Lehigh Med Summer 2019 - 29

L C M E D S O C .O R G

Hematopoietic stem cells can be obtained
from bone marrow, peripheral blood, and
umbilical cord blood in order to treat leukemia, lymphoma, aplastic anemia, sickle cell
anemia, and thalassemia major, among other
diseases. Umbilical cord blood is obtained
from the blood remaining in the umbilical
cord and placenta following the birth of an
infant. The advantages of using umbilical
cord blood include expanded donor pool,
ease of procurement, lack of need to
complete human leukocyte antigen match,
and decreased graft-versus-host disease.
The disadvantages of using umbilical cord
blood includes increased risk of graft failure,
delayed immune reconstitution, limited
number of stem cells, and unavailability of
the donor for additional donations. There
are two main types of cord blood banks that
exist to store cord blood for potential future
transplantation. Public cord blood banks
perform collections at a limited number
of hospitals and place them in a public
database accessible to health care providers.
Maternal blood testing is performed within
seven days to screen for Hepatitis B and C,
HIV, Cytomegalovirus, Syphilis, Malaria,
West Nile, and Chagas disease. Some public
banks also require saliva testing of the infant
to screen for Cytomegalovirus as well as
a six-month follow-up examination. On
the other hand, private cord blood banks
are for-profit enterprises that facilitate
collections for families that want to pay
for it and reserve it for their personal use
regardless of maternal blood testing results.
Regardless the type of cord blood bank,
informed consent must be obtained by
the infant's mother.

THE CORD BLOOD
COLLECTION PROCESS
IS TO NEVER
COMPROMISE THE
SAFETY OF THE MOTHER
OR INFANT DURING
CHILDBIRTH AND CAN
EITHER BE PERFORMED
PRIOR TO OR FOLLOWING
THE DELIVERY OF
THE PLACENTA.

Within 48 hours, cord blood units must accurate information regarding the process
be tested, processed, and stored for future if requested. Legal aspects surrounding
use, but the overall process varies as it cord blood banking is actively evolving
is relatively unregulated. This may soon considering it is relatively new and there
change as the US Food and Drug Admin- continues to be unresolved ethical issues.
istration is now requiring donor cord blood Regardless, it is an interesting topic and one
establishments register with them, making that can potentially offer great benefits to
them subject to inspection. Private banking the ever-changing medical field.
fees vary but average $2,000 for processing
the initial specimen with a $125 storage
fee per unit per year. There is no accepted
shelf life of cord blood units, but studies SOURCES:
have shown anywhere between 12 and 23 https://www.uptodate.com/contents/
years of storage showed minimal loss of collection-and-storage-of-umbilical-cord-blood-for-hehematopoietic progenitor cells. Given the matopoietic-cell-transplantation?search=cord%20
blood&source=search_result&selectedTiuncertainty of this medical advancement, tle=1~150&usage_type=default&display_rank=1
the American Academy of Pediatrics does
http://www.bonemarrowmx.com/
not recommend that parents store their umbilical-cord-blood-transplant/
infant's umbilical cord blood unless there
is an immediate medically-indicated use
for a sibling. The American College of
Obstetricians and Gynecologists does not
recommend routine storage of umbilical
cord blood as biologic insurance against
possible future disease, but does support
providing patients with balanced and
SUMMER 2019 | Lehigh County Health & Medicine 29

http://www.LCMEDSOC.ORG https://www.uptodate.com/contents/ http://www.bonemarrowmx.com/

Lehigh Med Summer 2019

Table of Contents for the Digital Edition of Lehigh Med Summer 2019