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Cord Blood: To Store or Not to Store?
Dr Alex Tang
In the last few years, a few companies have been set up to store cord blood of newborn for use in the future. Cord blood contains foetal red blood cells and other cells which can be harvested for stem cells. The argument is that if the child needs a bone marrow transplant in the future, there is already in cold storage, a ready source of his or her own cord blood.
On the surface, this seems like a good argument for planning and storing your newborn’s cord blood. After all, as parents, we want the best for our child. Recently, there has been a move by the Ministry of Health in Malaysia to register and limit the licensing of cord blood storage companies to three. There is also talk of including these companies under the Private Hospital Act. There are a few reasons for this.
First, there is a matter of degeneration of the DNA and mitochondrial RNA of the cord blood cells over time. This degeneration is inevitable. Thus when the frozen cord blood is needed, which is usually in 20-30 years’ time, there will be some notable degeneration in the DNA and RNA. Nobody knows at present what the effect of this degeneration is because cord blood storage and retrieval has not been around that long.
Second, cord blood is stored frozen at a very specific low temperature. This temperature is maintained by liquid nitrogen as the cooling agent. Thus the companies storing cord blood must have very sophisticated instruments to monitor the temperature of the frozen cord blood and there must not be any large variation in temperature. All it takes is a single episode of temperature variation for the cord blood cells to be destroyed. In the case of a power failure, the few seconds for the back-up generator to come online make the difference (provided the backup generators work, of course).
Third, the cost of storing and maintaining cord blood can be prohibitive over time. The initial start up cost of collection, freezing and storage may cost about RM3,000 or more. Then there is the yearly cost of about RM1,000 per year. Multiply that with the number of years you want to keep it for your child and you will get an idea on how much it will cost you. Cord blood storage will be for the rich only. What about the poor?
Four, an argument is set forth for cord blood for marrow transplantation as an insurance policy in case your child develops leukaemia or thalassemia (these are the two common diseases quoted). Leukaemia and thalassemia have a genetic basis. Therefore, it does not make sense to transplant into your child the same genetic materials that caused the leukaemia and thalassemia in the first place.
Finally, there is the matter of the volume of cord blood stored. Most companies stores about 50-100 ml. By the time your child needs the cord blood for transplantation, he or she may be about 19-20 years old. The stored cord blood will not be enough for a single bone marrow transplantation. On the other hand, I am not denying that there is a need for cord blood storage. Cord blood does provide a viable source for stem cells. I will strongly support the formation of a cord blood bank, preferably by the Ministry of Health, where cord blood from all newborns are stored. This functions like a regular blood bank, where all can draw from it as their needs requires, both rich and poor.
|posted 6 December 2007|
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