News Excerpt
Poona Citizen Doctor Forum (PCDF), a body that aims to rebuild trust among citizens and doctors and promote ethical rational medical practice, has come forward to bust the aggressively promoted concept of cord blood banking.

•    Cord blood is collected from the placenta and umbilical cord after a baby is delivered. Not only does it contain all components of whole blood (red and white cells, platelets, and plasma), but it contains blood stem cells, also called hematopoietic stem cells, which can produce all types of blood and immune cells for a person’s entire life.
•    Blood stem cells can be used to treat and even cure some diseases of the blood and immune system through a stem cell transplantation. These stem cells can be collected from cord blood as well as from bone marrow and peripheral blood (e.g. from an arm vein) and then delivered intravenously to a patient.
•    Cord blood can be used immediately to treat disease, or easily stored for future public or private use.
•    Cord blood banking is the process of collecting the cord blood , extracting and cryogenically freezing its stem cells and other cells of the immune system for potential future medical use.

What Can It Be Used For?
    Globally, cord blood banking is recommended as a source of hematopoietic stem cell transplantation for haematological cancers and disorders. For all other conditions, the use of cord blood as a source of stem cells is not yet established.
    Cord blood contains blood-forming stem cells that can be used in the treatment of patients with blood cancers such as leukemias and lymphomas, as well as certain disorders of the blood and immune systems, such as sickle cell disease and Wiskott-Aldrich syndrome.

Using cord blood as a source of stem cells for transplantations
o    Advantages
    Stem cells from cord blood have a lower risk of carrying blood borne infectious diseases, or of causing the potentially fatal immune response, graft-versus-host disease.
    Cord blood may offer a matched source of stem cells for patients who cannot find an immunological match in bone marrow donor registries.
o    Disadvantages
    Fewer blood stem cells are available from an umbilical cord sample than other sources. Two cords are typically required for each adult transplant.
    The immune system recovers more slowly after a cord blood transplantation, putting the recipient at greater risk for certain infections.
    There is a higher probability that a cord blood transplant will be unsuccessful.

    Cord blood banking involves taking the umbilical cord blood, which is a rich source of stem cells, and preserving it for future use. Private companies who have forayed into this field offer packages anywhere between ₹50,000 and ₹1 lakh to store and preserve the cells in right conditions. However, the Indian Council of Medical Research (ICMR) does not recommend commercial stem cell banking.
    Stem cell banking has been aggressively marketed over the past decade evenas its use is still in experimental stages. Companies charge enormous fees from parents to preserve cells. Moreover, the concern is that it is merely by emotional marketing that companies convince parents to bank the cells for several years promising future therapeutic use.
    So far there is no scientific basis for preservation of cord blood for future self-use and this practice therefore raises ethical and social concerns.

Alternatives to cord blood banking
Bone marrow and other sources- If someone doesn't have cord blood stored, they will have to rely on stem cells from another source. For that, we can go back to the history of cord blood, which really begins with bone marrow. Bone marrow contains similar although less effective and possibly tainted versions of the same stem cells abundant in cord blood. Scientists performed the first bone marrow stem cell transplant in 1956 between identical twins.

Cord blood is one of the sources of blood stem cells that can repopulate a patient’s blood and immune system. Cord blood has both advantages and disadvantages compared to bone marrow or peripheral blood as a source of blood stem cells. It is unlikely that someone will use their own stem cells in a blood stem cell transplant. It is currently recommended that cord blood is donated to public banks to increase the chance that people in need of a transplant can find an immunological match.  

Cryopreservation, FDA, stem cell