Private Cord Blood Banking

When we fell pregnant with N all our friends told us to get on to cord blood banking.  Debate ensued as to which of the private cord banks were the best. Private cord banks are big here.  There are seven operating in Spain, and their marketing is evidently effective.  At no time did anyone address whether banking your cord blood with a private bank was the right thing to do.  So confident were they of the need for private cord blood banking that one can see how expecting parents come to assume that cord blood banking is a given obligation.  It almost feels un-parent like to be questioning the benefits of committing to anything that might benefit your child in future.  ‘How could we not invest in something that may one day save our child’s life?’ you ask yourselves.  This line of thinking is encouraged directly (or indirectly via your peers) by the well executed and powerful marketing messages of private banks.  Private cord blood banking is a very expensive programme with questionable benefits.  You need to go beyond the marketing material to make your decision.

To make matters worse, you may find it’s not easy to find impartial advice.  When we asked our gynaecologist to make a recommendation or talk us through the pro’s, con’s and facts, he simply handed us a brochure (actually, the brochure of the only company allowed access to our particular hospital to collect Umbilical Cord Blood – UCB) and non-committally advised that it was a personal choice.  He wasn’t going to make a recommendation either way.  Well, no, let me make my choice based on the marketing brochure of a large international profit making corporation, not the impartial medical advice of a doctor trained not only in medicine but also educated in regards to assessing the merits, statistical processes and consequent claims of medical trials.  Go ahead, that seems ethical.  So anyway, I was forced to do my own research.

I’m not saying you shouldn’t consider private cord blood banking. You should just be aware of the facts before you make a decision. And unfortunately, ascertaining the facts isn’t all that easy.

Cord blood can be an alternative to bone marrow transplantation in the treatment of patients with blood and immune disorders requiring a source of haematopoietic stem cells (HSTC).  In these cases the transplantations are allogeneic [taken from an individual other than the recipients UBC] and the cells used are obtained from donation – that is, public cord banks.  Public cord banks are helping doctors and researchers make extraordinary gains in the treatment of these illnesses and others.  Most developed country governments have a public blood cord bank programme in place, whether the funds and political support are sufficient is another issue and there is a need for international cooperation that could probably do with a push.

If you have the opportunity to donate to a public blood cord bank you absolutely should, from an altruistic point of view.  At this point, and depending where you live and what hospital you go to, this may not be a choice open to you.  Government public banking programmes are generally run through specific hospitals and according to a set capacity rather than on-demand.  They also aim to collect UCB from a wide variety of ethnic groups to expand the genetic diversity of the bank, so it may also depend on who you are rather than just the hospital.

So then, what is the benefit of private banking? Well, not much, many say. Public banking is universally supported by medical bodies and professionals.  Private banks are not.

Private cord blood banking allows you the possibility of autologous (that means own-use) umbilical cord blood (UCB) later in life. There are some very rare genetic diseases for which storing one child’s blood cord, may, but not necessarily, provide a suitable HSTC match for another sibling should they develop this disease.  If you have any of family history of these your doctor will direct you to private cord blood banking.

The other advocated uses of UCB transplants (such as regenerative medicine, for which there are other methods) are at this stage theoretical.  But the potential regenerative uses of UCB are really the clincher for a lot of people – we don’t know what the future of medicine will bring – the emotional part of our brain asks us, ‘what if a rapid breakthrough means your child’s own blood cord is suddenly a genuine life saver and, (worse, if you have chosen not to bank their blood cord) the only life saver?’.  It doesn’t matter how small the chance is that you will need it, this is the stuff nightmares are made of.  And that’s what private banks are..well..banking on.

The marketing machines of the private banks are a lot slicker and faster than the administrative, legal and budgetary hurdles faced by government health agencies.  Google “cord blood banking” and you are more likely to come across company backed sites or information re-published by third party sites and blogs than government or medical organization advice (my favourite is “blood cord bank misconceptions” which will give you an entire page of private blood cord bank company pages with a list of legitimate and complex medical issues raised by the profession in relation to UCB but conveniently transformed in to absolute true or false statements that then allows them to label the statements as false).

But if you read a variety of reports (I have provided a list below) I think you’ll arrive at a more rational perspective, which may or may not lead you to decide that private cord banking is for you.  But at least it will be a more informed decision.

The reports below address the merits of private cord blood banking and the reasons these bodies do not support private cord blood banking.  Note some are a few years old and you need to bear this in mind when reading, given that there are continually new developments in this area.

In fact, some experts say the policies that don’t support private banking are outdated, specifically because none of the medical society opinions take into account the latest study of transplant rates, published in March 2008.  Of the reports below, only one was written after 2008 so you they have a point.

If you do decide to undertake private blood cord banking you should consider whether they comply with UK HTA (Human Tissue Authority), EU guidelines or equivalent.  Also, take a look at whether there are any companies in your country offering a combination of public and private banking. Virgin launched this world first public-private model in the UK last year, in cooperation with the UK’s NHS.  Don’t let the rock star and hot airline hosties association lead to assumptions – ever the pioneer, Virgin seem to have come up with the right formula here with one of the most logical approaches, 80% of the collection goes to a public bank and 20% to the Virgin private bank.  So you have a portion that could in theory be used one day for autologous purposes and the rest goes to the public bank.  I think this is a nice compromise.  Nice one Sir Richard.

Ok, so put your reading glasses on and let’s get started.  You have some decisions to make.  Here are those reports.  Happy reading!

The Medical Journal of Australia, “Umbilical cord blood banking: public good or private benefit?” Gabrielle N Samuel, Ian H Kerridge and Tracey A O’Brien. MJA 2008; 188 (9): 533-535

Not a report as such but very useful:

Baby Center, “Private cord blood banking: Is it for you?” Last updated: November 2009

American Academy of Pediatrics, “Frequently Asked Questions about Cord Blood Banking” (Posted January 2007)

The (British) Royal College of Obstetricians and Gynecologists, Scientific Advisory Committee “Opinion Paper 2″ Revised June 2006

Opinion of the European Group on Ethics in Science and New Technologies Commission No 19, “Ethical Aspects of Umbilical Cord Blood Banking” 16^th March 2004

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