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By Mary Carmichael
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When I wrote this piece on umbilical-cord stem-cell banks back in December 2008, I was six months pregnant. I hoped that by analyzing the banks' promises as a journalist, I'd be better able to decide what to do about them as an expectant mom. By then I'd already been bombarded with propaganda for private cord blood banks. There were ads in every pregnancy magazine, on every parenting Web site, on the side of my Facebook page: "Cutting edge stem cell technology!" "May potentially save a life!" But after several days of reporting at Cord Blood Registry's hypermodern headquarters in Tucson, I wasn't convinced that the science behind the banks was anywhere near solid enough to justify the multi-thousand-dollar cost of private stem-cell storage. Most of the outside researchers I spoke with were skeptical that children would benefit later in life from their parents' saving their umbilical stem cells at birth. On the other hand, the scientists used very cautious language─they weren't condemning the banks so much as raising their eyebrows. I decided not to bank my daughter's cord blood, but a small part of me still wondered if I'd made the right decision.
I suppose if I wanted reassurance I should have just called Dr. Irving Weissman, director of the Institute of Stem Cell Biology and Regenerative Medicine at Stanford University in California. Over the weekend, according to a wire story from the AFP he had this to say at the annual meeting of the American Association for the Advancement of Science (AAAS):
Umbilical cords contain blood-forming stem cells at a level that would maintain the blood-forming capacity of a very young child ...They don't make brain, they don't make blood, they don't make heart, they don't make skeletal muscle, despite what various people claim ... [The banks] do the therapies, then they let the patients go on their own, short of maybe 50-150,000 dollars for a therapy that has no chance─taken away from a family that needs them when they have an incurable disease. It is wrong.
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Ouch. Those are strong words─much stronger than the measured language that the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics have used in their own criticisms of the banks. Maybe Weissman is just saying what the professional societies are quietly thinking. Or maybe he's reacting to the fact that cord blood banks seem to get more popular every day: there was even a congressional act introduced last year to raise awareness about cord blood cells─or from taking off in other countries, especially India. And in the last few years, another stem-cell banking industry has sprung up alongside the cord-blood companies. You didn't save the cord blood? No problem, you can still bank your child's teeth:
At least four dental stem cell banking companies exist so far, charging anywhere from $575 to more than $1,600 for the initial extraction plus an annual storage fee of around $100 per year … "I got an email saying if you were not able to [bank the umbilical cords of] any of your children, there was this option [of dental banking instead]," said Wakefield. "It wasn't too late to do it." A recent press release from a company called Save-A-Tooth that services dental banking company Store-A-Tooth.com even stated that "... baby teeth and extracted wisdom teeth can be a source of stem cells that are the equivalent to umbilical cord blood stem cells." In fact, stem cells from cord blood are quite different than those extracted from dental pulp.
It's a shame that the cord-blood banks are so quick to hype the promise of the stem cells they're storing, and all this early, unproven marketing may make it easy to just dismiss the concept of cord blood as a medical treatment altogether. But cord-blood cells may well turn out to be an effective treatment for some rare childhood diseases or brain injuries, according to some promising, albeit very early, trials underway. (They're unlikely to help adults, since the number of cells in cord blood isn't large enough to have an effect on a full-sized body.)
For now, though, no one knows what the early trials are going to show. Even the scientists involved with them are hesitant to make any predictions. And it's likely that being treated with other people's cord-blood stem cells from public banks will turn out to be just as effective medically─in some cases, perhaps even more effective─as being treated with one's own, privately banked cells. Widespread public banking would effectively negate the need for private banks. Why pay to store your own cells when, in the unlikely event that you need cells, you can get someone else's for free?
If you're pregnant and you believe in the promise of cord blood, for now, there are two things that are probably best to do. No. 1: Donate your baby's cells to a public bank, as this Slate article suggests. That's assuming you can─many hospitals, including the major academic medical center where I delivered, aren't set up to receive donations. Which leads us to No. 2: Support an increase in funding for public cord-blood collection and banking. That has the potential to be good for everyone's health─except, perhaps, the private cord-blood banking industry's.
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