What is Cord Blood

B]What is Cord Blood?
Cord blood is the blood remaining in the umbilical cord and placenta after birth. Cord blood is rich with stem cells, which are the building blocks of blood and immune systems in the body. Stem cells have the ability to become many other types of cells, so used to repair and maintenance of many other damaged cells in the body.

The body’s immune system and blood system also originate from stem cells. There are many convincing clinical evidences proving that stem cells from umbilical cord blood extended much farther than the blood forming and immune systems, and that they can differentiate themselves into brain, heart, liver and bone cells.

Currently, cord blood is being used to treat malignant diseases such as Leukemia, Lymphoma, Neuroblastoma and numerous other types of cancer. It is also being used to treat non-malignant diseases such as Aplastic Anemia, Thalassemia, Congenital Cytopenia, Hunter Syndrome, Osteopetrosis, Severe Combined Immunodeficiency Syndrome, Sickle Cell Anemia, Wiskott Aldrich Syndrome and many others.

Before 1989, the only way to treat patients with such diseases was Bone Marrow and Peripheral Blood Transplantation. But with Bone Marrow there was a big problem that mostly patients do not find a suitable donor for bone marrow. But today, and with cord blood stem cells, people have another great alternative to bone marrow.

Stem cells divide to create:

• Red blood cells, which carry oxygen to the brain.
• White blood cells, used in the body's immune system
• Platelets, which help blood clotting and prevent bleeding.

Much like bone marrow, cord blood is one of the richest sources of stem cells that can ever be collected. It is from the umbilical cord and the placenta right after the cord has been cut. Normally cord blood is discarded after birth, but with increasing knowledge and awareness to the benefits of this blood today, people are saving (private) or donating (Public) this blood to a cord blood bank.

As cord blood is also found in the placenta, so sometimes it is also called Placenta Blood. When cord blood from the umbilical cord was unknown it was considered as a useless thing. But in reality after many clinical and individual evidences, cord blood is considered to be very important and useful blood.

Cord blood stem cells are immature cells that have the ability to differentiate into other tissues, organs, and blood vessels, and they can be used to treat a host of diseases.

For patients with conditions like leukemia, for instance, chemotherapy is often used to rid their bodies of diseased cells and restore normal blood cell production. Usually, normal blood cell production resumes and the disease change into remission. But if the treatment fails or disease recurs, doctors often add a stem cell transplant to the treatment regimen.

By using a transfusion of stem cells in cord blood from a healthy donor, a new blood and immune system can be generated and the patient has a better chance of making a full recovery. Unlike the stem cells in bone marrow — the most common source of stem cells today — stem cells in cord blood are immature and haven't yet learned how to attack foreign substances. As a result, patients who receive stem cells from cord blood are less likely to reject the transfusion.

Why Store Cord Blood?
Why should cord blood be stored? Well, it is the latest concern amongst all new parents or would be parents. Because umbilical cord blood contains special cells called "stem cells" which can be used as part of the treatment therapy for nearly 50 life-threatening diseases. Cord blood stem cells can be used as part of the treatment therapy in certain cancers, such as leukemia, and immune and genetic disorders and research may provide answers to Stroke, Heart Disease, Diabetes, and Muscular Dystrophy.

Most families bank their baby's cord blood because they want the comfort and confidence that comes with knowing that, should the need arise, their baby's cord blood stem cells are readily available. Still others choose cord blood banking because they are excited about the possibilities that science may provide in the future.
Naturally, there are those who have an existing medical need, such as a history of disease or a family member who is sick with a condition that would use cord blood stem cells as part of the treatment therapy. More opportunities are being discovered every year but, since each case is different, there is no guarantee that a cord blood transplant will be an appropriate treatment therapy or that it will provide a cure.


Apart from Cord Blood, other good sources of stem cells include bone marrow and peripheral blood; however there are a number of benefits to using cord blood stem cells in transplants, including:
• There is no risk involved. Collection is a very simple and painless procedure, but it must be done at birth.
• It is much easier to collect and harvest without the risks of general anesthesia required to harvest bone marrow.
• It is readily available if needed (if collected and stored at birth).
• It has lower procurement costs compared with peripheral blood or bone marrow harvesting.
• Its stem cells are a perfect match for your baby, have a 25% probability of being an exact match for a sibling (even greater chances of being a viable match), and can be potentially used for parents and grandparents.
The umbilical cord blood is rich in the same hematopoietic stem cells that form the basis for bone marrow transplants. Hematopoietic stem cells are the building blocks of red blood cells, platelets and the immune system. Every year, 14,000 people in the United States require a bone marrow transplant for life-threatening diseases. But not everyone is willing to donate bone marrow, so there is always a scarcity of donors as compared to the need. To meet any contingency, physicians have started using umbilical cord blood as an alternative source for stem cells.

Not just the donation purpose, but for personal use for your child to survive some of the most deadly diseases and debilitating conditions, you can store the blood from your baby's umbilical cord. In fact you're giving your baby the chance to avail the likely benefits in the future in case of any need. Umbilical cord blood is rich in stem cells, the immature cells that develop into part of the body's immune system. And it does not take much. Only 60-80 milliliters of cord blood contains millions of stem cells. Because these stem cells are compatible with your child's immune system, they can be used to fight more than 50 diseases, including leukemia and Hodgkin's disease, with no risk of rejection.

Your baby's cord blood stem cells are unique to your family and have several benefits over other types of stem cells. The immune cells in cord blood are "younger" and are more likely than bone marrow to be a suitable match between family members. This is important because some studies have shown that survival rates double when the patient receives a stem cell transplant from a relative. Cord blood stem cells are associated with less graft vs. host disease (GVHD) as compared to treatments with other sources of stem cells. This type of rejection is the leading cause of death in stem cell patients during any transplantation.

So, by storing the cord blood of your baby today, your baby's stem cells are immediately available if needed, and may help with more rapid treatments the science may provide in the future. Families who have their babies' stem cells banked are positioned to take advantage of the exciting medical breakthroughs. Stem cells are an important biological resource and researchers are continuing to investigate the potential of umbilical cord blood stem cells for future applications. In every sense it is a wise decision to be made and it doesn’t cost you much as compared to the benefits it is already having or may have in the time to come.

Pros and Cons of Storing Cord Blood?
Due to latest research findings, medical promises and increased awareness more and more people are inclined to storing cord blood of their newborns. However, consensus is equally divided amongst the anti and pro groups. But still, there are many families for which cord blood banking makes sense. Certain issues, such as family histories of genetic diseases or belonging to certain ethnic or racial groups, factor into the decision.

According to experts, if you have a family history or are worried about a tendency to certain diseases, cord blood banking can give you peace of mind. As of today, cord blood transplants treat over 50 diseases; malignancies, such as leukemia and other cancers; metabolic disorders; blood disorders, such as sickle-cell anemia, and immune - deficiencies.

There are number of factors which should be considered:
One of the most important factors is compatibility of the Recipient, because cord blood is a more primitive source of stem cells, the recipient runs a lower risk of graft vs. host disease (GVHD), a potentially life-threatening immune response.

The second important factor could be the convenience. Not only is cord blood easy to retrieve (than to bone marrow), because it’s cryogenically stored, it is available for transplant whenever it is needed. Bone marrow, on the other hand, is more difficult to get a hold of; it is harder to find a donor matching your HLA type, and the process of retrieval is comparatively more complicated.

The next great factor is about your ethnicity or belongings. Belonging to certain ethnic or racial groups may mean a longer wait to find a bone marrow donor; therefore, donating or privately banking your baby’s cord blood will make transplants readily available to these individuals.


