For general questions about cord blood stem cells, see frequently asked questions below. For more specific questions, see other FAQs listed on the left.
• What is cord blood?
• What are stem cells?
• How are stem cells used in medicine?
• How do cord blood stem cells compare to other sources of stem cells?
• What types of diseases are treated with stem cell transplantation?
• If a child develops leukemia, isn’t it likely that the cord blood unit collected has leukemia cells? If so, can it still be used to treat the child?
• Why are doctors turning to cord blood instead of bone marrow?
• What is graft vs. host disease (GvHD)?
• What is HLA matching?
• What is proposed in terms of cord blood transplant in the future?
• What types of applications for stem cells may be available in the future?
What is cord blood?
Cord blood, or umbilical cord blood, is the blood remaining in your child's umbilical cord following birth. Cord blood is rich in stem cells, the building blocks of the blood and immune systems.
What are stem cells?
Stem cells divide endlessly to become other types of cells. The stem cells found in umbilical cord blood as well as bone marrow can divide and become different types of cells in the body. Stem cells have been used as a component of treatment therapy in over 40 different cancers, immune deficiencies and genetic disorders.
Opportunities for the use of stem cells 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 for a specific disease or that it will provide a cure.
How are stem cells used in medicine?
Stem cells are used therapeutically to assist an individual in rebuilding their immune system with cells to fight disease and infection. This is especially valuable when an individual's immune system has been damaged by radiation or chemotherapy.
There are over 40 different cancers, immune deficiencies and genetic disorders for which stem cell therapy is used as part of the treatment therapy.
Today stem cells are primarily used in transplant medicine to regenerate a patient's blood and immune system after they have been treated with chemotherapy and/or radiation to destroy cancer cells.
At the same time the chemotherapy and radiation destroys the cancer cells in a patient, they also destroy a patient’s immune system. An infusion of stem cells or a stem cell transplant is performed after the chemotherapy and/or radiation treatment which assists the patient's bone marrow to regenerate cells to create a new blood and immune system for the patient.
Several research projects are showing encouraging results using stem cells for other medical treatments. Cord blood stem cells have been "triggered" to differentiate into neural cells, potentially leading to treatments for diseases such as Alzheimer's and Parkinson's. They have also proven their ability to turn into blood vessel cells, which could some day benefit treatments for heart disease.
How do cord blood stem cells compare to other sources of stem cells?
Cord blood is a rich, non-controversial source of stem cells because they may not have the same scientific limitations of adult stem cells but neither do they carry the ethical concerns of embryonic stem cells.
Cord blood stem cells have successfully treated children and adults. Cord blood stem cells are now used in the treatment of over 40 life-threatening diseases. Cord blood is readily available when needed (if collected and stored at birth). Cord blood stem cells are a perfect match for your baby and have up to a 75% chance of being a match for your baby's siblings. A source of stem cells (e.g., cord blood) from one's own self or someone related is always the best treatment option.
Umbilical cord blood stem cells are the "youngest", safely available stem cells. This may be important. Some researchers are finding that the less mature the cells, the greater the opportunity there is for cells to be manipulated into developing into the types of cells needed. Freezing these cells essentially stops the clock and prevents aging and damage that may occur to the cells later in life.
Another source of immature stem cells, embryonic stem cells, has been at the heart of heated public debate and written about in the media frequently. Currently, embryonic stem cells are not being used to treat humans.
A third category of stem cells is Adult Stem Cells, such as those found in bone marrow or peripheral blood. Adult stem cells are the most widely used cells in transplants today and serve very specialized roles in children and adults and are not as proliferative as those found in cord blood. NeoStem offers Adult Stem Cell collection options for all over the age of 18 who quality.
What types of diseases are treated with stem cell transplantation?
The list below reflects most of the types of diseases that have treatments involving stem cell transplantation. Not all diseases amenable to stem cell transplantation have been treated specifically with cord blood stem cells. Cord blood stem cells are used in the treatment of over 40 life-threatening diseases, including some cancers, genetic diseases, blood disorders, and immune system deficiencies. Cord blood stem cell therapy has already been used in the treatment of the following diseases:
CANCERS
• Acute lymphoblastic leukemia (ALL)
• Acute myelogenous leukemia (AML)
• Burkitt's lymphoma
• Chronic myelogenous leukemia (CML)
• Juvenile chronic myelogenous leukemia (JCML)
• Chronic myelomonocytic leukemia (CMML)
• Juvenile myelomonocytic leukemia (JMML)
• Hodgkin's lymphoma
• Langerhan's cell histiocytosis
• Liposarcoma
• Myelodysplastic syndrome (MDS)
• Neuroblastoma
• Non-Hodgkin's lymphoma
BLOOD DISORDERS
• ß-thalassemia (Cooley's anemia)
• Sickle-cell anemia
GENETIC DISEASES
• Adrenoleukodystrophy
• Batten disease (inherited neuronal ceroid lipofuscinosis)
• Gunther disease
• Hunter syndrome
• Hurler syndrome
• Krabbe disease (globoid cell leukodystrophy)
• Lesch-Nyhan disease
• Maroteaux-Lamy syndrome
IMMUNODEFICIENCES
• Omenn's syndrome
• Severe combined immune deficiency (SCID and SCID-ADA)
• Reticular dysplasia
• Thymic dysplasia
• Wiskott-Aldrich syndrome
• X-linked lymphoproliferative disease
• Leukocyte adhesion deficiency
OTHER DISEASES/SYNDROMES
• Evans syndrome
• Familial hemaphagocytic lymphohistiocytosis
• EBV-assoc. hemophagocytic lymphohistiocytosis
• Osteopetrosis
• Severe aplastic anemia
• Diamond-Blackfan anemia
• Dyskeratosis congenital
• Fanconi anemia
• Amegakaryocytic thrombocytopenia
• Kostmann's syndrome
Cord blood stem cells are being used in the treatment of more and more diseases. Click here for more Life Saving Applications of Cord Blood. Some of the research currently being conducted using cord blood stem cells for treatment in cellular repair and regeneration are listed under Potential Future Stem Cell Applications.
