------------------------------------------------------------------------
--------
 
 Posted on Wed, Dec. 04, 2002   
 


Parents freezing umbilical cord blood

BY SHARI RUDAVSKY
[log in to unmask]

Peace of mind for Mercy Mesa sits frozen in two small vials in a Florida
Gulf Coast laboratory. Those two containers hold stem cells, distilled
from the umbilical cord blood of the South Miami mother's two youngest
daughters, a potential weapon against disease.

Umbilical cords, and the blood that flows through them, used to be
discarded along with the placenta after childbirth. Now, as medical
researchers have realized this blood contains valuable stem cells, more
parents are opting to store their baby's cord blood. These stem cells
are the progenitors of every other blood and immune cell in the body.

Cryo-Cell, the Clearwater company that Mesa used, has in storage the
cord blood of more than 42,000 individuals, almost 20,000 of which have
been collected in the past year. Viacord, another major industry player,
has about 23,000 samples in its Northern Kentucky lab, about 80 percent
of which have arrived in the past two years.

While concerned parents have embraced the storage option, many doctors
remain skeptical, arguing that the chance of a sample being used is too
minuscule to warrant the cost, ranging from $315 to $1,500, plus an
annual storage fee.

Estimates put the probability of needing a stem cell transplant at
somewhere between 1 in 1,000 and 1 in 200,000 by the age of 18. Studies
show these cells can last at least 15 years although industry officials
believe the cells will be proven to have an even greater longevity.

Currently, stem cells can treat about 50 blood cancers and genetic
diseases. In the future, advocates expect cord blood may serve as a
therapy for many more conditions. It's that hope that drives parents
like the Mesas to pay to store their children's cord blood. While Mesa's
two younger daughters have samples stored with Cryo-Cell, 5-year-old
Stella was born before Mesa learned of the option.

PRECIOUS KIDS 

''I figure that maybe by the time they do need it, there will be much
more research and things that could be done with it,'' Mesa says. ``It's
worth it. It's not that expensive and my kids are too precious.''

The actual collection takes but a few minutes in the delivery room.
After clamping the umbilical cord off the newborn, the obstetrician
draws the blood from the cord, usually between 100 and 150 milliliters.
The sample then is sent to a storage facility where it is processed.

For diseases like lymphomas that attack the immune system, doctors can
knock out a patient's diseased immune system and replace it with a new
one, using healthy donor stem cells.

For years bone marrow was the only source for stem cells. Now cord blood
offers an alternative that may prove even better in some cases for
children and small adults, as collection samples are often too small to
treat larger people.

About two dozen public banks exist across the country, none in South
Florida. But industry officials argue that research has shown that
donations from relatives result in a much lower incidence of graft vs.
host disease, a devastating potential side effect of transplant.

''There's tremendous clinical evidence that the related cell is the only
choice for your family,'' says Marc Beer, CEO of Viacell, Viacord's
Boston-based parent company.

Storage cost depends on which of the handful of companies a parent
chooses. Viacord represents Cadillac storage, charging $1,500 for
collection and $95 annually for storage. This covers all fees, including
courier costs and HLA (Human Leukocyte Antigen) typing.

At the other end of the spectrum, Cryo-Cell charges $315 for collection
and the first year of storage, $90 for each additional year.

''We believe that every expectant parent should have the opportunity to
participate in this service. If you believe that, you have to come to
the conclusion that it has to be affordable,'' says Jerry Maass,
Cryo-Cell vice president of marketing.

But some experts believe that given the chance of actually using the
blood, the cost is just too high. With some diseases, an individual's
own cord blood would be the last place doctors would turn, fearing those
cells would be likely to develop the same disease.

The American Academy of Pediatrics three years ago issued a statement
calling it ''unwise'' for parents to store their child's cord blood
unless they had another family member facing stem cell transplantation.

`KIND OF A SHAM' 

Thus far, only 11 of Viacord customers have used their samples for
transplant, either in the same child or in a sibling. Cryo-Cell has
twice released samples for transplant. Such numbers are low enough to
convince many doctors that there's little advantage to saving your
child's blood.