Advantages of cord blood banking: Stem cells, like those found in a newborn's umbilical cord blood, are the source of platelets, oxygen-carrying red blood cells, and give birth to the body's immune system. Medical researchers are currently exploring new uses for umbilical cord blood stem cells in numerous medical conditions. One of the main advantages of cord blood banking is that someday, the stem cells you preserve could potentially save the life of the donor or other family members. So, overall it is considered to be a good idea. Otherwise also, there is no harm and the process is really simple and painless to the child as well as to the mother.

Cord blood banking is neither a fashion statement nor a routine in hospital or home deliveries - it's a procedure you have to choose and plan beforehand, so be sure to consider your decision carefully before delivery day, because once it is lost cannot be recovered. The primary reason that parents consider banking their newborn's cord blood is that because they have a child or close relative with or a family medical history of diseases that can be treated with bone marrow transplants.
Cord Blood Advantages
There are numerous advantages of cord blood stem cells and only because of these advantages cord blood collection and storing have gained much momentum during last few years. Studies suggest that stem cells from cord blood offer some important advantages over those retrieved from bone marrow. For example, stem cells from cord blood are much easier to get because they are readily obtained from the placenta at the time of delivery. Whereas, harvesting stem cells from bone marrow requires a surgical procedure, usually under general anesthesia, that can cause post-operative pain along with a small risk to the donor.

Cord blood stem cells can benefit a large number of recipients. Cord blood stem cells can be stored and transplanted back into the donor, to a family member or to an unrelated recipient, whereas in case of bone marrow transplant, there must be a nearly perfect match of certain tissue proteins between the donor and the recipient (which becomes a hard to achieve task sometime).

One positive finding is that cord blood transplant patients appear to suffer less from acute graft-versus-host disease (GVHD) than patients who receive bone marrow transplants. GVHD is a very serious, and sometimes fatal, condition that occurs when the patient's new immune system -- which is made up of stem cells from the donor -- starts attacking the patient's body. GVHD affects the skin and internal organs such as the liver and intestines. A 2000 study found that children who received a cord blood transplant from a closely matched sibling were 59 percent less likely to develop GVHD than children who received a bone marrow transplant from a closely matched sibling.

Other big advantages are the availability and ease of use. The use of cord blood may make blood stem cell transplants available more quickly for people who need them. About 30,000 individuals each year are diagnosed with conditions that could be treated with a bone marrow transplant. Approximately 25 percent of these individuals have a relative who is an appropriate tissue match. While suitable donors can be located for many through national bone marrow registries, the process can take months. It often is more difficult to find a bone marrow match for members of non-white ethnic and racial groups; transplants from cord blood may make timely treatment available for more of these individuals. Banked stem cells from cord blood can be more readily available, and this can be especially crucial for patients with severe cases of leukemia, anemia or immune deficiency who would, otherwise, die before a match can be found.

Cord blood also is less likely to contain certain infectious agents, like some viruses, that can pose a risk to transplant recipients.
Moreover, some studies suggest that cord blood may have a greater ability to generate new blood cells than bone marrow. Ounce for ounce, there are nearly 10 times as many blood-producing cells in cord blood. This fact suggests that a smaller number of cord blood cells are needed for a successful transplantation.

In addition, cord blood stem cells offer some exciting possibilities for gene therapy for certain genetic diseases, especially those involving the immune system. Donald Kohn, MD, and colleagues at the Children’s Hospital of the University of Southern California in Los Angeles and the University of California in San Francisco, made the first attempt at gene therapy with cord blood in 1993 in three children suffering from adenosine deaminase (ADA) deficiency, a potentially fatal defect that cripples the immune system. The children, who also receive additional drug treatment, appear healthy to date, even though their blood now carries only a small amount of the gene introduced into their stem cells.

To sum up the above-discussed advantages, below given are some main advantages of cord blood stem cell transplantation over marrow or blood stem cell transplants include:

• Large potential donor pool;
• Rapid availability, since the cord blood has been prescreened, tested, frozen and is ready to use;
• No donor attrition, since the cord blood stem cells are already stored;
• Potential for greater racial diversity and balance in the donor pool by focusing collection efforts on hospitals where births of children from diverse ethnic backgrounds are well represented;
• No risk or discomfort for the donor;
• Rare contamination by viruses and
• Lower risk of graft-versus-host disease (a condition that occurs when donor cells attack the recipient's organs and tissues), even for recipients with a less-than-perfect tissue match.
Obtaining Cord Blood
Cord Blood is a rich source of stem cells as Bone Marrow, but it is very easy to attain as compared to bone marrow. The collection process is comparatively easy and painless, and does not interfere with the delivery or subsequent care for your newborn and yourself.

Immediately after delivery of the baby, the umbilical cord is clamped and the baby is separated from the cord. The Obstetrician or Midwife cleans a 4-to 8-inch area of umbilical cord with antiseptic solution and inserts the blood bag needle into one of the three veins in the umbilical cord. The blood flows into the bag by gravity, until it stops, after which the collection is complete.

The blood bag is clamped, sealed and labeled. The collection typically takes 2 to 5 minutes. Three tubes of maternal blood are also drawn. After a successful collection about 75 to 90 ml (less than 1/2 a cup) of cord blood is collected. This quantity is about 10 times less than is usually used for a bone marrow transplant.

The bag comes equipped with an anti-coagulant to keep the blood from clotting before it reaches to the concerned laboratory. The process is non-invasive, painless, and unlike traditional bone marrow collection which usually requires a general anesthesia and recovery, generally takes between three and five minutes to complete. In many cases patients are supplied with a cord blood collection kit prior to delivery date (to bring along with them) to the hospital for the physician or midwife to collect the cord blood after delivery.

When the placenta is expelled, more blood will be collected from the veins in the placenta. After the placenta is out of the womb, the cord blood collection may not be successful because the volume collected is insufficient or there is a clot.
The minimum requirement of cord blood sample is 100g. The main goal when collecting cord blood is to collect the maximum number of hematopoietic progenitor cells possible (without affecting the safety of the mother or fetus). The number of stem cells is important to the success of the transplant.

Is Cord Blood Collection Risky?
For the expectant parents it is matter of great curiosity is cord blood collection risky or painful. Well, cord blood is collected from the umbilical cord immediately after the birth of the baby but generally before the placenta has been delivered. The collection can only take place at the time of delivery and generally takes few minutes. There is absolutely no pain or risk to the mother or child during the collection process since the blood is harvested from the cord once it has been clamped and cut.

Stem cells from cord blood are much easier to get because they are readily obtained from the placenta at the time of delivery. Harvesting stem cells from bone marrow requires a surgical procedure, usually under general anesthesia, that can cause post-operative pain and poses a small risk to the donor. Normally there are no health risks related to cord blood collection. Cord blood is retrieved from the umbilical cord after it has been cut preventing any possible pain, discomfort, or harm. Cord blood collection is safe.

According to researchers and medical experts cord blood donation is medically safe and poses no health risks to you or your baby. Moreover, donating does not affect your baby or your birth experience because the cord blood is collected after your baby is born. If you or your baby experiences any complications during delivery, your doctor will not collect the cord blood.
How is Cord Blood Stored?
After cord-blood collection has taken place, the blood is placed into bags or syringes and is usually taken by courier to the cord blood bank. Once there, the sample is given a unique identification number. Then the stem cells are separated from the rest of the blood and are stored cryogenically (frozen in liquid nitrogen) in a collection facility or a cord-blood bank.

While storing cord blood, each vial is clearly marked with: Cord Blood Number, Date of Birth, Baby's Name, Date of Processing, and Contents, before it is sent to the first stage of the Cryopreservation process.


After cell processing is completed, cells are placed into the liquid nitrogen tanks where they will be stored at -190 degrees centigrade. All of these tanks are located in the highly monitored and secured facility.

