Stem cells, the new insurance
When a new baby is on the way, parents start planning and dreaming about their child’s future. Everything from nursery to university is discussed and planned.
But one aspect of a child’s future that you can’t plan for is their health, with the worst scenario being a fatal illness.
By harvesting and storing a baby’s stem cells, gathered from the placenta and umbilical cord, a child can be “insured” against life-threatening, blood-related diseases like leukaemia, lymphoma, thalassemia, Fanconi’s anaemia and sickle cell anaemia.
So why isn’t this part of the normal birthing process and available to all pregnant women?
A simple answer could be the cost – about R14 000 to R15 000, which many doctors or gynaecologists feel reluctant to recommend, as the chances of using these stem cells are rare.
“Not every family thinks far ahead or is aware that their child might have that remote chance of developing a rare illness,” explains Dr Yvonne Holt of Netcells Cryogenics.
“It’s not just the baby and siblings that can benefit.
“Although the chances go from one in four of a match in a sibling to one in eight with a parent, this beats the often almost insurmountable odds of finding a suitable bone marrow donor.
“And should you need to source bone marrow for a family member worldwide, it will cost you R75 000 to start a local and international search with the South African Bone Marrow Registry, with an eventual cost of anything between R150 000 and R250 000.
According to Caroline Robertson of the SA Bone Marrow Registry, although they are a non-profit organisation these are purely the costs incurred in activating these searches and transporting bone marrow if found.
“Stem cell cryogenics is a form of insurance,” explains Holt. “We are aware the cost makes it prohibitive for many people and would love to see a public bank in South Africa to serve the community, where people donate their stem cells.
“This would come about when someone may have banked stem cells with their first or second baby and then donates any further stem cells to a public bank.”
According to Dr Stephen Purcell, medical director at Cryo Save, there have been two major advances in regenerative medicine in the past five years.
The first is in the treatment of brain problems such as cerebral palsy and the second is in type 1 diabetes.
So where do you start this whole process?
You register with one of South Africa’s stem cell cryogenic companies.
They will deliver your collection kit and explain the process for the collection of the stem cells and possible cord blood collection.
You then contact your gynaecologist, doctor or midwife, who are generally used to this procedure, but if they have any queries they contact the company storing your cells who will go through it step by step with them.
On the day of the birth you arrive at the clinic with your collection kit and, as soon as the baby is born, the cord is clamped, cut and the baby handed to the mother.
Then the obstetrician or midwife inserts a needle attached to a special blood bag (part of your collection kit) into the umbilical cord vein of the placenta to drain the blood.
There’s absolutely no pain or discomfort for either mother or baby.
This is a simple procedure but has to be done carefully to ensure that a minimum of 60ml of blood (maximum 200ml) will be collected in a sterile condition.
The average amount of blood collected is 100ml, as obviously the more blood collected the more chance of harvesting a good quantity of stem cells.
A new development is the use of part of the umbilical cord itself, which contains blood extra rich in stem cells.
These are known as Mesenchymal stem cells, which in time (when full research has been carried out) will be used in bone cell, cartilage and even liver to regenerate new cells, taking over the functioning of dysfunctioning cells.
There are also advanced clinical trials being carried out using these cells in the areas of cardiac disease, stroke and other forms of brain damage and bowel and joint disease.
If you use this extra cord blood about 15cm of undamaged umbilical cord will be cut off, cleaned, with the remaining blood squeezed out by the gynaecologist or midwife who will place this in a special tube to be sent with the blood bag in a temperature-controlled bag by specialist courier to the laboratory to store your cells.
This blood is viable for 72 hours, with the best results being if the blood is processed between 24 and 36 hours after collection.
Cord tissue is viable up to 48 hours after collection. Once this arrives it’s carefully logged into the system with a unique registration number and bar code.
The next step is checking the viability (cells deteriorate quickly and can become unviable) of the cells and whether there are enough to store, with only 3 percent a month failing this test.
At the laboratory the cord blood stem cells and cord are processed and stored in special laminated cryobags (recommended by the EU) and placed in an additional external protective bag before being placed in an aluminium metal canister for protection against mechanical damage and cross-contamination.
From here they are cryogenically frozen at -196ºC, which means literally frozen in time, making them viable for the next 20 or more years.
When the child turns 18 they become the guardian of these cells, deciding whether they want to extend the contract.
What happens when Eskom has a power cut?
“Our cells are not stored with electricity,” explains Holt.
“We use tanks filled with liquid nitrogen for storage, which are monitored electronically, with generators, which would take over in emergencies.”
While at present these stem cells are only used for bone marrow transplants, research is currently being carried out for many other conditions (see box right).
“There is ground-breaking research being done in this field around the world,” enthuses Holt.
“This is just the infancy of this type of medicine.”
Why consider storing your baby’s stem cells?
* Family history of specific illnesses, such as blood cancers or disorders or inherited immune deficiencies
* Sibling with disease treatable by stem cell transplant
* Families of African origin and mixed race marriages, as it is extremely difficult to find suitable donors, who are seriously under-represented in public banks
* Form of medical insurance, giving you peace of mind
Remember that more and more diseases will become treatable with stem cells.
Areas being researched for the use of cell stem transplants
* Cardiac muscle regeneration
* Bone repair in non-union fractures
* Diabetes, Type 1
* Auto-immune diseases
* Nerve cell repair: eg cerebral palsy, Alzheimer’s, Parkinson’s, spinal cord injury, stroke recovery
* Organ repair: eg liver and kidney
Readers will be able to find out about stem cell storage at the Baby Expo MamaMagic in Durban this week. The expo is on From Friday to Sunday from 9am to 6pm. Tickets are R60 and children under 10 enter free (maximum two children).