This pamphlet explains

the difference between stem cells and other cells how the stem cells in cord blood can be used to treat disease when stem cells cannot be used to treat disease how cord blood is collected and stored

It is important to know all of the facts about saving cord blood for future use before making a decision.

What Are Stem Cells?

Most cells can make copies only of themselves. A skin cell can make another skin cell, for example. Stem cells are like blank slates. They can mature into different kinds of cells. The blood-forming stem cells found in cord blood make new blood cells to replace old ones in the body.

How Are Cord Blood Stem Cells Used?

Blood–forming stem cells in cord blood can be used to treat some types of illnesses, such as disorders of the blood, immune system, and metabolism. They also are used to offset the effects that cancer treatments have on the immune system. Other uses are being studied.

Stem cells occur in places other than cord blood. They are found in blood and bone marrow in adults and children. Using cord blood to treat disease has some benefits over using bone marrow. For example, it is harder to collect bone marrow than it is to collect cord blood. Collecting bone marrow poses some risks and can be painful for the donor.

What Are the Limits to Stem Cell Use?

Stem cells are not a “miracle cure.” Only a few diseases can be treated with stem cells. There also are other limitations:

• If a baby is born with a genetic disease, the stem cells from the cord blood cannot be used for treatment because they will have the same genes that cause the disorder.
• A child’s stem cells cannot be used to treat that child’s leukemia, a cancer of the blood. However, stem cells from a healthy child can be used like any other donated organ to treat another child’s leukemia. Careful matching of the recipient and donor are done to make sure that the stem cells will work. urn. If symptoms recur after the treatment is finished, see your doctor. A different treatment may be needed.

How Is Cord Blood Stored?

Cord blood is kept in one of two types of banks: public or private. They differ in important ways that may affect your choice.

Public Cord Blood Banks

Public cord blood banks operate like blood banks. Cord blood is collected for later use by anyone who needs it. The stem cells in the donated cord blood can be used by any person who “matches.” The cord blood is tracked in a database so that a unit can be found quickly when needed.

Public banks do not charge to collect cord blood. The National Marrow Donor Program (http://www.marrow.org/) is a network that has a list of public banks. Public banks are not available in all areas.

Donors to public banks must be screened before birth. Screening entails a detailed medical history of the mother and father and their families. The goal is to learn of any blood or immune system disorders or other problems. Donors also are asked about their lifestyles. Many people will not meet these screening standards.

Some of the following factors rule out donating to public banks:

• Travel to certain countries
• Exposure to some vaccines
• Use of illegal drugs
• High-risk sexual behavior
• History of cancer on either side of the family
• Mother or father being adopted

Private Cord Blood Banks

Private banks store cord blood for “directed donation.” The blood is held for use in treating your baby or relatives.

Private banks most often charge a yearly fee for storage. There also will be a fee for collecting the cord blood. Some doctors may have a financial or other conflict of interest in a private bank. Your doctor should tell you about any conflicts.

How Is Cord Blood Collected?

Cord blood is collected by your health care pro-vider or the staff at the hospital where you give birth. Not all hospitals offer this service. Some charge a separate fee that may or may not be covered by insurance. Certain steps must be done in advance:

• The bank must be notified far in advance (usually 6 weeks or more) of the due date.
• A family medical history must be provided.
• A consent form must be signed before labor begins.
• Collection materials must be obtained.

Sometimes, not enough cord blood can be collected. This problem can occur if the baby is premature or if there is more than one baby and they share a placenta. It also can occur for no reason. If an emergency occurs during delivery, it may not be possible to collect cord blood.

Problems with the mother may not allow any cord blood to be collected. These problems make it more likely for cord blood to carry an infection:

• Herpes or genital warts
• Infection of the placenta or amniotic fluid

Making A Decision

The decision about whether to store cord blood needs to be made several weeks before delivery. Whether to donate cord blood is up to you. You have three choices:

1. Donate the cord blood to a public bank to possibly help others.
2. Store the cord blood in a private bank in case your child or a relative has a disease that can be treated with stem cells.
3. Do not donate cord blood.

• Many diseases cannot be treated with a person’s own stem cells.
• The chance that cord blood stem cells will be needed to treat your child or a relative is very low—about 1 in 2,700. However, research is being done into new uses for stem cells. Research also may uncover new ways of treating disease that do not involve stem cells.
• Currently, it is not known how long cord blood can successfully be stored.

• What will happen to the cord blood if a private bank goes out of business?
• Can you afford the collection fee and yearly storage fee for a private bank?
• What are your options if results of the screening tests show you cannot donate to a public bank?

Finally...

The stem cells in cord blood can be used to treat some diseases, but their uses are limited. Cord blood banking makes it possible to store these cells in case they are needed in the future. You should know all of the facts about cord blood banking before making a decision. Your health care provider can help you decide whether cord blood banking is a good option for you and your baby.

Glossary

Cells: The smallest units of a structure in the body; the building blocks for all parts of the body.

Bone Marrow: The spongy tissue in bone cavities that produces new blood cells.

Genes: DNA “blueprints” that code for specific traits, such as hair and eye color.

Immune System: The body’s natural defense system against foreign substances and invading organisms, such as bacteria that cause disease.

Metabolism: The physical and chemical processes in the body that maintain life.

Placenta: Tissue that provides nourishment to and takes waste away from the fetus.

Umbilical Cord: A cordlike structure containing blood vessels that connects the fetus to the placenta.

This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women’s health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as “superior.” To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright © September 2009 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

ISSN 1074-8601

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