American Academy of Pediatrics Encourages Use of Public Cord Blood Banks

Stem cell transplantations from cord blood have risen over the past decade to save children with fatal diseases, most often through use of public cord blood banks.

Cord blood is increasingly being used to treat fatal or debilitating diseases, prompting the American Academy of Pediatrics to release a policy statement that calls for renewed emphasis and education about the advantages and need for public cord blood banking.

The policy statement, "Cord Blood Banking for Future Transplantation," published in the November 2017 issue of Pediatrics, serves as an update to the Academy's 2007 policy and references the latest research on clinical outcomes from cord blood transplants. The statement, to be published online Oct. 30, observes that a growing number of states are requiring universal newborn screening for diseases that could be treated with stem cell transplantation.

"Most parents will never need cord blood for their own family's use, but they can donate this precious life-saving gift to benefit others," said William T. Shearer, MD, PhD, FAAP, lead author of the policy statement. "We expect the need for these therapies that rely on stem cell transplantation to grow, and would like families to understand the choices they have."

Cord blood, taken from the placenta of healthy newborn infants, was routinely discarded until it was discovered to be an excellent source of stem cells for hematopoietic stem cell transplantation for some diseases. By 2013, worldwide, more than 30,000 stem cell transplants had been performed using cord blood, according to research.

Cord blood is used most often in transplantation in infants and children with fatal diseases such as malignancies, blood disorders, immune deficiencies and metabolic disorders.

Donating cord blood is safe for the baby and it doesn't interfere with labor and delivery. Because families must register ahead of time -- so a collection kit can be sent and used after the baby's delivery -- the AAP recommends that physicians talk with families during an early prenatal visit.

Also recommended is that physicians discuss the value of cord blood and the difference between public cord blood banks versus private, for-profit cord blood banks.

The AAP policy statement lists these differences between public and private cord blood banking:

• Public cord blood banks serve patients worldwide by matching individuals in need. Private banks store the cord blood for the donor family's potential self use, although there is little evidence supporting this use unless a family shares a known genetic defect.
• Donation to a public cord blood bank is free. Private cord blood banks charge a placement fee of $1,350 to $2,300 and an annual maintenance fee of $100-$175.
• Public cord blood banks are highly regulated by oversight accrediting institutions. Private cord blood banks may not meet stringent requirements, which can cause cord blood to be of lesser quality.
• The rate that cord blood stems cells are utilized from a public bank is 30 times higher compared with private cord blood banks. Yet more cord blood donations from ethnic/minority populations are needed to meet increasing need.

"The research is evolving in this area, which is exciting news for patients whose lives may someday depend on a donation of cord blood," Dr. Shearer said. "The hope is that more doctors will discuss the options with expectant parents well in advance of their baby's birth, so they understand the tremendous potential to help others in medical need."

Parents can find information at HealthyChildren.org.

###

The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds