Cord Blood Storage Much More Hope than Hype

By Doris Fu, Panorama, September 1, 2006

One of the first things Chang did when his twin baby girls arrived into the world was to instruct the doctor to preserve a sample of blood from their umbilical cords. Of course, the new father waited until after he was satisfied cuddling them and his wife for the first time.

Chang saw first hand what leukemia can do to its victims, his brother died from the disease. His brother was given two options, chemotherapy and radiation. His only hope, as his white blood cell count continued to drop sharply as treatment after treatment continued, was to receive a transplant of cells that would enable bone marrow to form new blood cells. There is only a very small chance of finding a fitting donor in such circumstances.

An ad for a cord blood bank caught Chang's eye not long after his brother passed away. The best alternate for bone marrow in such cases, the undifferentiated and primitive cells found in the blood of a child's umbilical cord would be ideal proclaimed the ad. Chang could not stand to see another family member suffer from the wasting disease, and knowing that hereditary can be a factor in diseases like leukemia, he decided to store the blood.

Change stated that, "If his brother had been able to save his cord blood, he might not have died."

Newspapers, magazines and even clinics all over Taipei are packed with advertisements for private cord blood banks just like the one Chang saw. Some companies are making extraordinary claims as the competition becomes intense due to the booming cord-blood stem-cell industry that is rising on the island. Some say they have the highest-quality service, others the best technology or they boast being the leading player in the business. With all this, fewer expectant parents are willing to risk the chance of not saving their babies' cord blood, an insurance against possible illness that may befall their children down the road. This very environment had caused demand to grow by leaps and bounds.

A viable substitute for more conventional stem-cell transplants from bone marrow, the cells derived from cord blood have demonstrated that they are an effective alternative in treating conditions such as leukemia. Individuals with spinal injury and other blood disorders such as sickle cell disease, and metabolic disorders are possible candidates for treatment. Incurable diseases like Parkinson's disease and Alzheimer's can be treated with cord blood stem cells as well. Members of the donor's family can also use the cord blood stem cells for treatment in addition to the donor himself. The use of cord blood stem cells for disease treatment holds exciting promise.

"Cord blood transplants have been widely used to treat children with blood-borne cancers, and we have witnessed successful cases," said Chiu who is the director of the National Health Research Institutes' Stem Cell Research Center. "Cord blood is even a better alternative than bone marrow, as it is less difficult to find a matching donor, less painful to extract the stem cells, and less likely the cells will be rejected," he added. "This is what I refer to as hope."

Due to the successful use of umbilical cord blood transplants in treating blood and immune-system diseases, private and public cord blood banks have sprung up since the mid to late 1990's. Using a syringe, three to four ounces of placental blood is drawn from the umbilical cord. In preparation for freezing and preserving the blood, the content of the syringe is deposited in a bag or vial. The family can then use this blood at a later date based on a written contract (binding for a 10 or 20 year period) that the parents sign.

The government medical policy is not the only reason for the thriving private cord blood storage market in Taiwan. Originating from the traditional Han Chinese societal customs, the strong sense of family values in the country has much do with it, said Chris who works for one of the original cord blood banks in the country.

"Children are considered very precious and many parents are willing to sacrifice for their children," said Chris. "If there's a chance to save their children someday, then parents can't afford not to."

"Moreover, unlike most of the countries in Europe, whose governments are responsible for overall medical services and cord blood cell storage is a public service included in the governmental infrastructure, in Taiwan, cord blood storage is not included in public health services. People have to turn to private cord blood banks instead," he explained.

In terms of the medical uses for cord blood stem cells, Chris added that there remains an ample prospect for development. The field could have an enormous impact, not only in treating disease, but also in pharmaceutical development and new innovations, such as regenerative cosmetology.

In Taiwan, no more than 5 percent of new parents take advantage of banking, and cord blood storage remains an option only available to those who can afford it. This is despite public donation option plans.

"It may probably cause pressure to those parents who are less well-off because they feel guilty for not offering the best to their children," said Chou, an associate professor at National Taiwan University's department of national development.

Successful cases using cord blood to save lives may make physicians and families happy, but it is also used as good PR by private cord blood banks. The idea is uncomplicated: parents pay for peace of mind. Those families who can afford it pay for a sense of security.

As for Chang's twins, they are now healthy, happy two-month-olds, and blood from their umbilical cords is securely stored in a blood bank.

"We are just trying to prepare for the worst, especially since our family has a history of leukemia," Chang said. "The best thing that could happen is we never need it."