Why do families preserve newborn stem cells?
Both cord blood and cord tissue are rich sources of newborn stem cells. Stem cells are the body’s “master cells,” helping to build organ tissues, blood, and the immune system. Cord blood predominantly contains hematopoietic stem cells (HSCs), which form the blood and immune systems. Mesenchymal stem cells (MSCs) can form bone, cartilage, and tissue cells and are predominantly found in the cord tissue. Stem cells can heal the body and promote recovery. They also offer an enormous amount of therapeutic potential.
While HSCs and MSCs can be collected from other sources in the body, newborn stem cells are younger more flexible compared to adult stem cells from other sources like bone marrow. First, they have less risk of certain complications when used in transplants. Second, they are immediately available and can minimize disease progression in early treatment. Third, they can be stored in their pristine state and avoid exposure to aging and harmful environmental factors that can decrease their function over time.
How are newborn stem cells used in medical treatments?
Not only are doctors using cord blood to save lives today, they’re researching cord blood as a potential treatment for diseases that don’t currently have a cure. Stem cells from bone marrow were first used to regenerate blood and immune cells in patients who had received chemotherapy for cancer. This evolved to include treatments for blood and immune disorders as well as certain inherited metabolic disorders. In the late 1980s, doctors started using cord blood stem cells to treat these same conditions. Cord blood is currently used in the treatment of over eighty conditions as part of a stem cell transplant.
Newborn stem cells are also being researched in an exciting new area called regenerative medicine. It’s all about establishing normal function in the body through gene therapies, tissue engineering, and cell-based therapies. Newborn stem cells are being evaluated in clinical trials to one day treat conditions like cerebral palsy, traumatic brain injury, acquired hearing loss, multiple sclerosis, lupus, Alzheimer’s, Parkinson’s, and diabetes. These therapies are still experimental, and there is no guarantee that treatments will be available, but newborn stem cells are already being studied in 500+ clinical trials for regenerative medicine uses. The U.S. Department of Health and Human Services has identified the value of this cutting-edge approach and stated that “regenerative medicine is a rapidly growing field of biomedicine that will revolutionize health care treatment.”
- Mason, Brindley, Culme-Seymour, Davie. Cell therapy industry: billion dollar global business with unlimited potential. Regen Med. 2011:6(3)265-272.
- S. Department of Health and Human Services. 2020: A New Vision. A Future for Regenerative Medicine. 2006.
- Verter F, Couto PS, Bersenev A. A dozen years of clinical trials performing advanced cell therapy with perinatal cells. Future Sci OA. 2018;4(10):FSO351. doi:10.4155/fsoa-2018-0085
- Clinicaltrials.gov
- Roura S, Pujal JM, Gálvez-Montón C, Bayes-Genis A. The role and potential of umbilical cord blood in an era of new therapies: a review. Stem Cell Res Ther. 2015;6(1):123. Published 2015 Jul 2. doi:10.1186/s13287-015-0113-2
- Rocha V, Wagner JE Jr, Sobocinski KA, et al. Graft-versus-host disease in children who have received a cord-blood or bone marrow transplant from an HLA-identical sibling. Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources. N Engl J Med. 2000;342(25):1846-1854. doi:10.1056/NEJM200006223422501
- Behzad-Behbahani A, Pouransari R, Tabei SZ, et al. Risk of viral transmission via bone marrow progenitor cells versus umbilical cord blood hematopoietic stem cells in bone marrow transplantation. Transplant Proc. 2005;37(7):3211-3212. doi:10.1016/j.transproceed.2005.07.007
Is preserving newborn stem cells dangerous?
Cord blood collection is fast, easy, and painless for both baby and mother. Cord blood is collected after the baby is born and the umbilical cord has been clamped and cut. The cord blood and tissue being collected would normally be discarded after birth. It is not necessary to alter the normal birthing process in any way, except to collect the baby’s cord blood and tissue.
Can families preserve newborn stem cells with a C-section delivery?
In general, the chosen delivery method (vaginal, C-section) should not impact the ability to perform a cord blood or cord tissue collection.
Can families preserve cord blood and do delayed cord clamping?
Preserving newborn stem cells gives a family access to potential future stem cell treatments for conditions that occur over their lifetimes, but we also recognize the value in practicing delayed cord clamping. It is possible to practice delayed cord clamping AND collect cord blood. Providers who practice delayed cord clamping can maximize the cord blood collection by:
- Starting the collection as soon as the cord is clamped and cut.
- Keeping the collection bag below the level of the cord and placenta to enhance the effects of gravity.
- Following our recommended collection procedures included in each kit.
Additionally, delayed cord clamping does not affect the ability to collect cord tissue. Please see CBR’s CAPPA blog post on this topic for more details!
Should families consider preserving newborn stem cells if they do not have a family history of diseases treatable with stem cell transplants?
