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Banking umbilical cords has its limitations

Provided by: Sun Media
Jul. 30, 2006

Many parents are led to believe that the argument for locking up their baby's individual cord blood sample is simple: If the baby ever needs it, it's there.

According to a myriad of professionals, this assumption is fraught with misconceptions and false hope.

Dr. John Doyle dispels most of them quickly, saying it is rare a child will ever use his or her own banked sample.

"It's very, very seldom as it stands right now," said the pediatric hematologist/oncologist and section head of blood and marrow transplants at The Hospital for Sick Children in Toronto.

"The opportunity to use the cord blood for the same child with today's technology is limited. They'd be banking now mostly (on the hope) of future uses, such as to replace an injured heart or other organs."

Since the first transplant Doyle performed in 1997, he's completed more than 20 -- 2005 was a busy year, in which he did nine transplants -- and only two were used in the same children. Six samples came from relatives and 12 samples were plucked from public banks in the U.S or Europe and were donated by total strangers.

Aside from certain cancers, such as breast or bowel, which often come in the form of a solid tumour and aren't likely to spread to the blood, stem cells have the same genetic diseases as the child, so transplanting them back into the same child could have tragic consequences.

With today's technology, stem cells are used as a substitute for bone marrow in repairing damaged immune systems in children suffering from diseases, such as cancer.

"The use for the same child is limited and based on future promises," Doyle said. "It's a gamble."

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The risky nature of banking provides a powerful argument in favour of public banking -- a concept that U.S. President George W. Bush endorsed heartily in the last few months with a $150-million cash infusion into the effort to create such a system in the United States.

A public program would enable Canadians to get their hands on umbilical cord stem cells donated by parents who choose not to bank privately.

Stripped of their originating identity, categorized by stem cell type and entered into a database and stored, the stem cells would wait to be called up as a match.

But Canada is miles, years and millions of dollars away from implementing such a program, said Stuart Irwin of Cells for Life, a cord blood bank located in a small office building attached to the Markham Stouffville Health Centre.

With both a private and public component, the facility processes and stores some samples at no cost to donors. As one of only three such facilities in Canada, Cells for Life finances its public bank from its own profits, so it can only afford to bank rare samples, from donors with unique genetics, and must turn down offers from many parents willing to donate.

If a couple demonstrates financial need or has a medical reason to bank, most banks, including Cells for Life, will oblige for free or at a negligible cost to the donor.

Cells for Life currently has 71 frozen cords -- too few to register a blip on Canadian Blood Services' blood, marrow and stem cell matching radar.

"We only deal with dealers worldwide," spokesperson Bev Campbell said, explaining stem cell banking in Canada is so new, public facilities don't have the infrastructure to handle requests for matches. "We have to know people are reputable."

Dr. Anthony Armson believes a national program would greatly benefit society -- especially as uses for the powerful cells increase. Currently, only 1% to 3% of Canadian parents bank their babies' blood.

If all the discarded cords were added to a public registry, finding a match would be a breeze.

"But how do you convince the federal and provincial governments to see this as a priority when they're dealing with so many other issues of health care?" asked the specialist in maternal/fetal medicine and representative of the Society of Obstetrics and Gynecologists of Canada.

And how do you convince parents to waive their exclusive rights to their child's cord -- especially since they'd be banking on future hope for the cells rather than what they can provide today?

New mom Naomi Lieberman can't answer that.

"If we were not in a financial position to commit to doing it," she said, "I think public banking is a great idea."

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