“I don’t know where the science is going to go. I don’t think anybody does right now,” says Ernest Stacey, president and chief executive officer of Lifebank. “But clearly you’ve got a very interesting cell … and it may have some potential down the road.”
But parents being bombarded with messages about the importance of cord-blood banking may not hear that uncertainty, nor many of the more direct criticisms of the private clinics. The Society of Obstetricians and Gynecologists of Canada in 2005 recommended against private cord-blood banking for personal use because “of the limited indications and lack of scientific evidence to support the practice.”
Hits and misses
Private banks are not required to disclose how many customers ever use cord-blood units or how many are rejected for use in transplants because they are too small. But Insception says that of its roughly 39,000 units, only 12 have been used in transplants, which represents less than a tenth of one per cent. An additional nine units have been released for use in clinical trials.
One of those units was used in Barrett Ross, who was diagnosed with Type 1 diabetes in 2006 at age 9. Upon hearing the news, his mother, Christine, scoured the Internet and found a clinical trial where researchers inject newly diagnosed diabetic children with their own cord-blood stem cells.
The trial was being conducted at the University of Florida in Gainesville, only a few hours from the family’s home outside of Tampa. (While Barrett was born in Toronto and his father, Brian, is Canadian, the family relocated shortly after his birth.)
Barrett was nearly 10 when the infusion took place, and more than five years later, his pancreas still has some function. He takes only one-third the insulin he needed at his initial diagnosis and continues to be in good health. It wouldn’t have been possible if they hadn’t banked his cord blood, Ms. Ross says.
“I know that something happened and it is not definable by anything other than using his cord blood, in my opinion.”
Rita Alexopoulos came to a different conclusion. When she was pregnant last year, promotional materials at her obstetrician’s office in Toronto persuaded her that banking her baby’s cord blood was a great idea.
“I was completely sold at the beginning,” says Ms. Alexopoulos, who gave birth to her son last October. “This is your child. How could you not do that?”
Then she mentioned her decision to a friend who is an immunologist. Instead of congratulating her, the friend offered a wake-up call: The odds that her child would ever need the stem cells were very low. And in many cases, not enough cord blood can be captured to make a unit viable – even the best collections have only enough stem cells to treat a child, not an adult.
Furthermore, when a child needs a stem-cell transplant to treat metabolic or blood disorders, doctors are unlikely to use that child’s own cells – donor cells can spark the necessary immune response to keep disease at bay (though those patients must take immunity-suppressing drugs to prevent graft-versus-host disease).
Perhaps in response to all these limitations, private cord-blood clinics have taken to calling themselves “family banks”: If your child can’t use the cord-blood stem cells, they imply, maybe a sibling, grandparent or other relative can.
But the chances that family members will be a match are quite slim – around 25 per cent, says Armand Keating, director of the stem-cell therapy program at Princess Margaret Hospital and director of the University of Toronto’s hematology division. At that rate, families would be better off simply donating cord-blood to public banks, he says.
Given all that, Ms. Alexopoulos realized she couldn’t justify going with a private-cord blood bank: “It’s really just kind of a scam that people haven’t caught on to yet,” she says.
Taking it national