Have you heard of the terms cord blood and stem cells?
What about cord blood stem cell transplant?
Did you know that this procedure can be used to treat almost 80 diseases?
The basic terms
Before we proceed to learn more about cord blood stem cell transplant, here’s a primer on some important terms you should know:
> Stem cells: A type of cells with the potential to develop into many different types of cells in the body.
Stem cells serve as a repair system for the body. They function to replace, repair or regenerate damaged cells, for example, brain cells and cardiac cells.
Pluripotent stem cells can be found in bone marrow, peripheral blood and cord blood.
> Cord blood: The blood from the baby that is left in the umbilical cord and placenta after birth.
Cord blood is rich in haematopoietic stem cells (HSCs), special blood-forming stem cells that are similar to those found in bone marrow.
HSCs are primarily responsible for replenishing blood and regenerating the immune system. These precious stem cells may be preserved for later use in medical therapies.
Blood to the rescue
Stem cell transplant is a procedure taken to replace damaged blood cells with healthy ones, particularly when the bone marrow is damaged and no longer capable of producing healthy blood cells.
The procedure is also carried out to replace damaged or destroyed blood cells after an intensive cancer treatment.
There are two types of stem cell transplants: allogeneic (using matching stem cells from another person), and autologous (using your own stem cells extracted earlier).
Cord blood is one of the sources for stem cell transplant.
Other sources are bone marrow and peripheral blood.
Proven and emerging applications
Cord blood stem cell transplant has been approved by the United States Food and Drug Administration as standard care treatment for nearly 80 diseases.
More than 40,000 transplants have been conducted over the past 30 years since the first transplant was carried out in 1988.
Cord blood stem cell transplant is most commonly used to treat blood disorders, such as leukaemia, thalassemia, lymphoma and anaplastic anaemia.
It has also been used to treat various genetic illnesses, such as:
> Sickle cell anaemia
> Congenital cytopenia
> Gaucher’s disease
> Hunter syndrome, and
> Severe combined immunodeficiency diseases.
Even though the use of peripheral blood stem cells has been increasing in recent years, thus reducing the roles of cord blood stem cells in certain areas, research is also ongoing to explore the potential use of cord blood stem cells in new medical applications, such as in cellular therapy and regenerative medicine for autism, cerebral palsy, spinal cord injury, hearing loss, diabetes and more.
The following real life story (all names have been changed) demonstrates a successful cord blood stem cell transplant:
Maria, a young mother, was devastated when her sweet baby girl, Anna, was diagnosed with acute myeloid leukaemia when she was merely 12 months old.
During the initial assessment, doctors had given the child less than 10% chance of survival as her little body was suffering terribly due to the cancer.
Around the same time of the diagnosis, Maria also discovered she was pregnant with her second child.
Due to the stress and desperation to find cure for Anna, Maria considered having an abortion and consulted different doctors.
By chance, a gynaecologist advised her not to proceed with the abortion and introduced Maria to cord blood stem cell transplant.
This brought Maria a glimmer of hope in curing her daughter.
Maria was told Anna may stand a chance to survive if she can undergo a cord blood stem cell transplant using her younger sibling’s stem cells, provided Anna lived long enough until the birth of her baby brother and if his cord blood stem cells were a match for her.
Months later, Maria gave birth to Isaac and his cord blood stem cells were collected at birth for long-term storage.
The good news: they were a good match for Anna – Maria and her husband were overjoyed to hear this.
Two months later, the stem cell transplant was conducted successfully.
Little by little, baby Anna managed to regain her health and her life was saved, all thanks to her little brother’s gift of cord blood stem cells.
Cord blood banking
Cord blood banking refers to a process of collecting potentially life-saving stem cells from the umbilical cord and placenta of a newborn and storing them for future medical use.
The cord blood will be collected after birth from the umbilical vessels and placed into a collection bag, which will then be packaged and sent to a cord blood bank.
At the cord blood bank, the cord blood will be cryopreserved for long-term storage.
In Malaysia, the National Blood Bank established a public cord blood bank where parents can donate their children’s cord blood for public use.
It has been operating since 2001, mainly in collaboration with Hospital Kuala Lumpur.
However, since the end of 2021, new donations are no longer accepted, but collected units are still preserved.
Multiple successful transplants using the stored cord blood have been performed to date, for example involving patients with aplastic anaemia, Fanconi’s anaemia, acute myeloid leukaemia and acute lymphoblastic leukaemia.
A number of local private cord blood banks are also available, where parents can store their children’s cord blood for personal use.
Private cord blood banking is an option to consider for families with a history of malignant or genetic conditions treatable with stem cell transplants.
Cord blood from a family member has a higher chance of match for transplant compared to a stranger’s cord blood.
For example, siblings have a 25% chance of being a perfect match and 50% chance of partial match.
If stem cells are required as part of the treatment for your loved ones’ illnesses, the cord blood will be readily available and you don’t have to look for a donor.
Should you store all your children’s cord blood?
Multiple cord blood banking means storing cord blood from different members of the family.
Storing every child’s umbilical cord blood gives you more options because you will not know which unit will match which sibling if an allogeneic transplant is required.
Furthermore, a downside to cord blood is that it is limited and cannot be extracted multiple times.
So, having multiple cord blood stored may be necessary if you need reserve sources in case of transplant failure or disease relapse.
Cord blood stem cell transplant is part of medical progress that has saved the lives of many patients.
For families at risk of certain illnesses, it may be an option to consider in future.
Consult your doctor to learn more about the procedure and the necessary steps.
If you decide to store your child’s cord blood, do prepare yourself in advance before the date of delivery.
Dr Tan Yeen Inn is a consultant obstetrician and gynaecologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email firstname.lastname@example.org. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.