Opinions split on relevance of cord blood

A family in Shanghai, which paid 21,510 yuan (US$3,469) in advance to store their son's umbilical cord blood for 20 years, painfully found out it was not worth the effort as it did not help their son in the treatment of leukemia.

Doctors said the disease was likely caused by genetic disorder and cord blood was of little help in its treatment.

The family had to shell out another 20,000 yuan to find a matching sample at the Shanghai Cord Blood Bank. They said the bank misled them by exaggerating the use of the umbilical cord blood.

Umbilical cord blood is obtained by syringing out the placenta through the umbilical cord at the time of birth after it has been detached from the newborn.

Cord blood is collected and stored because it can be used like bone marrow. The key in both are the stem cells. Stem cells from umbilical cord blood are said to be better because they are less mature than those in adult bone marrow, less prone to rejection by the recipient and more active in developing into different types of cells.

Stem cells have been used in the treatment of diseases like leukemia, lymphoma, anemia and tumor. In addition, stem cells are also considered a promising form of treatment for other diseases like diabetes and cancer, as well as spinal and heart injuries.

Cord blood can be used on the donor or their family members.

According to the child's father, surnamed Li, his two-year-old son was diagnosed with leukemia when he was only eight months old. When he told doctors he had stored the umbilical cord blood, they suggested finding a matched sample from other donors.

Dr Chen Jing from Shanghai Children's Medical Center and the child's doctor, said the child had two types of leukemia at the same time and a stem cell transplant was the only solution, ruling out the boy's own umbilical cord blood for treatment.

The family bought a sample in October last year and his condition was said to be improving. But the inability to use the boy's own cord blood has caused distress and sparked debate.

According to the Shanghai Cord Blood Bank, the city's only such bank, parents can donate their child's cord blood, store it for private use or sell it to other patients at a later date. If they donate it, they can recoup all the collection, processing, testing and storage fees.

The bank charges 5,800 yuan (US$935) to collect, process, test the blood for private use and another 1,200 yuan per year for storage. Those who pay upfront to store it for 20 years can avail of a 10 percent discount, just like Li did.

"There are always two opinions on storing cord blood," said Lu Yao, an official with the Shanghai Cord Blood Bank. "Some experts believe that the chance of a person to use his or her cord blood for blood diseases is too few compared to the cost and the high possibility of finding a match among the donated samples. Others argue that saving own cord blood has its benefits as it helps in the development of regeneration medicine while also benefitting siblings and other family members."

"Our consultants at the maternity hospitals just tell the parents that cord blood can treat various diseases and does not have to be matched or tested if it has to be used. We never promise that cord blood cures everything," Lu said. "There are several cases of people using their own cord blood for treatment. Storing cord blood is a common practice in the world, including the United States."

By 2009, 18 cord blood banks in the world reported 211 cases of people using their own cord blood for treatment, she said.

"It will be better if the cord blood bank gives a more detailed and objective introduction on the benefits of storing cord blood to the parents. It has proven effective in clinical practice," said Dr Chen Qinfeng from Huashan Hospital's hematology department.

Experts said stem cell is a more effective treatment for children diagnosed with leukemia within a year after birth as it is likely to be related with the patients' congenital problems.

Children developing the disease after the age of three can use their own cord blood for treatment.

So far, the Shanghai Cord Blood Bank has more than 25,000 donated samples for public use, accounting for over half of China's total. A similar quantity of samples have been stored at the request of parents for family use.