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