Private cord-blood banking: Doctors cast doubt on its value to parents

June 19, 2009|By Trine Tsouderos, Tribune reporter

The advertising makes it hard for parents-to-be to say no. Pay us to bank your child's umbilical cord blood, they urge, because someday she, or another relative, may need it.

"The first and most important investment in your baby's future health," counsels CorCell. "Your love and cord blood are two of nature's most powerful protectors," assures FamilyCord. "Years from now, the cute outfits won't fit ... the stem cells will!" jokes NeoCells.

More than 70 diseases, from childhood leukemias to sickle cell anemia, can be treated with cord-blood stem cells, the companies note. And research into new ways to use them is promising, including work on spinal cord injuries, traumatic brain injuries and diabetes.

But talk to physicians who treat children and often you'll hear a different story.

"I think people are paying for nothing," said Dr. Eliane Gluckman, president of the European School of Haematology and the physician who did the world's first cord-blood transplant in 1988.

Although it can't hurt to save umbilical cord blood, many experts say the private cord banks are selling a costly service aimed at a scenario that is unlikely ever to happen.

The diseases that cord-blood stem cells may help are rare, and they frequently are treated in other ways, doctors said. If a transplant is recommended, they said, a match is nearly always found in the global public donor program, which has more than 300,000 units of cord blood banked.

Even if a child does have her cord blood stored, physicians wouldn't use it to treat her if she developed, say, sickle cell anemia. The blood would contain the same genetic defect.

At the same time, the banking service isn't cheap, running between $1,000 to more than $2,000 for shipping and processing, then $100 or so a year for storage of the frozen stem cells.

"I didn't consider doing it for my kids," said Dr. Steven Joffe, a pediatric stem cell transplant physician at the Dana-Farber Cancer Institute in Boston. "And that was after I had begun to work in this field."

Joffe surveyed 93 fellow pediatric stem cell transplant doctors five years ago and found most agreed with him. Joffe published his results in March in Pediatrics, the journal of the American Academy of Pediatrics. That group advises doctors to "discourage" parents from privately banking cord blood, unless there is an ill sibling who might need the cells.

Most private cord-blood banks acknowledge current uses for the cells are limited, though they cite cases of families that were grateful to be able to use banked cord blood to help a relative.

But "you don't do it for any one disease," said David Zitlow, spokesman for one of the largest and oldest cord-blood banks in the world, Cord Blood Registry. It has banked 285,000 units of cord blood.

You do it, he said, because of the rapid progress of medical research.

"If you believe in science, there are 70 diseases being treated now -- do you believe there will be 100 ten years from now?" said Calvin Cole, vice president of North America for StemCyte, a large cord-blood bank that handles both private customers and public donations. "It is proven it is saving lives."

Cord blood is medically valuable because it is rich in stem cells, which can divide to create more specialized cells. Cells from cord blood can be used, for example, to build new blood and a new immune system in a person suffering from blood cancer. Scientists are looking into whether the cells can also develop into forms that would be helpful for diabetes and other conditions.

Dr. Jennifer Willert, a pediatric oncologist specializing in blood and marrow transplants at Rady Children's Hospital-San Diego, is among the doctors who support private and public banking of cord blood. "The potential for regenerative medicine is significant," Willert said.

Banked cord blood is especially valuable for minority children and those of mixed ethnicities, who have a harder time finding a match in the public system, she said. "It might be the only chance they have to have a product that will match them."

Stephanie Loitz of Grant Park in Kankakee County chose to bank cord blood from all three of her children with Cord Blood Registry.

"We are a small town, and I remember my mom and aunt talking about three kids who passed from leukemia. I thought, this is something we can do and this is an insurance policy," she said.

Loitz says she knows the diseases treated with cord-blood stem cells are rare. "Whoever it hits, they didn't imagine it would happen to their family," she said. And with a family history of colon cancer and diabetes, she says the cells could be invaluable if researchers find a way to use them as treatments.

But physicians warn that the journey from "bench to bedside" can take decades and sometimes stops short.

"How often have we heard there will be amazing miraculous interventions for name-your-disease?" said Dr. Joel Frader, a pediatrician and bioethicist at Northwestern University Feinberg School of Medicine.