Kids and Health Care: Stem Cells and Cord Blood
Both the bone-marrow transplants related to leukemia treatments and the gene therapies being tested for conditions like CF bring us to a controversial topic -- stem cells.
Leaving politics aside, the reason that stem cells are useful is that they can be used to replace bone marrow and for the gene therapy that's considered the best prospect for curing genetic conditions like CF.
Controversy surrounds stem cell use because the cells are usually harvested from aborted fetuses; and any large-scale effort to harvest them not only would rely on abortions...but might lead some families to use pregnancy to sow the stem cells for later harvest. Even if you support government-funded stem cell research some people believe there is an undeniably troubling quality to the prospect of conceiving merely to generate stem cells.
There are some options to consider -- especially if you're pregnant and you know there's some chance that your baby might have a genetic condition like CF. When your child is born, you can choose to bank his or her "cord blood."
During the 1970s, medical researchers discovered that umbilical cord blood is a rich source of blood-forming (hematopoietic) stem cells. This particular kind of stem cell is found primarily in the bone marrow; and it's capable of developing into any of the three types of mature blood cells -- red blood cells, white blood cells and platelets. (This type of stem cell may also develop into other cell types, though research on that question is still pending.)
Umbilical cord blood can be collected easily and stored...somewhat easily. In many cases, hospitals already do this -- sometimes without making the practice clear to the women having babies. The cord blood is frozen in liquid nitrogen and kept in a collection facility, also known as a cord-blood bank.
The blood-forming stem cells can be thawed later and used in either autologous procedures (when a person receives his own umbilical cord blood in a transplant) or allogeneic procedures (when a person receives umbilical cord blood donated from someone else -- a sibling, close relative or donor).
You can request that cord blood be collected when you have a baby. Collection takes place shortly after birth (whether you have the baby traditionally or by cesarean); it's done using a specific kit that your OB/GYN can order from a cord-blood bank.
How long can blood-forming stem cells last when properly stored? The maximum time for storage and use is still being determined; but blood-forming stem cells stored up to 14 years have been used successfully in transplants.
The cost of storing core blood -- and who will bear this cost -- is less clear. In most cases, an insurance company or managed care plan will not cover storage unless it's medically necessary. In some cases, if you have a family history of conditions like leukemia or CF, your OB/GYN or primary care physician may be able to make the case that storing the blood is necessary and cost-effective.
If you have to pay for blood storage yourself, the market for storing blood (and semen and other bodily fluids) has become fairly consumer-friendly. As in any market-responsive industry segment, prices for storage can vary dramatically. Make some calls before the baby is due and get quotes for long-term (more than six months) storage. In most cases, after you pay a set-up fee, the monthly charge should be less than a dinner out.
