Cord Blood Stem Cell Transplant Statistics

While a cord blood stem cell transplant may be possible using your baby's own banked umbilical cord blood, the actual chance of this happening is very, very slim.


The research estimates that there is a 1 in 1,000 to 1 in 200,000 chance in a child's lifetime that their own cord blood stem cells may be needed.  That means between 1,000-200,000 parents must bank their child's umbilical cord blood for every 1 unit that is used.  However, even that number is misleading in that many other therapies may be used if the stem cells aren't available.   It does not mean that 1 in 1,000-200,000 children would die without their own stem cells for transplant.  


For example, while an autologous (self-donated) cord blood transplant may be possible to treat some forms of cancer, chemotherapy may also be just as effective a treatment.


However, one often-overlooked fact is that any genetic diseases the child develops will also be inherent to the child's umbilical cord blood stem cells.  That means if the child develops leukemia, his stem cells will also carry the mutation for leukemia and will not be suitable for use in his treatment.


It's much more likely that an allogenic (family member or unrelated donor) transplant would be needed to treat any diseases.  So, be aware that if you do choose to bank your baby's cord blood, it's much more likely that it would be used to treat other siblings or family members than the child from which it was taken.


There are some advantages to cord blood stem cell transplant, in that it requires looser matching between the HLA tissue types of the donor and recipient. For a traditional bone marrow transplant, all 6 key antigens must match to prevent complications like graf-versus-host reaction (commonly called rejection).   With a cord blood transplant, only 4 key antigens must match.  The HLA tissue type is inherited from the child's parents making the likelihood a of sibling match on 6/6 antigens is 25% and the likelihood of a 4/6 match rises to 39%.


Unfortunately, many cord blood banking companies tout their services as "biological insurance" for the child.  While that may be true, it's misleading in that most conditions will not be treatable with the child's own stem cells.  It can also give families a false sense of hope when their child does develop such a disease and they later learn that the cells are not viable for treatment.  It would be much more accurate to report that a cord blood stem cell transplant may be available for current/future siblings and/or other family members than for that particular child.



References

Nietfeld JJ, Pasquini MC, Logan BR, Verter F, Horowitz MM. Lifetime probabilities of hematopoietic stem cell transplantation in the US. Biol Blood Marrow Transplant. 2008;14:316-22.


Fisk NM, Roberts IAG, Markwald R, Mironov V (2005) Can Routine Commercial Cord Blood Banking Be Scientifically and Ethically Justified? PLoS Med 2(2): e44 doi:10.1371/journal.pmed.0020044


Gluckman E, Rocha V, Boyer-Chammard A, et al. Outcome of cord blood transplantation from related and unrelated donors. New England Journal of Medicine. 1997;337:373-381



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