval could not be guaranteed). With no risk factors, we declined the expense.