Stem cell storage overview
Introduction
What are stem cells?
What is stem cell storage?
Why should I store my baby’s stem cells?
What are they used for now?
Statistical chance of requiring cells for treatment of disease
How many cells are needed for treatment?
Should I store my baby’s stem cells?
Introduction
Recent years have witnessed a rapidly growing parental interest in stem cell storage. Stem cells are the basis of bone marrow transplants, a technique used to treat diseases such as leukaemia for many decades. Since the first stem cell transplant in 1988 much attention has been focused on stem cell storage and potential stem cell therapy applications. Funding for stem cell research has increased dramatically as confidence in the potential clinical benefits of stem cell therapy grows.
In the USA, private stem cell storage is now commonplace. However in the UK this is still a novel procedure and debate continues as to the real benefit of performing cord blood collection at birth for the purpose of stem cell storage. This is mainly due to the fact that the current uses of stem cells are limited to relatively few medical conditions which are relatively rare. Nevertheless, stem cell storage for donation is now established in the United Kingdom. The formation of a National Cord Blood Bank has allowed expectant mothers to donate their child’s stem cells for storage and use in the treatment of children with these diseases. There are specialised stem cell storage centres all around the country.
Over the next 20 years, the clinical uses of stem cells will undoubtedly increase, but the exact benefit individual parents will gain is uncertain. Parents must therefore be given appropriate information about stem cell collection and storage before considering this procedure for their children.
What are stem cells?
Stem cells are “naïve” cells – capable with the right stimuli to transform into other cells types found in the human body e.g. liver, skin, red blood cells. Some stem cells are more “plastic” than others – that is they are able to make more types of cells.
Umbilical cord blood stem cells are one of the most naïve types of cells in the body. Created during the earliest phases of development they have the potential, given the right stimuli, to become specialised cells such as red or white blood cells. It is these properties and the fact that the umbilical cord is a rich source of stem cells that has prompted private companies to offer frozen storage of these cells from umbilical cord blood collected at birth.
What is stem cell storage?
Stem cell storage is preserving your baby’s umbilical cord blood by freezing the cells in liquid nitrogen. This allows you to preserve the stem cells for many years, ready for use at any time in the future should you need them.
Why should I store my baby’s stem cells?
Current research has revealed positive results in the treatment of a wide variety of different medical conditions including ischemic heart disease, cancer, spinal cord lesions, bone fractures, burns, strokes, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, Huntington's disease and diabetes. Other research into its use in regenerating organs, repairing damaged muscle tissue and tendons and helping create skin grafts for burns’ victims has also shown encouraging outcomes.
What are they used for now?
These unique cells can be used to replace damaged or abnormal blood cells as part of the treatment of some malignant blood disorders, such as leukaemia, as an alternative to bone marrow transplantation. The potential benefits of stem cell transplantation are that the cells are immediately available, genetically identical and can avoid the potential risks of bone marrow transplant rejection and infection Indeed in couples of mixed ethnic background it may prove difficult to find a suitably matched bone marrow donor
Statistical chance of requiring the cells for treatment of disease
Curently, stem cells are primarily used for certain forms of cancer. So, for an individual parent, the chances of their child requiring their own stem cells are extremely small (probably one in several thousand). The presently calculated odds of a baby ever using the banked cord blood has been estimated at between 0.005% and 0.037%. It may be even less than this figure for certain individuals. This has led many organisations to conclude there is no place for the routine collection and storage of umbilical cord blood.
However, as explained above, the real reason to store stem cells is to take advantage of the increasing evidence that they will be one of the cornerstones of future medical treatments. It is likely that the chances of using your child’s stem cells will increase as the number of clinical uses of stem cells increases.
How many cells are needed for treatment?
The long term insurance that is offered is only beneficial if there are enough cells in the sample to offer an adequate transplant. A minimum nucleated cell dose of 2.0x107/kg recipient body weight is required for adults undergoing treatment for haematological disease.
The median total nucleated cell yield of a cord blood unit is 1 x 109 – approximately enough for a 50kg person to be treated using one average unit of cord blood
There are published techniques to amplify the number of stem cells, but these require successful completion of clinical trials and thus will not enter routine clinical practice for several years. It is likely that samples will need to be amplified to be used effectively for adult conditions treatable with stem cell therapy.
Should I store my baby’s stem cells?
In selected high risk cases a stored supply of stem cells can be invaluable, e.g. where there is a known genetic disease within the family that is treatable by HSC (haemopoietic stem cells) transplantation. Normally the clinician treating the patient initiates this. Because this use is so small, it is not routine for low-risk families to be given information regarding stem cell storage.
For most expectant parents, it is the future therapeutic possibilities that HSC represent that motivates them to take up this service. As the number and type of clinically trialled and proven therapeutic applications increase, the potential benefits of cord blood storage will increase.
Clinical trials of stem cell therapy are underway in common diseases such as heart disease, but their use in these conditions is not yet clinically proven. At present expectant mothers should be given balanced and factual information to make an informed decision about their child’s future health needs.
As the number and type of clinically trialled and proven therapeutic applications increase, the potential benefits of cord blood storage will increase.
Whilst the immediate statistics available indicate the probability of actually needing these cells for current therapies is very small, the prospective uses are far-ranging and no one has a crystal ball. That is not to say that it is and is going to be the only option available for therapeutic use, but it is a non-invasive pain free method of collecting a source of stem cells that has been shown to have therapeutic uses and advantages already.
We feel it is important that mothers who make an informed choice are able to have this service available to them in the UK, regulated and operated at the highest standards available.
Please look at our Library section for further information and papers discussing this.
Please also see the News section for articles and papers that discuss the pros and cons of umbilical cord blood and stem cell collection and storage.
