Cord blood: The building blocks of regenerative medicine

Stem cells can cure only blood-related diseases, so why there is a rush to save babies' cord blood?

Last Updated : Mar 28 2017 | 12:58 AM IST

From being discarded as waste at the time of a baby’s delivery to being recognised as a repository of stem cells and the building blocks of regenerative medicine, the cord blood and tissue has come a long way.

In the late 1980s, a decade when all sorts of exciting things were happening in the world of medicine, physicians discovered that cord blood contained stem cells. The exact use of these cells were ascertained a few years later, with their successful transplant into the body of a child suffering from Fanconi anaemia, a rare genetic disease. The source of cord blood stem cells was the patients’ sibling. Also umbilical cord blood (UCB) has 10 times greater the number of stem cells than adult bone marrow and it is easier to match UCB than bone marrow between a donor and recipient.

Stem cells have, unfortunately been marketed as a quick-fix for everything from dermatological anti-ageing treatments to curing degenerative diseases such as osteoarthritis and cerebral palsy. The truth is that at present, stem cells from the umbilical cord blood can cure only blood-related diseases. Sure, there is a great deal of research taking place around the world on all kinds of cures, but we will need to see these developments as a future hope, not a sure-shot cure at the moment.

So why then are companies rushing to save babies’ cord blood? And why are parents banking it? There are two parts to this answer. Banking your baby’s cord blood for his or her own use is of little purpose now. This is because genetic conditions that are ‘embedded’ in the blood cannot be cured by the UCB from the child - the genetic defects are prevalent in the cord blood too. Even a child who develops leukaemia will need umbilical cord blood from another donor. The chance of a baby later benefiting from his or her own banked cord blood is currently less than 0.04 percent, says the American Society for Blood and Marrow Transplantation.

Which brings us to the next part of the answer: cord blood banking companies are of two types - those that bank a baby’s blood for their own use; those that put blood into a pool, which makes your own baby’s blood available to other people and vice versa. What should parents ideally be doing? Putting their baby’s umbilical cord blood into a common pool where it could be saving someone’s life. Similarly, another’s UCB could save your child. Think of it like a regular blood bank, where you donate to save a life.

Dr Rahul Bhargava

In India, we have a huge potential when it comes to UCB storage simply because of the size of our population, in terms of numbers and genetic diversity. However, because people feel their baby’s UCB is a personal belonging, the transplants performed in India have been very low. We have an estimated requirement of 50,000 units annually, but most of the UCB stored in banks is not available to the public. Nearly 70 per cent of patients of Indian origin who require bone marrow transplantation do not find a match within their own family.

When parents opt for a bank, they must check on how the UCB will be harvested, what amount will be taken, how it will be stored, and for how long. The ideal amount to be collected is 80 ml, and you need to get this on paper. Also know that this is useful for treatment when your child is young. A person over 50 kg will need 2 cord blood units, making it necessary to tap into the pool.

So far, we can store cord blood for a little over 21 years. Ask if the bank will do so. UCB is stored cryogenically, which means it is frozen. How will this be frozen and thawed? Is there a system in place? What happens if the bank shuts down - does it have a provision to transfer the stored UCB to another bank? Besides selecting a pool banking system, do ask as many questions as you can, and then decide upon a bank in tandem with the haematologist, at the hospital you will be having your baby at.

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Dr Rahul Bhargava is director and head (hematology and bone marrow transplant), Fortis Memorial Research Institute, Gurgaon