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What Are The Pros And Cons Of Stem-cell Saving?
Posted on
Mon, 27 Jul 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 27 Jul 2015
Answered on
Fri, 21 Aug 2015
Last reviewed on
Question : We are going to have a baby soon.I wanted to know the pros and cons of Stem-cell saving at the time of birth.There are various in XXXXXXX like :
A. Cryobank
B. Cord Life
C. Lifecell
D. Stemcyte
But is it really necessary to go for it.I have read in some articles that it is not so mandatory helpful to the baby and there are other better options for treatment .Moreover this is just a marketing gimmick of few rich practitioners in these field who are just playing with the emotions of parents.What are the true notions?
Please advice and give your views.
A. Cryobank
B. Cord Life
C. Lifecell
D. Stemcyte
But is it really necessary to go for it.I have read in some articles that it is not so mandatory helpful to the baby and there are other better options for treatment .Moreover this is just a marketing gimmick of few rich practitioners in these field who are just playing with the emotions of parents.What are the true notions?
Please advice and give your views.
Brief Answer:
Have done my best to elaborate on this issue.
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
First of all - congratulations !
YOu are on your way to the wonderful journey of parenthood, and all my best wishes and blessings for you.
I really appreciate the frankness of your question, and I hope to answer it with equal directness and evidence - based facts.
Cord blood banking has sparked fierce debate in the scientific and medical community, mostly because the cost of private cord blood banking is high and the chances your family will use the blood are low. It is expensive because the cost of processing cord blood and storing it in medical freezers for years on end is considerable.
Considering the recent research, there are two areas, where stem cell therapy is proven to be of use -
1. Where it is a standard therapy for conditions - Conditions such as leukemias, lymphomas, immune disorders, metabolic disorders, etc.
Cord blood stem cells have unique advantages over traditional bone marrow transplantation, particularly in children, and can be life-saving in rare cases .
2. Clinical trials are underway - Also, research is underway for utilization of cord blood stem cells for treating diseases like diabetes, cardiovascular disease, stroke etc, but this is in the research phase. The future does hold promise for these applications. It is also under trial for disorders like cerebral palsy, autism etc, which might affect a child after birth.
That being said, no accurate estimates exist of the likelihood of children to need their own stored cells. The range of available estimates is from 1:1000 to 1:200,000. Empirical evidence that children will need their own cord blood for future use is lacking. For these reasons, it is difficult to recommend that parents store their children's cord blood for future use.
The consensus of various international societies is mentioned below for your perusal
- The Royal College of Obstetricians and Gynaecologists 2006 opinion states, "There is still insufficient evidence to recommend directed commercial cord blood collection and stem-cell storage in low-risk families "
- The policy of the Society of Obstetricians and Gynaecologists of Canada (SOGC) supports public cord blood banking (similar to collection and banking of other blood products, i.e. altruistic, anyone can use it), as well as stating it should be considered under certain circumstances.
- The policy of the XXXXXXX Academy of Pediatrics states that "private storage of cord blood as 'biological insurance' is unwise" unless there is a family member with a current or potential need to undergo a stem cell transplantation
- Similarly, the XXXXXXX College of Obstetricians and Gynecologists does not recommend private cord blood banking.
Currently, in XXXXXXX the companies that you have mentioned ( Cryobank, Cord LIfe, Life cell, Stemcyte ) are all private cord blood banks, there is no systematic public cord blood banking system in XXXXXXX
I can say right now that there is no evidence to support private cord blood banking , unless your family has the conditions that are mentioned running in the family.
Ultimately , the decision is a highly individualized one, considering your family profile, finances and the information available at present to you. only you can decide whether private cord blood banking is right for your family. If your family has a history of diseases, such as leukaemia, lymphomas, sickle-cell anaemia, immune deficiency disorders, aplastic anaemia or thalassaemia, cord blood storage may be a good idea, then your family's odds of needing a stem cell transplant are higher than the general population's. Your could choose for cord blood banking if there is a strong family history of genetically transmitted illness as listed above.
If you've decided to opt for cord blood banking,
1. Ensure that you choose a well-reputed bank, which is certified, has technological expertise and experience.
2. As a client you must choose a company which offers banking and stem cell therapy options to you. If the stem cell banking company does not provide therapy options, then the purpose of banking is defeated. If they do not invest in trials or do not take definite steps towards stem cell therapy, they are probably not providing enough for the price they charge their clients.
3. It is advisable to choose a bank which has its storage facility situated at a location less prone to natural disasters like floods or earthquakes etc. Also find out if their storage facility has power back up and generators, monitoring systems in place that ensure a controlled environment all the time.
4. The storage facility must also be protected against fire.
5. The bank you are considering should have a good network, accessibility and tie ups with hospitals to ensure that they will be able to deliver your child's stored cord blood cells soon enough when the need arises.
