Stem Cell Banking (3)
Benefits of saving cord blood
Here are some of the many reasons why you should store your baby’s cord blood stem cells.
A guaranteed match for autologous transplants.
Autologous stem cell transplants are transplants in which the same person is both the donor and the recipient of the stem cells. The cord blood you are saving for your baby now could be used as a medical resource in the future. Unlike traditional bone marrow stem cell transplants, cord blood does not need to be a perfect match. Every year, 40–60% of patients in Singapore who need a stem cell transplant can't find a good match in public cord blood banks or among bone marrow donors.1 The odds of finding a match within the same racial group are only 1 in 20,000.2
A readily available supply of stored Haematopoietic Stem Cells.
In the event that stem cells are needed for a transplant in an already time-critical situation, having your child’s cord blood stored compares favourably to having to conduct a costly and time-consuming national or international search. Procuring a cord blood sample can cost up to $90,000 in Singapore, assuming a match is found.3
Lower risk of Graft vs. Host Disease (GvHD) in autologous transplants.
When using stem cells from cord blood, the risk of Graft vs. Host Disease (GvHD) is lower for autologous transplants, where the donor and recipient are the same person, as compared to transplants from unrelated donors.
GvHD is a condition where the transplanted tissue cells (the graft) see the patient’s own tissue (the host) as foreign and attacks them.
Up to 75% chance of matching genetically between siblings.4
Umbilical cord blood from a sibling offers a lifetime of protection for the family as the stored cord blood offers a higher potential for genetic matches. Many families have benefited from using sibling stem cells for treatment.
Umbilical cord blood stem cells are younger and more primitive.
Umbilical cord stem cells can grow healthy blood cells faster than other types of stem cells obtained from other sources, such as bone marrow and peripheral blood.5,6 They are also more tolerant to HLA* mismatches.7
*Human leukocyte antigens, or HLAs, are proteins that help the immune system tell the difference between the body's own cells and foreign substances that could be harmful.
Cord blood collection is safe and painless for both mother and baby.
Cord blood collection is a simple task that is taken care of by your own OBGYN. The process of cord blood collection does not affect the birthing process in any way and can be done for both natural and C-section births.
References:
1 Treatment with cord blood page. Singapore Cord Blood Bank website. https://www.scbb.com.sg/cordblood/pages/treatment-with-cord-blood.aspx. Accessed July 23, 2021.
2 Yuen S. Wanted: More bone marrow donors from minority races. The Straits Times. September 18, 2016:13.
3 Criterion for new stem-cell transplant 50 per cent match. AsiaOne website. https://www.asiaone.com/health/criterion-new-stemcell-transplant-50-cent-match. Accessed July 23, 2021.
4 Jawdat D, Saleh S, Sutton P, Anazi H, Shubaili A, Tamim H, et al. Chances of Finding an HLA-Matched Sibling: The Saudi Experience. ScienceDirect. 2009;15(10): 1342-1334.
5 Bordeaux-Rego P, Luzo A, Costa FF, et al. Both interleukin-3 and interleukin-6 are necessary for better ex vivo expansion of CD133+ cells from umbilical cord blood. Stem Cells Dev. 2010;19(3):413–422.
6 Kadereit S, Deeds LS, Haynesworth SE, et al. Expansion of LTC-ICs and maintenance of p21 and BCL-2 expression in cord blood CD34+/CD38− early progenitors cultured over human MSCs as a feeder layer. Stem Cells. 2002;20(6):573–582.
7 Beksac M (2016) Is There Any Reason to Prefer Cord Blood Instead of Adult Donors for Hematopoietic Stem Cell Transplants? Front. Med. 2:95. doi: 10.3389/fmed.2015.00095.
DCR No. 4781, Version C, December 2022
Over 80 diseases 1 potentially treatable with cord blood stem cells
Stem cells are now at the forefront of one of the most fascinating and revolutionary fields in medicine. Blood-forming stem cells, also called Haematopoietic Stem Cells (HSCs), can be found in your baby's cord blood. These cells have the potential to treat more than 80 diseases 1, including some types of cancer like leukaemia, neuroblastoma, and lymphoma.
