Cord blood banking was all the rage about a decade ago. Companies pitched it almost as an insurance policy for a child鈥檚 future health, preserving the stem cells in the blood for life-saving treatments just over the horizon. Yet it has become increasingly clear that much of the promise was overblown 鈥� paying to bank your baby鈥檚 cord blood is rarely worth it.
鈥淭he hype was that everybody should do it because you never know if you could use it,鈥� says at Mount Sinai West, a hospital in New York City. 鈥淏ut we just don鈥檛 see a lot of people asking for it anymore because I think there鈥檚 more literature suggesting the likelihood of utilisation is exceptionally low.鈥�
Umbilical cord blood was viewed as medical waste until the , when it was discovered to contain haematopoietic stem cells, which have the ability to transform into any blood cell type. This meant it could be used to treat certain blood conditions.
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Haematopoietic stem cells can also be harvested from bone marrow or circulating blood, but those in the umbilical cord offer a slight advantage: they are more immune tolerant, meaning they are less likely to attack a transplant recipient鈥檚 cells. As such, cord blood transplants don鈥檛 require a perfect donor match, as bone marrow does, and they carry a lower risk of relapse, says at Duke University in North Carolina.
Researchers also began exploring whether cord blood could treat a wider range of conditions, including Alzheimer鈥檚 disease, type 1 diabetes and cerebral palsy. Some even believed it might reverse signs of ageing. Given the possibilities, companies started freezing and storing cord blood privately so that families could use it in the future, when it was thought cord blood treatments would be more common. But almost none of these other potential uses have panned out, at least not yet. 鈥淎 lot of [companies] say, 鈥榃ell you never know, the science may come up with new stuff,鈥欌�� says Rebarber.
Today, there are . Upfront costs range from $99 to nearly $2000, with annual fees of up to $240 a year. But despite the high price tag, few families actually benefit from banking their baby鈥檚 cord blood. 鈥淭he likelihood of utilising it is exceptionally low given the current technology,鈥� says Rebarber.
Cord blood stem cells are currently used to treat around , mostly blood cancers and disorders. However, the number of cases where privately banked cord blood is useful is even smaller. That is because many of these conditions are genetic, meaning the stored cord blood carries the same genetic variants or precancerous cells that led to illness in the first place.
The chance of someone developing a condition that could be treated with their own cord blood is estimated to be between 1 in 400 and 1 in 2500. In fact, privately banking cord blood is more useful for siblings who may develop one of these genetic conditions or cancers, says Rebarber.
Collecting adequate amounts of cord blood is also a challenge. Public cord blood banks 鈥� which store donations for anyone in need 鈥� discard samples that don鈥檛 contain enough stem cells to treat an adult. But private banks don鈥檛. 鈥淭he truth is, the average number they keep is enough for a child up to the age of probably 5 to 6 years, but not enough for that person as an adult,鈥� says Kurtzberg.
Cord blood is also prone to contamination due to the high levels of bacteria on the umbilical cord, says Rebarber. While public cord blood banks toss contaminated samples, private banks often don鈥檛 鈥� and some don鈥檛 even inform families when samples are contaminated, says Kurtzberg.
To complicate matters even further, a study published earlier this year suggests over the first five years of being frozen. Anecdotally, Kurtzberg says there have been successful transplants with cord blood that was stored for 20 to 30 years. Still, the results underscore the limitations of privately banking cord blood for use decades down the line.
For all of these reasons, medical associations such as the and the recommend parents donate cord blood to public banks rather than store it privately. Even so, only in the US participate in public cord blood banking, largely because of the time and money it takes to do so, says Kurtzberg.
鈥淎 lot of the private banks 鈥� not all, but many of them 鈥� promised that banking your baby鈥檚 cord blood would be the solution all of these diseases that befell your baby and your family. And that鈥檚 not true,鈥� says Kurtzberg. 鈥淚t鈥檚 not a useless thing to do, and there is value in it sometimes, but I do think the hype from 10, 20 years ago was overextended and anticipated more benefits than are going to be possible.鈥�
