Tuesday, April 9, 2013

Thousands of parents pay to store their children's umbilical cord blood (but scientists fear they are wasting their money)

By Alice Smellie Created 9:09 PM on 12th November 2011 Like any responsible new mother, Alex Silver wanted the very best for her first-born. That meant eating properly, no alcohol and exercising during pregnancy; non-toxic baby mattresses for the nursery and choosing the safest buggy. And when Scarlett was born five years ago, like a growing number of British parents, she chose to have the blood from the baby’s umbilical cord (once considered medical waste) frozen and ‘banked’ – at a cost of £2,000.     The concept, which has been a possibility for about a decade, may sound bizarre but advocates claim that stem cells from the banked blood may be used at a later date to cure the child or a sibling of a host of deadly diseases, should they be struck down. Future proofed: Alex Silver and daughter Scarlett. She has banked her daughter's umbilical cord blood in case of any future medical emergencies Today there are about ten businesses in the UK offering to freeze and store cord blood and industry insiders estimate that up to 100,000 parents have chosen to do so in the UK. The global stem-cell market is forecast to treble to a staggering £40 billion by 2015. ‘When you get ready for your new-born you want everything to be right,’ explains company director Alex, 42. ‘Banking the cord blood was an absolute necessity. I would have compromised on decorating her nursery or her future school fees to free up the funds, although luckily we’re fairly comfortable so I didn’t have to.’ Alex learned of the service in a leaflet at her GP surgery and was instantly persuaded. Today, she says of her decision: ‘I believe it’s insurance for her future should she have any health problems. What if she got leukaemia and I hadn’t done it?’ It is a sentiment that will no doubt be shared by many parents – not least myself. Alex and I have been friends for nearly 15 years, and I must admit I feel a frisson of guilt at any mention of the subject. My husband and I considered it with each of my three pregnancies, but never got any further than that. Are we negligent parents? It’s a question that still haunts me. During this investigation I spoke to a number of banks, posing as an expectant mother, to find out what they would promise me. Afterwards, I consulted leading scientists in stem-cell research – and while there is no suggestion the companies are illegitimate or fraudulent, what they told me left me wondering whether these business are profiteering from paranoias of new parents.   Cord blood contains embryonic stem cells. They can be made into more specialised cells and can reproduce copies of themselves almost indefinitely. There is currently research into a host of applications – from growing new organs to curing paraplegia. In theory, stem cells treat disease by replacing damaged or diseased cells. They are used in bone-marrow transplants to treat leukaemia – but in these cases, donor blood taken in the usual way is used to harvest the stem cells. To bank cord stem cells, the cord blood is extracted minutes after the birth of the baby and rushed by courier to be processed. Any cells that could be of future value are frozen at minus 180C and can then be stored for 25 years. It sounds like a great idea but how useful is it really? During this investigation I spoke to a number of banks, posing as an expectant mother, to find out what they would promise me. Afterwards, I consulted leading scientists in stem-cell research – and while there is no suggestion the companies are illegitimate or fraudulent, what they told me left me wondering whether these business are profiteering from paranoias of new parents. There are no published examples of a child’s own cord blood being used to cure them of leukaemia – one of the most common childhood diseases mentioned by the banks in their sales pitches. There are two cases of successful sibling transplants for children with the hereditary condition thalassemia, where the body makes an abnormal form of haemoglobin – the protein in red blood cells that carries oxygen. These were carried out in Singapore and Germany. Lavish promises of future treatments tend to be based on preliminary clinical trials – and should a child fall ill today, in many cases the technology doesn’t exist to actually use the harvested stem cells. In fact, some experts believe that reintroducing banked cord blood into a child could increase the chance of relapse – as disease-causing cells that existed from birth would be stored alongside useful stem cells. ‘Parents are worried that by not storing cord blood, they aren’t giving their child the best possible chance for future health,’ says leading consultant gynaecologist and obstetrician Mr Dickinson Cowan, who admits that when he first came across private banking, he thought it was a good idea. ‘I’d never recommend it now,’ he says. Tim Hardingham, Professor of Biochemistry at the University of Manchester, agrees. He says: ‘There is still so much doubt as to what can be done with the cord blood.’ The banks are easy to find on the internet. Their websites are often designed using a combination of sterile white and benign pastels and feature pictures of healthy-looking babies and happy, laughing parents. When I call Cells4Life, a man called Paul congratulates me on my ‘pregnancy’. He says: ‘Cord blood can be used in childhood leukaemia,’ – but points out that the child would still need to have chemotherapy. So what’s the point then? ‘The list is growing,’ he soothes. ‘There are clinical studies constantly showing new uses.’ The phone operator at Future Health BIOBANK says: ‘Cord tissue could be used to grow heart, ligament and cornea tissue – in ten years’ time. If your child had a hole in the heart, [cord blood] could be mixed with other tissues. In the case of leukaemia, you have a 100 per cent match.’ They could send someone to my house for a consultation, which will cost me £50. However, should I decide to go ahead within three days of the visit, they won’t charge me for the collection kit – savingme £110. Virgin Health Bank tells me: ‘In the future it could be used for diabetes and so many things – it’s hard to name them all.’ The banks are easy to find on the internet. Their websites are often designed using a combination of sterile white and benign pastels and feature pictures of healthy-looking babies and happy, laughing parents.  If I were genuinely a mother to be, I suspect I would have handed over my credit-card details on the spot. But the experts tell a different story. ‘Autologous [a patient’s own cells] stem-cell transplantation is in practice already – using the blood or bone marrow of the adult patient,’ says leading British leukaemia research expert Dr Andrea Buggins. ‘This is a risky process and often a last-ditch attempt. It runs the risk of returning the cancerous stem cells and thus inducing relapse. ‘In the case of cord blood, we don’t know how or when the malignant cell originates, so you may still be returning the cancer to the patient.’ Though stem cells from the patients themselves don’t carry the risk of rejection or infection associated with allogeneic transplants (using cells from another donor), the slight differences between these cells can work in the patient’s favour. ‘There is an effect called the Graft versus Leukaemia effect where the donor cells kill off any residual leukaemic cells because they recognise them as being foreign,’ explains Dr Buggins. ‘In an autologous transplant, this does not happen.’ Even if the blood can be used, one cord is enough only for a child up to a certain weight. Virgin Health Bank claims there is sufficient blood for a child weighing up to 6st – equivalent to a child of 12. But this has not been borne out in reality. The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists are unequivocal in their opinion. ‘There isn’t enough evidence suggesting it will be used,’ says Janet Fyle, Professional Policy Adviser at the RCM. Along with other experts, they  support communal banking, where you choose to donate your child’s cord blood to be used by others. There are six donation centres managed by NHS Blood and Transplant. ‘Cord-blood donations to the NHS Cord Blood Bank are made available for public use and are not kept specifically for individuals or their families,’ says Dr Martin Guttridge, head of NHS Cord Blood Bank. ‘Should a cord-blood transplant be necessary for you or your family, the registries will be searched for the most appropriate stem-cell unit with the best tissue match, regardless of its source. Experts concede that there is potential for cord blood to be used on the child it was taken from at birth. There are undoubtedly many  clinical trials in progress at the moment, but positive results may be years away. Future Health BIOBANK director Roger Dainty says: ‘Autologous stem cell use is likely to increase in coming years. Developments in cell expansion technology are making it possible to increase the number of stem cells for transplant from an original stored sample. Unlike the public bank, private banks can store cord tissue [which holds] the most exciting possibilities for regenerative medicine, such as bone and tissue repair. ‘The understanding of stem-cell medicine is still evolving and we therefore believe that it is extremely short-sighted to dismiss the idea of cord-banking at a time when each week can bring a new, ground-breaking development. In the end, if we are able to make a choice, most of us would rather have something that we never need to use rather than find we need it but don’t have access to it.’ Dr Buggins disagrees. ‘Stem cells are not easy to isolate and store. It is all an unknown area. Parents are depending on these companies remaining in business long-term.’ There may even be stem-cell treatments coming up that are superior to cord blood. ‘It is likely that other ways will soon be available to obtain the cells that are needed,’ says Professor Sir Ian Wilmut, leader of the research group that first cloned a mammal, Dolly the sheep. ‘This will be by taking skin or blood cells from the child and changing them directly to the cell type that is needed.’ In spite of all this, there is still the gnawing doubt that I should have gone ahead with the procedure. And therein lies the brilliance of the concept. http://www.dailymail.co.uk/health/article-2060822/Umbilical-cord-blood-banking-Are-thousands-parents-wasting-money.html

No comments: