- How long can stem cells be stored?
Based on current developments, cryogenic preservation of tissue under liquid nitrogen conditions can last indefinitely.(1) According to guidelines by the New York State Department of Health, there is no evidence at present that cord blood stem cells stored at -196 degrees Celsius in an undisturbed manner will lose either in vitro-determined viability or biological activity. Studies on the cryopreservation of other types of cells (like sperm cells and eggs) have indicated that these cells can be stored up to 50 years. Scientists in other parts of the world had cryogenically preserved human cells for over 30 years successfully.
Frozen at extremely low temperatures, the stem cells are in a dormant state and do not age. In theory, they could last almost forever if the ultra low temperature is maintained.Current records also show that umbilical cord blood stem cells stored for 30 years remained viable and retained their ability to engraft.(2 & 3)Although Cellsafe enters into a maximum 21-year contract with our client, it doesn’t mean that we could not preserve the stem cells beyond that time-frame. Cellsafe takes the stance that, upon the 21st anniversary of the contract, the legal ownership and custody rights of the stem cells pass on to the child (who will be legally an adult then). A fresh contract is required to be entered into with the owner of the stem cells then to continue with the cryogenic preservation of the stem cells.
1) Guidelines for Collection, Processing and Storage of Cord Blood Stem Cells (2nd Ed. Mar 2003), New York State Department of Health;
2) Broxmeyer, H.E. et al. (2003), “High-efficiency recovery of functional hematopoietic progenitor and stem cells from human cord blood cryopreserved for 15 years”, Proceedings of the National Academy of Sciences, USA, Volume 100. Issue 2, pp. 645-650;
3) Kobylka, P. , Ivanyi, P. , Breur-Vriesendorp, B.S. , et al. (1998) , “Preservation of Immunological and Colony-Forming Capacities of Long-Term (15 years) Cryopreserved Cord Blood Stem Cells”. Transplantation. Volume 65. Issue 9, pp. 1275-1278;
- What will happen to the stem cells after 21 years of storage?
After 21 years, a letter will be sent to the grown-up child to give him/her the choice of whether to continue with the stem cell storage.
- Who does the cord blood stem cells legally belong to ?
The umbilical cord is a unique organ that is shared between the mother and the baby. The legal stance of the blood drawn from the umbilical cord belonging to either the mother or the child has equal merit. Cellsafe adopts a policy that the legal custodian of the umbilical cord blood stem cells is the mother until the child reaches a mature age (21) to make decisions as an adult.
- Should I bank my baby’s cord blood stem cells with public or private cord blood banks? If I store cord blood stem cells with a public cord blood bank, can I retrieve them when I need them?
It is entirely the parents’ decision to opt for private or public cord blood banking. Private cord blood banking provides guaranteed availability when the cord blood is needed; while availability is not guaranteed if the cord blood is stored in a public cord blood bank. Do note that not all samples donated are eligible for storage in public cord blood banks.
- Why do I need to store my baby’s cord blood stem cells privately when I can store it in a public cord blood bank that can always provide me with donated samples?
When the need for transplantation occurs, the attending physicians’ priority will be to use the baby’s own cord blood (if available). If the baby’s cord blood stem cells were not collected and stored at birth, stem cells from a related donor (sibling or close relative) are used. If these are not available, only then will he choose to use samples from an unrelated donor. For transplants that take place using the baby’s own or related cord blood stem cells, the survival rate is approximately 63%. For patients that use unrelated cord blood samples for transplants, the survival rate plummets down to 29%. This is the reason why transplant physicians choose to use the child’s own cord blood. Additionally, for patients using unrelated cord blood, there may be a 20% chance that they develop GHVD(4) as opposed to a 5% chance for patients using related cord blood.
4) Gluckman, E. , Rocha, V. , et al. (1997) , “Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group”. New England Journal of Medicine, Volume 337. Issue 6, pp. 373-381;
- Is it sufficient to bank just one child’s cord blood stem cells?
Each child’s genetic composition is unique and hence siblings may have different HLA typing. For best results during stem cell transplantation, a perfect (100%) HLA typing match is preferred over a partial HLA matched sample. By storing each child’s cord blood stem cells, the likelihood of using the stored cord blood will be higher when a cord blood transplant is needed. Storing each child’s cord blood may also increase the chances of finding a good HLA match among family members.
- Why perform the maternal blood test when I already have a medical report from the doctor?
An antenatal check-up may have been performed, but the mother may still acquire an infection prior to delivery. A maternal blood test, performed in compliance with AABB standards, ensures that the cord blood is free of any infectious diseases. Maternal blood testing is essential to confirm the cord blood is virus-free. This is because not all detectable antibodies may be present in the cord blood.
- What if my child’s cord blood stem cells cannot be used because it could carry the disease?
Diseases such as leukemia, lymphoma, myeloma and solid tumours have been treated using the child’s own cord blood stem cells (autologous stem cells) in transplants. Besides this, it has also been reported in the Journal of Clinical Oncology that for some diseases detected within 12 months of birth, an autologous stem cell transplantation is still recommended over allogenic (from other people) stem cell transplantation. In treating various diseases, autologous stem cell transplantations are found to be as effective as allogenic stem cell transplantations. More importantly, there is no risk of Graft vs. Host Disease (GvHD), which is the rejection of donor cells by the recipient. Immediate availability and a low to zero chance of disease transmission from the transplant sample are also added advantages.(5)
5) Marco, F. , Bureo, E. , et al. (2000) , “High Survival Rate in Infant Acute Leukemia Treated with Early High-Dose Chemotherapy and Stem-Cell Support”. Journal of Clinical Oncology, Volume 18. Issue 18, pp. 3256-3261;
- Will my baby ever need it, as the odds of needing to use the cord blood stem cells seem very low?
Multiple sources have shown that the odds range from 1:1000 to 1:200,000. Considering the causes of most cancers remain unknown and the rapid development of stem cell therapies, the chances of using the cord blood can never be estimated accurately. Additionally, it has recently been revealed that cord blood may also be used increasingly in treatment for adults too. According to the Journal of Pediatric Hematology/Oncology(6), the odds of a child using his or her own cord blood stem cells by age 21 for existing treatments is 1:2700. Parents should take into account that research being carried out may widen the scope of treatment by stem cells.(7)
6) Johnson, F. , (1997) , “Placental Blood Transplantation and Autologous Banking”. Journal of Pediatric Hematology/Oncology Volume 19. Issue 3, pp. 183-187;
7) Laughlin, M. , Barker, J. , et al. , (2001) , “Hematopoietic Engraftment and Survival in Adult Recipients of Umbilical-Cord Blood from Unrelated Donors”. New England Journal of Medicine Volume 344. Issue 24, pp. 1815-1822;
- What happens if the number of cord blood stem cells collected is insufficient or less than the acceptable volume?
Should the number of nucleated cells collected be less than the acceptable minimum of 200 million cells or more, the client will be informed and their decision requested on whether or not to proceed with storing their child’s cord blood.
- Can single mothers store their baby’s cord blood stem cells?
Yes, we only require the consent of the mother (at the minimum) to cryogenically preserve the baby’s cord blood stem cells.
Self-originating from a particular individual. In the case of an autologous transplant, the same person acts as both donor and recipient.
Different, originating from two different individuals. In the case of allogenic transplant, it indicates that both the donor and recipient are different persons.
Human leukocyte antigen: The marker protein on the tissue surface indicating the immunological properties of a tissue. It is used as an identification agent for the immune system to distinguish the body’s own cells from foreign agents.
Stem cells responsible for building blood cells and immune system cells.