During a stem cell transplant, stem cells are infused into the patient’s bloodstream, where they start to heal damaged cells and tissues. The patient’s blood and immune system are regenerated after the stem cells successfully engraft.
DID YOU KNOW?
Haematopoietic Stem Cells (HSCs) can potentially be used to treat over 80 diseases1.
List of diseases potentially treatable with cord blood stem cells
The following diseases can potentially be treated with cord blood stem cell transplants. These cells can be derived from cord blood, bone marrow, or peripheral blood.
Blood Cancers
| STANDARD THERAPIES | Allogeneic | Autologous |
| Acute Biphenotypic Leukaemia | X | |
| B-cell Acute Lymphoblastic Leukaemia 2 | X | |
| T-cell Acute Lymphoblastic Leukaemia 2 | X | |
| Acute Myelogenous Leukaemia | X | |
| Acute Undifferentiated Leukaemia | X | |
| Chronic Myelogenous Leukaemia | X | |
| Chronic Lymphocytic Leukaemia | X | |
| Juvenile Myelomonocytic Leukaemia | X | |
| Juvenile Chronic Myelogenous Leukaemia | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Acute Myelofibrosis | X | |
| Agnogenic Myeloid Metaplasia (Myelofibrosis) | X | |
| Essential Thrombocythemia | X | |
| Polycythemia Vera | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Refractory Anaemia | X | |
| Refractory Anaemia with Excess Blasts | X | |
| Refractory Anaemia with Excess Blasts in Transformation | X | |
| Refractory Anaemia with Ringed Sideroblasts (Sideroblastic Anaemia) | X | |
| Chronic Myelomonocytic Leukaemia | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Multiple Myeloma | X | X |
| Plasma Cell Leukaemia | X | X |
| Waldenstrom’s Macroglobulinemia | X | X |
Non Malignant Blood Disorders
| STANDARD THERAPIES | Allogeneic | Autologous |
| Aplastic Anaemia | X | |
| Congenital Dyserythropoietic Anaemia | X | |
| Fanconi Anaemia 3 | X | |
| Paroxysmal Nocturnal Hemoglobinuria | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Pure Red Cell Aplasia | X | |
| Sickle Cell Anaemia | X | |
| Beta Thalassemia Major / Cooley’s Anaemia | X | |
| Diamond Blackfan Anaemia | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Amegakaryocytosis / Congenital Thrombocytopenia | X | |
| Glanzmann’s Thrombasthenia | X |
Immune Disorders
| STANDARD THERAPIES | Allogeneic | Autologous |
| Omenn Syndrome | X | |
| SCID with Adenosine Deaminase Deficiency (ADA SCID) | X | |
| SCID which is X linked | X | |
| SCID with absence of T & B Cells | X | |
| SCID with absence of T Cells, Normal B Cells | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Cartilage Hair Hypoplasia | X | |
| Erythropoietic Porphyria | X | |
| Hermansky Pudlak Syndrome | X | |
| Pearson’s Syndrome | X | |
| Shwachman Diamond Syndrome | X | |
| Systemic Mastocytosis | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Chediak Higashi Syndrome | X | |
| Chronic Granulomatous Disease | X | |
| Neutrophil Actin Deficiency | X | |
| Reticular Dysgenesis | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Kostmann Syndrome (Infantile Genetic Agranulocytosis) | X | |
| Myelokathexis | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Bare Lymphocyte Syndrome | X | |
| Common Variable Immunodeficiency | X | |
| DiGeorge Syndrome | X | |
| Hemophagocytic Lymphohistiocytosis | X | |
| IKK Gamma Deficiency 4,5 (NEMO Dificiency) | X | |
| IPEX Syndrome 6,7 | X | |
| Leukocyte Adhesion Deficiency | X | |
| Wiskott Aldrich Syndrome | X | |
| Lymphoproliferative Disorders | X | |
| X linked Lymphoproliferative Disease (Duncan’s Syndrome) | X | |
| Ataxia-Telangiectasia | X |
Metabolic Disorders
| STANDARD THERAPIES | Allogeneic | Autologous |
| Adrenoleukodystrophy (ALD) | X | |
| Krabbe Disease (Globoid Cell Leukodystrophy) | X | |
| Metachromatic Leukodystrophy | X | |
| Pelizaeus-Merzbacher Disease | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Niemann Pick Disease | X | |
| Sandhoff Disease | X | |
| Wolman Disease | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Hunter Syndrome | X | |
| Hurler Syndrome | X | |
| Maroteaux Lamy Syndrome | X | |
| Mucolipidosis II (I-cell Disease) | X | |
| Morquio Syndrome | X | |
| Sanfilippo Syndrome | X | |
| Scheie Syndrome | X | |
| Sly Syndrome (beta-glucuronidase deficiency) | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Lesch–Nyhan Syndrome | X | |
| Osteopetrosis | X |
Solid Tumors
| STANDARD THERAPIES | Allogeneic | Autologous |
| Hodgkin's Lymphoma | X | X |
| Neuroblastoma | X | |
| Non Hodgkin's Lymphoma (Burkitt’s Lymphoma) | X | |
| Retinoblastoma | X | |
| Medulloblastoma | X |
Storing cord blood does not guarantee that the cells will provide a cure or be useful in all situations. The treating physician will ultimately decide if cord blood can be used.
References:
1 Diseases treated page. Parent’s Guide to Cord Blood Foundation website. https://parentsguidecordblood.org/en/diseases. Accessed December 5, 2022.
2 B-cell and T-cell acute lymphoblastic leukemia page. Mayo Clinic Laboratories website. https://news.mayocliniclabs.com/hematology/lymphoma/b-cell-and-t-cell-acute-lymphoblastic-leukemia/#:~:text=Acute%20lymphoblastic%20leukemia%20accounts%20for,2%E2%80%935%20years%20of%20age. Accessed June 28, 2023.
3 Bizzetto R, Bonfim C, Rocha V, et al. Outcomes after related and unrelated umbilical cord blood transplantation for hereditary bone marrow failure syndromes other than Fanconi anemia. Haematologica. 2011; 96(1):134-141.
4 Picard C, J-L Casanova, Puel A, Infectious diseases in patients with IRAK-4, MyD88, NEMO, or IκBα Deficiency. Clin. Microbiol. Rev. 2011; 24(3):490-497.
5 Tono C, Takahashi Y, Terui K, et al. Correction of immunodeficiency associated with NEMO mutation by umbilical cord blood transplantation using a reduced-intensity conditioning regimen. Bone Marrow Transplant. 2007;39(12):801-804.
6 Immunodysregulation polyendocrinopathy enteropathy X-linked (IPEX) Syndrome page. Stanford Children’s Health website. https://www.stanfordchildrens.org/en/service/stem-cell-transplantation/conditions/ipex-syndrome. Accessed December 5, 2022.
7 Rao A, Kamani N, Filipovich A, et al. Successful bone marrow transplantation for IPEX syndrome after reduced-intensity conditioning. Blood. 2007; 109(1):383-385.
Clinical trials
Below are some of the diseases1 that are currently undergoing clinical trials using blood-forming cells or cord blood. As researchers continue to push the boundaries of stem cells for some of the most common life-threatening diseases, saving your baby's cord blood now will give your child access to her own stem cells once these therapies are available. For the complete and most updated list, please visit clinicaltrials.gov.