Theoretically, stem cells should last forever, but cord-blood research has only been ongoing since the 1970s, so the maximum time for storage and potential usage are still being determined. Blood-forming stem cells that have been stored up to 15 years have been used successfully in transplants. So we can safely say that the shelf life is good and if stored properly it can be used many years into the future.
Stem Cells Uses
According to one study, around 128 million Americans are affected by diseases for which researchers look to stem cell technology for promise of treatment. What they currently know indicates that adult stem cells have a limited ability to differentiate into useful tissues, fetal stem cells have a greater capacity to do so, and ES cells are thought to be able to differentiate into any other kind of cell.

The different types of cells all have promising applications; here is an overview:

Childhood-Onset Diabetes: In Type 1 Diabetes, the cells in the pancreas that produce insulin are attacked by the immune system. There have been attempts to treat it by transplanting pancreatic cells, but the immunosuppressive drugs required to perform the transplant are hard for the body to handle, and the number of transplants available is very small. Stem cells could be engineered to differentiate into the beta cells responsible for insulin production, and they could be manipulated to minimize the possibility of an immune response that usually impairs transplants.

Nervous System Diseases: There are certain cells in the body that reach maturation and no longer actively divide. Nerve cells are an example of such cells. Therefore, if these cells are damaged or destroyed, there is no repair or replenishment occurring. This is one deterrent from using drugs; they are known to damage and kill cells of the nervous system. Unfortunately, people afflicted with certain traumas or diseases to of the nervous system such as multiple sclerosis, Alzheimer's disease, Parkinson's disease, do not have a choice.

Researchers see stem cells as a potential treatment to such diseases. For example, participants in Parkinson's studies have shown some progress after fetal cell implantation in preliminary trials. Studies on rodents have also produced desirable results when subjected to similar conditions. Perhaps a treatment for such debilitating diseases and injuries is in our future.

Even in cases where actively dividing cells are damaged, stem cell treatment is desired. In diseases and injuries of the bones and cartilage, if differentiated stem cells could be transplanted into patients, perhaps long-term damage could be alleviated. Examples are arthritis, bone fractures, and chondrodysplasia.

Immunodeficiency Diseases: Not only have stem cells shown promise in nervous system traumas and diseases, but also they could potentially be used in treatment of primary (congenital) and secondary (acquired) immunodeficiency diseases. These diseases arise when an immune function is underdeveloped, suppressed, or absent. Examples of such diseases are Thymic aplasia (DiGeorge syndrome), Wiskott-Aldrich syndrome, and AIDS. If pluripotent stem cells could be transplanted to patients with autoimmune diseases, they may be able to direct the immune system to function normally.

Cancer: Finally, if stem cells can be manipulated into becoming bone marrow stem cells. Such cells are currently used in treating patients with deficiencies, such as post-chemotherapy cancer patients with some effectiveness. Future studies are aimed at developing treatments, which are more successful in hopes of lowering side affects from chemotherapy.

But, quite frankly this subject is not that easy as there are many legal, human and technical difficulties before researchers, scientists and medical experts. In fact there are many ways in which human stem cells can be used in basic research and in clinical research. However, there are many technical hurdles between the promise of stem cells and the realization of these uses, which will only be overcome by continued intensive stem cell research.

Studies of human embryonic stem cells (ES cells) may yield information about the complex events that occur during human development. A primary goal of this work is to identify how undifferentiated stem cells become differentiated. Scientists know that turning genes on and off is central to this process. A significant hurdle to this use and most uses of stem cells is that scientists do not yet fully understand the signals that turn specific genes on and off to influence the differentiation of the stem cell.

Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Parkinson's and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.

To be useful for transplant purposes, stem cells must be reproducibly made to:
• Proliferate extensively and generate sufficient quantities of tissue.
• Differentiate into the desired cell type(s).
• Survive in the recipient after transplant.
• Integrate into the surrounding tissue after transplant.
• Function appropriately for the duration of the recipient's life.
• Avoid harming the recipient in any way.
• Also, to avoid the problem of immune rejection, scientists are experimenting with different research strategies to generate tissues that will not be rejected.
Advances in stem cell technology have illuminated their therapeutic potential, but these