''It's kind of a sham,'' said Gary Kleiner, an assistant professor of
pediatrics at University of Miami's School of Medicine. ``What I tell
parents is you're better off taking that money and putting it in a
college fund -- It's not a bad idea, but you're sort of betting against
something where the chances are that nothing will happen to you.''

The exceptions to that rule come with parents of children who have
leukemia or certain anemias, Kleiner said. In those instances, the
desired cord blood would come from a healthy sibling.

Public cord blood banks offer another option, open to anyone in need of
a stem cell transplant, not just those people with the money to store
samples. At such places, storing cord blood is for treatment of current,
not future, diseases.

'Public cord blood cell banking is not a form of insurance at all. It's
a way to save kids' lives who would otherwise not have had a chance,''
says Bill Martinez, technical director of LifeSouth, a blood bank with a
public cord bank headquartered in Gainesville.

Unlike private banks, which will store whatever they can wring out of
the cord, public banks like LifeSouth must collect a sufficient number
of cells to make the sample worthwhile for transplantation. Almost 70
percent of the cords harvested do not meet this criteria, Martinez says.

While private collection has flourished in recent years, in most areas
of the country interested parents cannot opt to donate their child's
blood. The service is offered only in hospitals affiliated with a cord
blood bank and none exists in South Florida.

A bill to establish a statewide public cord bank overseen by the
University of Florida, the University of South Florida, the University
of Miami and the Mayo Clinic in Jacksonville stalled in the state senate
two years ago.

But some parents see no reason to trust in a public bank if they can
have the security of knowing that there's a sample waiting for them and
their children.

After Jane and Greg Reigs lost their first child, no cost could dissuade
them from doing everything they could to protect their second two
children.

Just days after his first birthday, the Coral Springs couple learned
their first child Gregory had liver cancer. About a year later, while
Gregory was being treated at Memorial Sloan-Kettering, doctors mentioned
cord blood banking to Jane Reig, then four months pregnant with her
second child. Although stem cells could not have saved Gregory, the
Reigs knew they had to save the cord blood of both Georgia, now 21
months old, and her five-month-old sister Layla.

''Now that we know about cancer, we know that it can happen to anyone,''
Jane Reig says. ``We don't think about taking the chance. I can't
believe that it wouldn't be offered as a standard point of delivery at
this point.''

Reig's obstetrician, Bruce Zafran, shares her astonishment, although
seven years ago he decided against cord blood storage for his own
daughter, deeming it too expensive. Now, however, the Coral Springs
doctor can't believe that anyone would just discard cord blood. Not only
does Zafran tell his patients about private storage, he also informs
them that they can donate the stem cells to the University of South
Florida. Only about a fifth of his patients pursue either option, the
vast majority of those who do save the blood for themselves.

WASTE NOT 

''Ninety-nine percent of people discard cord blood as medical waste. But
it's so valuable, so important and so potentially useful that to discard
it as medical waste seems silly,'' Zafran says. ``The potential uses for
stem cell therapy are so overwhelming that to deny this as a potential
modality would really be foolish -- I want to educate everyone that
whatever you decide to do with it, don't just throw it away.''

Pembroke Pines mother Becky Ehrlich doesn't need a lesson to that end.
She read an article about cord blood banking and knew instantly she'd do
it for her two children, Sophie born three years ago, and Ava, born in
July.

With both births, one of the first calls her husband, Jeff, made was to
Viacord to arrange for pick-up of the sample. She knows the girls'
samples sit in a Viacord storage facility and, like Mesa, appreciates
that security.

''God forbid that something should happen and cord blood would have been
of help, I would never forgive myself if I hadn't done it,'' Ehrlich
says. ``It can't cure everything and I certainly recognize that, but to
me anything is something. Hopefully we'll never use it.
 


 


------------------------------------------------------------------------
--------

© 2001 miamiherald and wire service sources. All Rights Reserved.
http://www.miami.com 

---
Outgoing mail is certified Virus Free.
Checked by AVG anti-virus system (http://www.grisoft.com).
Version: 6.0.408 / Virus Database: 230 - Release Date: 10/24/2002
 
  

----------------------------------------------------------------------
To sign-off Parkinsn send a message to: mailto:[log in to unmask]
In the body of the message put: signoff parkinsn