| STANDARD THERAPIES | Allogeneic | Autologous |
| Alopecia Areata | X | |
| Amyotrophic Lateral Sclerosis (ALS) | X | |
| Crohn’s Disease | X | |
| Eczema (Atopic Dermatitis) | X | |
| Graft-versus-Host Disease (GvHD) | X | |
| Lupus | X | |
| Multiple Sclerosis | X | |
| Psoriasis | X | |
| Rheumatoid Arthritis | X | |
| Systemic Sclerosis | X | |
| Ulcerative Colitis | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Aging Frailty | X | |
| Duchenne Muscular Dystrophy | X | |
| Epidermolysis Bullosa | X | |
| Gaucher’s Disease4 | X | |
| Hereditary Ataxia | X | |
| Lysosomal Storage Diseases | X | |
| Metabolic Syndrome | X | |
| Severe Combined Immunodeficiency | X | |
| Spinal muscular atrophy | X | |
| Tay-Sachs Disease | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Acute Myocardial Infarction (Heart Attack) | X | |
| Cardiomyopathy | X | |
| Critical Limb Ischemia (CLI) | X | |
| Heart Failure | X | |
| Hypoplastic Left Heart Syndrome2 | X | |
| Ischemic Heart Disease3 | X | |
| Peripheral Arterial Disease (PAD) | X | |
| Surgery for Congenital Heart Defects | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Ankylosing Spondylitis | X | |
| Cartilage Injury | X | |
| Cleft Palate Repair | X | |
| Non-Union Fractures | X | |
| Osteoarthritis | X | |
| Osteochondral Lesion | X | |
| Spinal Fusion Surgery | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Diabetes, Type 1 (Auto-Immune) | X | X |
| Diabetes, Type 2 | X | X |
| Diabetic Foot Ulcer | X | |
| Diabetic Peripheral Neuropathy | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Alzheimer’s Disease | X | |
| Autism | X | X |
| Cerebral Palsy | X | X |
| Encephalopathy | X | |
| Global Developmental Delay | X | X |
| Hearing Loss (acquired sensorineural) | X | |
| Intraventricular Hemorrhage | X | X |
| Parkinson’s Disease | X | |
| Spinal Cord Injury | X | |
| Stroke | X | X |
| Traumatic Brain Injury | X | X |
| STANDARD THERAPIES | Allogeneic | Autologous |
| Acute Respiratory Distress Syndrome (ARDS) | X | |
| Bronchopulmonary Dysplasia (BPD) (lung disorder due to premature birth) | X | |
| COVID-195 | X | X |
| Erectile Dysfunction | X | |
| Eye Diseases | X | |
| Fistula | X | |
| HIV | X | |
| Kidney Failure | X | |
| Liver Cirrhosis | X | |
| Liver Failure | X | |
| Ovarian Cancer6 | X | |
| Peyronie’s Disease | X | |
| Premature Ovarian Failure | X | |
| Testicular Tumour7 | X | |
| Uterine Scars | X | |
| Wounds | X |
*The clinical trials listed above may use cell lines other than Haematopoietic Stem Cells, such as Mesenchymal Stem Cells.
A majority of autologous infusions/regenerative applications listed above were performed under clinical trial.
References:
1 Therapies in clinical trials page. Parent’s Guide to Cord Blood Foundation website. https://parentsguidecordblood.org/en/diseases#trial. Accessed December 5, 2022.
2 ClinicalTrials.org registry… NCT01883076, NCT03431480, NCT03779711. Last accessed December 5, 2022.
3 Umbilical cord derived mesenchymal stem cell therapy in ischemic cardiomyopathy page. ClinicalTrials.gov website. https://clinicaltrials.gov/ct2/show/NCT01946048. Accessed December 5, 2022.
4 ClinicalTrials.org registry… NCT00176904, NCT04528355. Last accessed December 5, 2022.
5 Mesenchymal stem cells and COVID-19: Cure, prevention, and vaccination page. Hindawi.com website. https://www.hindawi.com/journals/sci/2021/6666370/. Accessed December 5, 2022.
6 Cady C., McAsey M., Li J. Progress towards a stem cell based therapy for ovarian cancer – Proceeding of the STEMSO Conference. https://www.cellr4.org/article/780. Accessed December 5, 2022.
