Stem cell therapy has been taking new shapes as cord blood becomes an alternative source for obtaining both hematopoietic stem cells and progenitor cells to assist in treatment of malignancies and other life-threatening diseases. American Academy of Pediatrics (AAP) provides guidelines and stipulations on how collection of cord blood cells should be done, how patients wanting to consider cord blood banking should be handled, and the role cord blood banks should play.
The revised version of the 2007 AAP policy statement entitled “Cord Blood Banking for Potential Future Transplantation” shows touchy issues that need to be addressed as the hematopoietic stem cell transplants (HSCTs) gain focus on umbilical cord blood. The AAP guide helps professionals in the field of stem cell transplants including pediatricians and obstetricians or other healthcare providers to respond intuitively, reasonably, and responsibly to questions raised by parents that want to know much about cord blood donation and storage.1
New applications for hematopoietic cells derived from cord blood necessitated the updating of the 2007 AAP policy statement. Cord blood can provide stem cells that treat malignancies, metabolic diseases, hemoglobinopathies, and primary immunodeficiencies. The AAP policy statement supports and recommends the use of public cord blood banks by parents to donate their newborn’s cord blood cells. It has also been mentioned that physicians should ensure that parents understand the two most applied concepts in the treatment of patients using cord blood matches. These are autologous (referring to own or self use) and allogeneic (referring use of stem cells taken from another person who may be related or unrelated). Parents need to know the limitations and benefits that come with cord blood donations.1,2,3
The concept of private cord blood banking being touted as a biological insurance is also discouraged, and that parents should consider public banking as the most beneficial and sound way of donating cord blood. Many parents may make uninformed decision when they are not educated on how to go about with their cord blood banking needs. You have probably been told that cord blood banking is a once-in-a-lifetime chance, so if you don’t collect and store cord blood, you may not be able to get stem cells for treatment of the life-threatening malignancies and non-malignant conditions that affect your child, family member, or a relative.3
Collecting and storing cord blood in private banks may work better in some situations, and it shouldn’t be seen as the only life-saver. In fact, many parents storing blood in private banks may never use it because they properly didn’t get the right advice. For example, a genetic counselor may help you if you have risks or history of the family having heritable diseases like leukemia.
If parents are directed to bank cord blood because they have a member with a disease treatable using hematopoietic stem cell transplant, it should be available through private or public banks. The parents should make their own choice. The policy statement also highlights the need for underserved ethnic minorities to be encouraged and educated on the importance of donating cord blood to public banks. There are ethical and operational principles and values that should be followed when conducting cord blood banking. For example, consent policies, conflict of interest, financial disclosures, and other contentious issues should be worked on through a set of standards to guide those involved.1,2
Healthcare professionals or physicians that advice pregnant women and the families to consider private cord blood banking should make sure that they disclose their financial interests or reasons they are doing do. Some physicians may have vested interests in recommending certain services like cord blood banking, particularly for monetary gains, and this is something parents and families should be aware of.
When the guidelines provided in the AAP policy statement are followed, they help shed light on some of the myths on cord blood banking and what should be done to the interest of all stakeholders, with the family taken as primary decision maker.
Keywords: cord blood cells; umbilical cord blood; cord blood donation; public cord blood banks; donating cord blood; bank cord blood; myths on cord blood banking
- AAP releases updated information on cord blood banking. https://www.clinicaladvisor.com/pediatrics-information-center/aap-updates-information-on-cord-blood-banking/article/703747/
- Umbilical Cord Blood Banking. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Genetics/Umbilical-Cord-Blood-Banking
- Cord Blood Banking for Potential Future Transplantation. http://pediatrics.aappublications.org/content/early/2017/10/26/peds.2017-2695