Striking a cord: Is it worth saving stem cells? Yes, if you plan to share
New parents are beginning to bank their baby’s cord blood cells in the hope that they can be used to treat serious diseases later on in the child’s life.
Many of them have been told that the cells can already be used to treat about 80 blood and immunological conditions. So they fork out thousands a year for the service.
What they are not told is that the tiny amounts saved at birth would not be sufficient to treat a serious condition in an adult.
“Globally, around 50,000 cases of cancer have been treated with stem cells from cord blood, but banking is not a feasible solution because the amount preserved is not enough for bone marrow transplants in adults,” says Dr Dharama Choudhary, bone-marrow transplant specialist at BLK Super Speciality Hospital.
For example, if one child has leukemia and has a newborn sibling, instead of using the cord blood doctors would rather wait for a couple of years and use the bone marrow of the younger child for transplant, adds Dr IC Verma, senior consultant of medical genetics and genomics at Delhi’s Sir Ganga Ram Hospital.
“Even if you have enough, using cord blood cells is more costly and the recovery period is longer,” Dr Choudhary adds.
FROM SOLO TO POOL
Currently, cord blood is preserved in less than 1% of deliveries in urban centres, with the number being a higher 2% in private tertiary-care hospitals. “The percentage is higher in Hyderabad, Bangalore and Pune, although we have not been able to ascertain the reason,” says Upamannyue Roy Choudhury, CEO of CordLife India, a private cord blood bank.
The idea of public registries run by charitable organisations never really took off. “That registry was meant so that anyone could purchase stem cells from a shared bank, but it has only about 5,000 units of cord blood banked across India. Private banks have about 500,000,” says Mayur Abhaya, executive director at Life Cell International, one such private bank.
To help more people get treated using stem cells from cord blood, private banks should now promote sharing within their own pool, doctors add. “We have underutilised assets, so pools would benefit people who have not banked cord blood,” says Abhaya.
His company charges an initial fee of Rs 17,000 for the processing of banked cord blood and then Rs 4,000 a year for banking it. “We have now started a sharing system where, for the same amount, the baby, its parents and both sets of grandparents can draw cord blood too – from the shared pool – at no extra cost,” he says.
Life Cell estimates that even with the sharing of saved cord blood, utilisation would be only around 10%, because of the low incidence of the conditions that cord blood can be used to treat.
In the four months since starting the community pool, 99% of new customers have opted for the sharing model. “We are now going back to older customers and trying to bring them into this pool as well,” Abhaya says.
On average, only about 0.004% to 0.005% of people who store cord blood end up using it for their own treatment, says Dr Choudhary of BLK.
In addition to the problem of too little cord blood being harvested for treatment of serious diseases in adults, there is the issue of incorrect storage. “Storage is not done correctly in many Indian banks. The cord blood is cryopreserved, and when it is thawed, the number of viable cells drops drastically,” Dr Choudhary says.
Public cord blood banking, though, has a future. “Storing cord blood in a public banking system, where it may be used by others in need, is more feasible,” says Dr IC Verma. “It will take another couple of decades before people will be able to meaningfully use their own cord blood.”