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December 21, 1999
The Hope, and Hype, of Cord Blood
By DENISE GRADY
Should parents pay a blood bank to store the blood from their newborn baby's umbilical
cord and placenta, in case that child or another family member ever needs it to treat cancer
or leukemia?
Expectant parents are being urged to do so by companies that have sprung up during the
past few years to sell cord-blood banking as a form of "biological insurance" against such
dreaded diseases. The pitch is based on reports in medical journals, such as a major study
published last week in the New England Journal of Medicine, showing that cord blood can
sometimes be used in place of a bone marrow transplant.
Like bone marrow, cord blood is rich in stem cells, which can churn out many different
types of cells to rebuild a patient's blood supply and immune system after high doses of
radiation and chemotherapy. And a patient's own cord blood, or that from a relative, is
more likely than cord blood from an unrelated donor to be a good tissue match and to be
accepted by the recipient's body.
Some experts in bone-marrow transplantation and blood banking frown on the cord-blood
business, arguing that people are being frightened into wasting money on a service they
will probably never need. Moreover, private companies are growing in tandem with public
banks, and some scientists worry that private banking will limit public access to cord
blood. They are concerned because the cord blood in private banks remains the property
of the donor family and is not available to patients seeking a compatible donor.
But the companies say that however remote the possibility that the blood will be needed,
people who choose to bank their own cord blood have a right to do so. In most cases their
cord blood would be thrown away in the delivery room if they did not pay to bank it.
There are only a few cord-blood banks in the United States, and most hospitals do not
have specially trained staff members to collect the blood.
Like bone marrow, cord blood must be matched to the recipient by tests for six inherited
traits that determine an individual's tissue type. Cord blood does not have to be as
precisely matched as bone marrow, but still, the closer the match, the better the odds of
success. The weaker the match, the more likely it is that the recipient's body will reject the
transplant, or the transplant will attack the recipient's tissues, in a life-threatening reaction
called graft versus host disease.
The companies that freeze cord blood and bank it point out that a person's own cord
blood is a perfect match, and a sibling's cord blood a more likely match than a specimen
from a stranger. And so, the argument goes, the best way to protect an entire family from
the unthinkable is to save the newborns' cord blood.
Promotional literature for one company, Cord Blood Registry, in San Bruno, Calif.,
emphasizes that people with cancer in the family may have a special interest in cord-blood
banking, along with those who have the hardest time finding matches, which includes
members of racial minorities, especially families in which the parents are of different races.
According to a spokeswoman, Scoti Kaesshaefer, the company reaches parents-to-be by
promoting itself to doctors, nurses and childbirth educators, and by leaving information at
hospitals. Among the promotional materials the company provided to the New York
Times were copies of articles from other newspapers suggesting that cancer among
children is on the rise. The company also has a Web site and an 800 number with a
recorded greeting that instructs callers to have their credit cards ready.
The idea of saving one's own cord blood seems to be catching on. Cord Blood Registry,
which describes itself as the largest private cord-blood banking firm in the United States,
has stored 10,000 samples during the past three...
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