Since many conditions that are treatable with a stem cell transplant don’t run in families, family history is not a reliable indicator of need. For example, many forms of leukemia often occur spontaneously and do not always run in families. While we can look to family history for clues about risks for some common conditions being investigated in regenerative medicine (e.g., heart disease, diabetes, stroke, etc.), environmental conditions also impact whether or not someone develops these conditions. There are also no family indicators from sports injuries or anoxic brain injuries, which could potentially be treated with newborn stem cells in the future.
Who can use a baby’s newborn stem cells for medical treatments?
Any close family member who is a suitable match may be able to use the baby’s cord blood stem cells. The baby is always a perfect genetic match to their own stem cells, but for inherited genetic conditions and certain early onset cancers the child’s own cord blood may not be used for their own treatment. Full siblings are the most likely to be compatible matches, with a 25% chance to be a perfect match and a 50% chance to be a partial match. Biological parents are always a partial match to the baby’s cord blood stem cells. It is less likely that other family members will be a sufficient match, and there is no guarantee that an adequate stem cell match will be found for any given patient.
Cord tissue stem cells are not involved with the blood and immune system in the same way blood-producing stem cells found in cord blood are, so they don’t have the same stringent matching requirements prior to use. This means that cord tissue could potentially one day be used not only for the baby, full siblings, and parents, but also grandparents, aunts and uncles, and the child’s eventual children, nieces, nephews, and grandchildren.
Should families preserve newborn stem cells for each child?
Yes. Saving cord blood for each child gives a family more options. Each child would have access to his or her own genetically unique cells. Additionally, there would be an increased likelihood that a family member in need will have access to a related source of matching cord blood. In the case of twins or higher order multiples it is still important to save cord blood for each child separately, even if they are expected to be identical.
How long can newborn stem cells be cryopreserved and still be viable?
Given all the information available today, it is believed that cord blood units in proper cryostorage should be able to be preserved indefinitely. Since cord blood preservation has only been around since 1988, however, cryopreservation tests are limited by time. Even so, there have been successful transplants made with cord blood samples stored for over twenty years.
One independent laboratory study published in 2011 showed that cord blood stem cells that had been in cryostorage for over 20 years — and then thawed — behaved similarly to freshly collected cord blood stem cells. In addition, a recent 2017 article concluded that long term cryopreservation (10 years) had no effect on the expansion potential or function of expanded cord blood natural killer cells (a cell population being researched for a promising treatment for certain cancers called immunotherapy). This study provides evidence that other cell populations in cord blood, aside from stem cells, can be cryopreserved for at least ten years. As time goes on, we suspect that other similar studies will be performed which will continue to inform our thinking on this topic
- Broxmeyer HE, Lee M-R, Hangoc G, et al. Hematopoietic stem/progenitor cells, generation of induced pluripotent stem cells, and isolation of endothelial progenitors from 21- to 23.5-year cryopreserved cord blood. Blood. 2011;117(18):4773-4777. doi:10.1182/blood-2011-01-330514.
- Nham T, Poznanski SM, Fan IY, et al. Ex vivo-expanded natural killer cells derived From long-term cryopreserved cord blood are cytotoxic against primary breast cancer cells. J Immunother. 2017. doi: 10.1097/CJI.0000000000000192.
Can families donate newborn stem cells?
Maybe. Certain hospitals that have partnerships with public banks allow families to donate cord blood, but cord tissue donation is not currently available through public banks. When a family donates cord blood to a public bank, the cord blood may be available to any patient who needs a transplant, so it is unlikely to be available in the future for the family who donated it. It is also important to understand that not all donated samples are banked. As many as 71% of donations may be rejected by public banks based on family medical history, maternal medical history, collection volume, and examination of the maternal blood sample. For more information about cord blood donation, visit BeTheMatch.org.
CBR offers family (also called private) preservation, so the baby’s newborn stem cells are saved and available for the family if ever needed.
Why are stem cells being researched for helping treat COVID-19-related conditions?
Because cord tissue stem cells have well-documented anti-inflammatory and tissue-repair properties, they are ideal candidates for intervention in a number of different diseases, including COVID-19. In fact, MSCs found in cord tissue have been successfully used in many clinical trials for the treatment of lung conditions, even before the emergence of COVID-19.
Since newborn stem cells can help regulate inflammation and stimulate tissue repair, they’re becoming relevant for treating respiratory symptoms from acute lung injury, including damage from severe COVID-19.
- Baraniak PR, McDevitt TC. Stem cell paracrine actions and tissue regeneration. Regenerative Med. 2010 Jan; 5(1):121-143.
- Leng Z, Zhu R, Hou W, et al. Transplantation of ACE2– mesenchymal stem cells improves the outcomes of patients with COVID-19 pneumonia. Aging and Disease. 2020;11:216-228.
Is CBR working on a COVID-19 treatment?
As we announced in our latest press release, we’re officially collaborating with NantKwest, a clinical-stage immunotherapy company, to develop a COVID-19 treatment using newborn stem cells.
Not only will this bring more value to those affected by COVID-19, it will help advance the science of newborn stem cells while protecting our families’ futures.
When approved, we will be the first U.S. private newborn stem cell bank to participate in an FDA-approved human clinical trial with cord tissue mesenchymal stem cells for COVID-19.