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Umbilical-Cord Blood: Lifeline or Hype?
By Kevin Darst
Coloradoan staff
Fort Collins Coloradoan
06 July 2005
KevinDarst@coloradoan.com
Parents bank on stem cells' medical potential
When Debra and Mark Holmes sent their son's umbilical-cord blood to be cryogenically frozen, they banked on the life-saving promise of stem cells.
"Keaton will probably be our only child," said Debra Holmes. "We looked at it as potential security."
So do the thousands of parents who bank their children's cord blood with private firms, hoping they'll never have cause to use it but speculating that science will come up with more advanced uses down the road.
Cord-blood banks market cord-blood stem cells as insurance against blood diseases such as leukemia and suggest that those same stem cells might one day have the ability to cure other diseases, including diabetes, Parkinson's and Alzheimer's.
Cord Blood Registry, or CBR, the Tucson, Ariz., bank that holds the blood from Keaton Holmes' umbilical cord, also holds blood for about 90,000 other families, according to a company spokeswoman. Nationwide, nearly a quarter-million customers have stored their children's cord blood with private banks.
The Holmeses paid CBR about $1,300 up front and will pay about $100 a year to keep 6-month-old Keaton's blood frozen until he's 18. At that point, they say they'll leave it up to him.
Cord-blood stem cells, called hematopoietic cells, are different from embryonic stem cells. They also come without the moral debate stalling research on embryonic stem cells.
Cord-blood stem cells can become only blood cells; embryonic stem cells can become any cell in the body.
Cord-blood stem cells also are found in bone marrow but exist in higher numbers in cord blood.
Parents-to-be are bombarded with advertisements in pregnancy magazines that claim banking cord blood can cure blood diseases, including cancer, and one day could be there to cure their children of debilitating illnesses like Parkinson's, heart disease or diabetes.
"That's a potential, and we would love to see that happen, but we can't do it today," said Neena Kapoor, director of the transplant program at Children's Hospital of Los Angeles. Kapoor compared the gamble on cord-blood stem cells with taking $2,000 to Vegas and "hoping you win."
Physicians and researchers like Kapoor are cautious about cord blood's potential.
While it's possible science one day will be able to do more with cord-blood stem cells, doctors call claims about curing ailments like diabetes and Alzheimer's disease "hype."
"If you're taking money away from your retirement, I wouldn't do it," said Dr. Mick Covlin, an obstetrician and gynecologist at the Fort Collins Women's Clinic.
The American Academy of Pediatrics has discouraged private cord-blood banking since 1997, claiming the industry preys on guilt and unproven promises.
Children are unlikely to need their own cord blood to treat blood diseases such as leukemia because those stem cells would also be expected to have the disease.
Cord Blood Registry's Web site says stem cells stored for its customers have been used in 37 transplants since 1993. Four of those transplants were for the child, 32 were for siblings, and one was for the mother.
A CBR spokeswoman said most of the bank's customers stored cord blood in the past few years and that the number of transplants should increase in years to come.
The doubts don't seem to discourage hopeful parents who can afford private banking.
Andrea and Brian Kaplan did not bank cord blood for their first child, 4-1/2-year-old Sam. But when Max was born two years ago, the couple didn't hesitate. They plan on banking cord blood for their third child, a girl due in October.
"What if I didn't do it and something happened?" Andrea Kaplan said. "I'd blame myself."
Guilt is a big driver in the private cord-blood bank market, said Dr. Ralph Quinones, a physician with the pediatric bone-marrow transplant program at The Children's Hospital in Denver.
Quinones also is the medical director of the University of Colorado Cord Blood Bank. The public bank opened in 1996, accepting donations from several hospitals in Colorado, including Poudre Valley Hospital in Fort Collins.
During the next five years, the bank collected about 12,000 cord-blood donations and kept 6,400 of them for transplant in unrelated patients.
Lacking funding, it stopped accepting cord blood at the end of 2001. Quinones said it might resume donations this year and, if so, again would tap into PVH for cord blood. Bonfils Blood Center in Denver, the other nonprofit, unrelated cord blood bank in Colorado, also has stopped accepting cord-blood donations, leaving Colorado residents unable to donate cord blood to public banks in the state.
Banking cord blood for anything but hereditary blood diseases is "pie in the sky" now, Quinones said. And banking the blood of a child who develops leukemia in the first years of life won't help that child, he said.
"If a child has leukemia in the first five or six years, we wouldn't even touch that cord blood," Quinones said.
Still, there's a chance that scientists will develop other uses for cord-blood stem cells, he said.
"What we thought was hard (in the 1970s) is routine now," Quinones said.
The Kaplan and Holmes families say they know they could be wasting their money.
"I'd be totally fine with that," Mark Holmes said. "If he never uses it, oh well."
David Harris, scientific director at Cord Blood Registry and a professor of immunology at the University of Arizona, said parents should bank based on what they know cord-blood stem cells can do. He pointed out that leukemia and the other blood diseases that can be treated with cord-blood stem cells are rare.
"Parents are worried about kids getting cancer regardless of how much you explain the odds," Harris said.
They're also usually willing to do anything for their children, regardless of the risk.
"If there's a chance you could help them in that degree, why not, except for money?" Mark Holmes said.
His wife agreed.
"In our opinion," Debra Holmes said, "the benefit outweighs the risk of not using it and sending our money down the drain."
On the Internet
http://www.aabb.org
http://www.fda.gov
http://www.cordblood.com
http://www.cryo-cell.com
http://www.viacord.com
http://www.cordbloodbank.com
http://www.cordpartners.com
http://www.cordblooddonor.org
http://www.marrow.org
http://www.nationalcordbloodprogram.org
By the numbers
$1,200-$2,000 Up-front cost private firms charge to collect cord blood
$100 About the cost private firms charge to store cord blood annually
250,000 Number of customers claimed by the three biggest private cord-blood banks, Cord Blood Registry, ViaCord and CryoCell
50,000 Number of new customers Cord Blood Registry plans to add this year
76,000 Number of cord-blood samples stored at public cord-blood banks in 2004
Zero Number of public cord-blood banks in Colorado. The University of Colorado Cord Blood Bank plans to resume collecting donations in July.
4 million Number of births each year in the United States
V. Richard Haro/The Coloradoan
Mark and Debra Holmes, of Fort Collins, paid to have the umbilical-cord blood of their son, Keaton, 6 months, cryogenically frozen for possible future use against disease.
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