7 High-dose chemo & stem cell transplant for testicular cancer page. American Cancer Society website. https://www.cancer.org/cancer/testicular-cancer/treating/high-dose-chemo-stem-cell.html. Published May 17, 2018. Accessed December 5, 2022.
.DCR No. 4990, Version K, September 2023 (reference from QR 8.1-8-5-J)
What are cord blood stem cells?
The umbilical cord is a tube-like structure connecting the foetus to the placenta in mother's womb, providing nutrients and removing waste from baby. Cord blood, which is also called "placental blood", is blood that remains in the umbilical cord and placenta following the birth of a baby and after the umbilical cord is cut after delivery. Through the science of cord blood banking, cord blood can help nurture life, long after a baby's birth and provide a source of stem cells should the need ever arise for a stem cell transplant. This is because cord blood is a rich source of stem cells known as haematopoietic stem cells (HSCs). These HSCs are primarily responsible for replenishing blood and regenerating the immune system.
Cord blood stem cell transplants are used in the following ways:
- Replace and regenerate damaged or diseased bone marrow
- Treatment for blood cancers
- Correct genetic defects (sibling/allogeneic transplantation)
- Potential for cellular therapy and regenerative medicine
They have the unique ability to differentiate into various cell types found in blood as depicted in the diagram below:
Red Blood Cells
Carry oxygen to all cells in the body
White Blood Cells
Fight infection
Platelets
Assist blood clotting in the event of injury
Why Save Cord Blood Stem Cells
-
A guaranteed match for autologous transplants (where the donor and recipient are the same individual).
Autologous stem cell transplants refer to transplants where the donor and recipient of the stem cells are the same individual. The cord blood that you are storing for your baby today is a potential medical resource for the future, and does not require stringent matching as opposed to conventional bone marrow stem cell transplants. About 70% of patients who need a transplant are unable to find a suitable match within the family1. -
A Readily Available Supply of Stored Haematopoietic Stem Cells
In the event of an already time-critical situation where stem cells are required for a transplant, having your child’s cord blood stored compares well to having to do a national or international search which is both costly and time-consuming. The cost of procuring a cord blood sample in Singapore can cost up to $75,0002, and that is, if a match is found. -
Lower risk of Graft vs. Host Disease (GvHD) for autologous transplants
Graft vs. Host Disease refers to a common complication where the transplanted tissue attacks the patient's own tissue. This disease will usually occur in transplants when the donor and recipient are different. -
Ease of collection, which is pain-free and risk-free to both mother and child.
Cord blood collection is a relatively easy task, which is handled by your own delivering doctor (OBGYN). This process does not affect the birthing process in any way and can be done on both natural and c-section births. -
Umbilical cord blood stem cells are younger and more primitive
In comparison to other types of stem cells, e.g bone marrow and peripheral blood stem cells, there is a notably higher rate of engraftment. This means the cells are faster in growing and making healthy blood stem cells and are more tolerant to tissue mismatches. -
1 in 217 chances of using stem cells for treatment in a lifetime
Statistics have shown that 1 in every 217 persons may need stem cells for treatment in their lifetime3. Your baby’s cord blood contains a rich source of such stem cells. Since 1988, doctors have used cord blood stem cells to treat more than 30,000 patients4 suffering from diseases such as certain cancers like leukaemia, blood disorders as well as those in clinical trials
References:
1 Be The Match website. www.bethematch.org. Assessed 21 Jul 2014
2Joan Chew (July 18, 2013). Criterion for new stem-cell transplant. The Straits Times.
3 Nietfeld JJ, Pasquini MC, Logan BR, Verter F, Horowitz MM. Lifetime probabilities of hematopoietic stem cell transplantation in the U.S Biology of Blood and Marrow Transplantation. 2008;14:316-322
4 Ballen KK, Gluckman E, Broxmeyer HE. Umbilical cord blood transplantation: The first 25 years and beyond. 2013; Blood: 122(4)