By Brooke Adams
Excerpted from Salt Lake Tribune
November 6, 2003
Merlaine and Ryan Waldron consider the tiny vials of blood tucked away in a cryogenic vault in Arizona as the best investment they have made yet for their two children.
The vials contain umbilical cord blood collected at each child's birth -- Lucas, now 3, and Katherine, 3 months.
With a family history of adult-onset diabetes, the Waldrons were willing to take the "what-if" gamble that their children eventually might need the stem-cell-rich blood
though use of stem cells to treat diabetes is merely an area of research today.
"I would hate to look back 10 years from now and say too bad we didn't store your cord blood," said Merlaine Waldron, who lives in West Valley City. "I am glad we took advantage of it."
Once routinely tossed in the trash, umbilical cords are now becoming a hedge in the treatment of such diseases as sickle cell anemia, leukemia and other cancers.
Cord blood can be an expensive investment and one critic says it is unwarranted except for families with proven histories of certain diseases.
But that isn't stopping thousands of new parents from signing up to have their newborn's cord blood stored at the dozen or so private cord blood banks operating around the country. Some parents are even conceiving babies with the intent of using cord blood stem cells to aid an already ill sibling.
Others are donating the blood to one of the nearly two dozen public banks, such as those associated with the American Red Cross or the National Marrow Donor Program, that make supplies available to anyone in need.
The fluid is gathered within moments of birth by a nurse or doctor, using either a syringe or blood bag to drain the placenta and cord after it is cut. Once delivered to a bank, it is processed and stored in a cryogenic vault. The most recent studies show the fluid is viable for 15 years -- and perhaps longer.
Researchers and blood industry experts figured out in the late 1980s that stem cells in cord blood could be used the same way as those gathered from bone marrow -- with added benefits.
Among the benefits: Collecting the blood is painless and less risky than a bone marrow transplant. Because of their immaturity, cord blood stem cells are less likely to be contaminated with disease. The cells are more likely to be a good match for siblings, parents and other relatives, are immediately available and improve survival rates. The cells also are easier to match to unrelated individuals than bone marrow.
Compared to bone marrow stem cells, cord blood cells are less likely to trigger an adverse reaction, particularly in relatives.
Currently, stem cells are used to regenerate blood and the immune system, typically after chemotherapy or radiation treatment for cancer. At least one clinical study is using the cells to grow heart tissue, and researchers are looking at their use in growing bone, nerve, skin and brain tissue.
"A lot of families are doing it not just for what it can be used for now, but what it will be used for in the future," said Rita Kennen, spokeswoman for Cord Blood Registry in San Bruno, Calif., the nation's first and one of the largest private banks.
It's that iffy future that concerns some doctors. They say parents without family histories of certain diseases are making an emotional, rather than scientifically justified, decision in opting to store cord blood in a private bank. That's primarily because of the rarity of contracting one of the diseases that stem cells can treat -- between 1-in-2,000 and 1-in-3,000, according to a Salt Lake City physician.
"It's probably not cost-effective," said Steven Clark, medical director of the Maternal and Fetal Medicine Program at LDS Hospital. "They are using emotional pressure to get people to sign up for something that may not be beneficial."
Collection fees charged by private banks range from $400 to $1,500, with annual storage fees of $50 to $120. Some banks have assistance programs for families with a proven medical need.
Public banks don't charge but also don't guarantee your supply will still be available should you need it.
Helen Ng, spokeswoman for the National Marrow Donor Program, seconds Clark's opinion.
Public banking, however, is a "good thing to do because there is someone out there in need," Ng said. "It offers those without a [bone marrow donor match] to have another option. When a baby is born, a mother is giving life twice."
There is a particularly pressing need for donations from minority families, who are underrepresented in donor registries and whose ethnic makeup makes finding a match difficult.
According to the National Marrow Donor Program, there were 2,000 transplants using cord blood through December 2000. Cord Blood Registry's reserves have been used in 28 transplants, most on behalf of a sibling with some form of leukemia.
Kennen said her company supports greater public supplies of cord blood. But the availability of a secure, genetically related supply of stem cells is reassuring to many families.
"For what it costs, you would spend that amount on a widescreen TV you would throw away in three years," said Kennen, whose company began commercial storage in 1995 and now keeps 50,000 samples at its facility in Tucson, Ariz.
Jayna and Tyler Haws, of Provo, are among the firm's 28 clients in Utah who like the added "insurance" of providing for any future eventualities. Jayna's parents, who own an insurance agency in Boise, Idaho, provided the coverage as a gift to their granddaughter.
"It's cheap insurance for cancer or other horrible things," Jayna Haws said.