If a child develops leukemia, isn’t it likely that the cord blood unit collected has leukemia cells? If so, can it still be used to treat the child?
While it is true that blood borne cancers are problematic in this regard, it is not clear what causes various types of cancers, including leukemia. It is not unreasonable to speculate at this point that if it took 5 years to develop cancer, a cord blood product might – at worst – give 5 more years before recurring. This may be a viable option for a child who awaits a better option – hoping that a better option becomes or is available. Some experts also note that the “5 years to recurrence” scenario presumes that the natural history of the disease is genetically programmed and does not consider that an environmental insult to a genetically predisposed individual (or not) may have initiated the disease, in which case avoidance of the insult might just avoid the disease. Recently a case report was published in the journal, Pediatrics, of a 3-year old girl treated for childhood leukemia with her own cord blood transplant. At the time of publication she was doing well and in complete remission 20 months after transplant.
It should also be noted that an important reason to bank a child’s cord blood stem cells is for the potential event that a family member develops a disease proven treatable with stem cell therapy. There is a higher likelihood of a match for stem cells stored from a family member's cord blood.
Why are doctors turning to cord blood instead of bone marrow?
Cord blood is identical match for your child and may present a higher degree of matching other family members than donated bone marrow or adult stem cells.
Bone marrow is difficult to match between the donor and recipient because a "perfect match" is usually required. Cord blood immune cells, however, are less mature than in bone marrow and may be successfully used even when there is only a half-match. This means there is more opportunity for transplants between family members when cord blood is stored. Some studies have shown that overall survival rates for related transplants are more than double that of transplants from unrelated donors.
Cord blood stem cells once harvested and stored are immediately available.
Early treatment of many illnesses can minimize disease progression. Some researchers have found that cord blood transplants could provide possible survival that is unlikely with the more time consuming process of unrelated marrow donation.
What is Graft vs. Host Disease (GVHD)?
Graft vs. Host Disease (GVHD) is the formal designation for a type of transplant rejection. GVHD occurs when the transplanted stem cells recognize the recipient's body as foreign, and "reject" it. In a cord blood transplant, the stem cells from the donor do not need to match the recipient as closely as with bone marrow. As a consequence, overall, patients who receive cord blood transplants from a relative experience significantly less GVHD which is the leading cause of death in stem cell transplant patients. According to one study, the three-year cumulative incidence of chronic GVHD was 6% for matched siblings who received cord blood transplants versus 15% for matched siblings who received bone marrow transplants.
What is HLA matching?
On the surface of white blood cells and other tissues in the body there are six proteins called Human Leukocyte Antigens (HLA). Matching refers to these six HLA points, or loci, to determine tissue compatibility between a patient and a donor. A perfect match would be best, and means that the patient and the donor have the identical six HLA points on their cells; studies have shown that cord blood transplants are successful, even when only three of the six loci match. With cord blood, the immune cells are less mature than those in bone marrow, and therefore siblings are twice as likely to be able to use each other's cord blood, compared to bone marrow. When the donor uses their own stem cells, an autologous donation and transplant they of course are guaranteed of a six out of six match. This is why if your child ever needs their own stem cells in the future, there is a greater chance for a successful transplant.
What is proposed in terms of cord blood transplants in the future?
To date, umbilical cord blood has been used in more than 3,000 transplants by children and adults. In many cases, the cord blood was used by the baby's sibling. Other transplants have occurred for the newborn themselves, the newborn's mother, father, and even the newborn's cousin.
In the past two years alone, research has demonstrated that cord blood stem cells can differentiate into other types of cells in the body. The regenerative qualities of stem cells have been brought to the forefront in the field of cellular repair. Stem cells have been labeled an important biological resource and researchers are conducting more and more studies to unlock the potential of umbilical cord blood stem cells in future applications for diseases like Alzheimer's, diabetes, heart and liver disease, muscular dystrophy, Parkinson's disease, spinal cord injury, and stroke.
Over 35,000 American children and adults and 150,000 people worldwide with life-threatening illnesses require a stem cell transplant each year. These stem cell transplants will be bone marrow transplantation or transplantation of stem cell units derived from cord blood (such as those stored with NeoStem). According to the National Marrow Donor Program, the number of stem cell transplants using cord blood as a source of stem cells was expected to surpass those using bone marrow in 2007.
What types of applications for stem cells may be available in the future?
The use of cord blood stem cells in research is more popular than ever. New findings are occurring continuously regarding the potential of cord blood stem cells to be used in therapeutic treatment. Currently, there are over 40 different cancers, immune deficiencies and genetic disorders that use stem cell therapy as part of the treatment therapy. New potential applications for the use of cord blood stem cells include heart disease, stroke, diabetes and muscular dystrophy. Click here to learn more about Life Saving Applications of Cord Blood
