Introduction

Until recently umbilical cord blood was considered medical waste.
Little is known about the prevalence of conditions potentially amenable to cellular therapy among families storing umbilical cord blood in private cord blood banks. This is the first cross-sectional study of disease prevalence among families with stored umbilical cord blood (UCB) at a private cord blood bank.

UCB is a rich source of hematopoietic stem cells. Recent research has suggested that UCB has the potential to play a role in regenerative medicine applications where it may promote repair of organs and tissues outside of its hematopoietic lineage.

In these applications, it is thought that UCB may repair damaged tissues either via cell differentiation and replacement or, more likely, through the release of anti-inflammatory and other factors that stimulate endogenous repair mechanisms.

A range of conditions are being studied including cerebral palsy, hearing loss, hypoplastic left heart syndrome, hypoxic-ischemic encephalopathy, pediatric stroke, type I diabetes and autism.

Methods

A cross-sectional study of families with at least one child who stored umbilical cord blood in the largest private cord blood bank in the United States was performed. Respondent families completed a questionnaire to determine whether children with stored cord blood or a first-degree relative had one or more of 16 conditions amenable primarily to allogeneic stem cell transplant (‘‘transplant indications’’) or 16 conditions under investigation for autologous stem cell infusion (‘‘regenerative indications’’), regardless of whether they received a transplant or infusion.

Results

Of 284 982 eligible families, 94,803 families responded, representing 33.3 % of those surveyed.
And of respondent families:

  • 16.01 % indicated at least one specified condition.
  • 1.64 % reported at least one first-degree member with a transplant indication potentially treatable with an allogeneic stem cell transplant.

The most common transplant indications reported among first-degree family members were:

  • Non-Hodgkin’s Lymphoma (0.33 %)
  • Hodgkin’s Lymphoma (0.30 %)
  • Acute Lymphoblastic Leukemia (0.28 %)
  • 4.23 % reported at least one child with a regenerative indication potentially treatable with an autologous stem cell infusion.

The most common regenerative indications among children with stored umbilical cord blood were:

  • Autism/Autism Spectrum Disorder/Apraxia (1.93 %)
  • Other Developmental Delay (1.36 %)
  • Congenital Heart Defect (0.87 %)
  • Childhood hearing loss (0.40 %)
  • Diabetes, type 1 (0,26 %)

Discussion

Among families storing umbilical cord blood in private cord blood banks, conditions for which stem cell transplant or infusion may be indicated, or are under investigation, appear to be prevalent, especially for regenerative medicine indications.

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