I hope I have been able to clarify all points. Feel free to ask for further clarification
Best wishes to you always.
Have done my best to elaborate on this issue.
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
First of all - congratulations !
YOu are on your way to the wonderful journey of parenthood, and all my best wishes and blessings for you.
I really appreciate the frankness of your question, and I hope to answer it with equal directness and evidence - based facts.
Cord blood banking has sparked fierce debate in the scientific and medical community, mostly because the cost of private cord blood banking is high and the chances your family will use the blood are low. It is expensive because the cost of processing cord blood and storing it in medical freezers for years on end is considerable.
Considering the recent research, there are two areas, where stem cell therapy is proven to be of use -
1. Where it is a standard therapy for conditions - Conditions such as leukemias, lymphomas, immune disorders, metabolic disorders, etc.
Cord blood stem cells have unique advantages over traditional bone marrow transplantation, particularly in children, and can be life-saving in rare cases .
2. Clinical trials are underway - Also, research is underway for utilization of cord blood stem cells for treating diseases like diabetes, cardiovascular disease, stroke etc, but this is in the research phase. The future does hold promise for these applications. It is also under trial for disorders like cerebral palsy, autism etc, which might affect a child after birth.
That being said, no accurate estimates exist of the likelihood of children to need their own stored cells. The range of available estimates is from 1:1000 to 1:200,000. Empirical evidence that children will need their own cord blood for future use is lacking. For these reasons, it is difficult to recommend that parents store their children's cord blood for future use.
The consensus of various international societies is mentioned below for your perusal
- The Royal College of Obstetricians and Gynaecologists 2006 opinion states, "There is still insufficient evidence to recommend directed commercial cord blood collection and stem-cell storage in low-risk families "
- The policy of the Society of Obstetricians and Gynaecologists of Canada (SOGC) supports public cord blood banking (similar to collection and banking of other blood products, i.e. altruistic, anyone can use it), as well as stating it should be considered under certain circumstances.
- The policy of the XXXXXXX Academy of Pediatrics states that "private storage of cord blood as 'biological insurance' is unwise" unless there is a family member with a current or potential need to undergo a stem cell transplantation
- Similarly, the XXXXXXX College of Obstetricians and Gynecologists does not recommend private cord blood banking.
Currently, in XXXXXXX the companies that you have mentioned ( Cryobank, Cord LIfe, Life cell, Stemcyte ) are all private cord blood banks, there is no systematic public cord blood banking system in XXXXXXX
I can say right now that there is no evidence to support private cord blood banking , unless your family has the conditions that are mentioned running in the family.
Ultimately , the decision is a highly individualized one, considering your family profile, finances and the information available at present to you. only you can decide whether private cord blood banking is right for your family. If your family has a history of diseases, such as leukaemia, lymphomas, sickle-cell anaemia, immune deficiency disorders, aplastic anaemia or thalassaemia, cord blood storage may be a good idea, then your family's odds of needing a stem cell transplant are higher than the general population's. Your could choose for cord blood banking if there is a strong family history of genetically transmitted illness as listed above.
If you've decided to opt for cord blood banking,
1. Ensure that you choose a well-reputed bank, which is certified, has technological expertise and experience.
2. As a client you must choose a company which offers banking and stem cell therapy options to you. If the stem cell banking company does not provide therapy options, then the purpose of banking is defeated. If they do not invest in trials or do not take definite steps towards stem cell therapy, they are probably not providing enough for the price they charge their clients.
3. It is advisable to choose a bank which has its storage facility situated at a location less prone to natural disasters like floods or earthquakes etc. Also find out if their storage facility has power back up and generators, monitoring systems in place that ensure a controlled environment all the time.
4. The storage facility must also be protected against fire.
5. The bank you are considering should have a good network, accessibility and tie ups with hospitals to ensure that they will be able to deliver your child's stored cord blood cells soon enough when the need arises.
I hope I have been able to clarify all points. Feel free to ask for further clarification
Best wishes to you always.
Above answer was peer-reviewed by :
Dr. Prasad
Thankyou very much for yoru warm wishes and the detailed answer,insight and feedback on the said Qs.I can infer that this is not so mandatory, still we will think on this option.
Another Qs I wanted to ask which may not be related to this.
The Qs is we did the LFT test yesterday and the SGPT,SGOT levels comes out to be 481 and 310 respectively which I think is considerably higher figure.Ref level is <35.Doctor has earlier given a date of 7th of August(mutually agreed - 8 month and 18th day) but asked to test the SGPT,SGOT levels last friday which came abnormally high ~600-700.Doc suggested to go for another LFT test to see wether it is abnormally increasing or not, if increasing we may have to prepone the date by one week.We did the Ultra sound the baby seems just fine with the average weigh of 2.5+ 2.5 weeks back.
We wanted to know your kind opinion on wether we should stick to 7th Aug date or go for early date.
And yes it is a C-Section.
Another Qs I wanted to ask which may not be related to this.
The Qs is we did the LFT test yesterday and the SGPT,SGOT levels comes out to be 481 and 310 respectively which I think is considerably higher figure.Ref level is <35.Doctor has earlier given a date of 7th of August(mutually agreed - 8 month and 18th day) but asked to test the SGPT,SGOT levels last friday which came abnormally high ~600-700.Doc suggested to go for another LFT test to see wether it is abnormally increasing or not, if increasing we may have to prepone the date by one week.We did the Ultra sound the baby seems just fine with the average weigh of 2.5+ 2.5 weeks back.
We wanted to know your kind opinion on wether we should stick to 7th Aug date or go for early date.
And yes it is a C-Section.
Brief Answer:
More details please ?
Detailed Answer:
Hello again.
Yes, it is not mandatory, and not even recommended.
It is advisable for you only if the certain high risk conditions run in your family.
Please clarify a few things.
What do you mean by ' the doctor has given a date of 7th of August ' ?
When was her last menstrual period ?
And why has a C section been planned ?
Also , please upload the LFT report and the latest ultrasound scan.
I do not see any indication for such an early delivery.
May I know whom are you consulting ?
Also, what were her symptoms, why was the LFT Done ?
Is this the first pregnancy ?
What is her age ?
Any other medical issues apart from the LFT report ?
Please write in detail so that I can give you my detailed feedback.
Thank you for the appreciation, and best of luck always.
More details please ?
Detailed Answer:
Hello again.
Yes, it is not mandatory, and not even recommended.
It is advisable for you only if the certain high risk conditions run in your family.
Please clarify a few things.
What do you mean by ' the doctor has given a date of 7th of August ' ?
When was her last menstrual period ?
And why has a C section been planned ?
Also , please upload the LFT report and the latest ultrasound scan.
I do not see any indication for such an early delivery.
May I know whom are you consulting ?
Also, what were her symptoms, why was the LFT Done ?
Is this the first pregnancy ?
What is her age ?
Any other medical issues apart from the LFT report ?
Please write in detail so that I can give you my detailed feedback.
Thank you for the appreciation, and best of luck always.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello,
Thanks for the answers and the best wishes.I will try to furnish as much information as possible.Below are my replies inline.
There is no risk conditions running in the family by Gods Grace.
What do you mean by ' the doctor has given a date of 7th of August ' ?
>>We are under the Gynaec from past 8+ months(last November 2014) and after examining the mother and after we came to that baby has a cord around the neck she decided on it.We also agreed on this.
When was her last menstrual period ?
>>November 20 ,2014
And why has a C section been planned ?
>>Cord around the baby.
Also , please upload the LFT report and the latest ultrasound scan.
>>Last LFT done :
AST(SGOT) 310 U/L <35(bio-Ref Level)
ALT(SGPT) 481 U/L <35
GGTP 111 U/L <38
ALP 278 U/L 30-20
Bilirubin Total 1.30 mg/dl 0.30-1.20
Bilirubin Direct 0.61 mg/dl <0.20
Bilirubin Indirect 0.69 mg/dl <1.10
Total Protecin 6.20 g/dl 6.40-8.30
Albumin 3.00 g/dl 3.50-5.20
A:G Ratio 0.94 0.90-2.00
we did the LFT test day before yesterday and the SGPT,SGOT levels comes out to be 481 and 310 respectively as shown above ,prior to that on last Friday the SGPT,SGOT levels were ~600-700 respectively.
We dont know the reason of such a high figure and then dropping after two days.She started udliv 150 from saturday morning.
I do not see any indication for such an early delivery.
May I know whom are you consulting ?
>>Gynaec at XXXXXXX from a reputed Medical Hospital.
Also, what were her symptoms, why was the LFT Done ?
>>Itching,scratching on body(previous 1 month),restlessness.She has never any liver issue by God's grace.We did the FibroScan at Gastro Specialist as well but it was fine.
Is this the first pregnancy ?
>>Yes
What is her age ?
>>30
Any other medical issues apart from the LFT report ?
>>None
>>I was not able to upload the Ultra sound report but according to doc, after doing Some Doppler Test, baby seems to be fine in every-sense.
Please write in detail so that I can give you my detailed feedback.
Best Rgds
Thanks for the answers and the best wishes.I will try to furnish as much information as possible.Below are my replies inline.
There is no risk conditions running in the family by Gods Grace.
What do you mean by ' the doctor has given a date of 7th of August ' ?
>>We are under the Gynaec from past 8+ months(last November 2014) and after examining the mother and after we came to that baby has a cord around the neck she decided on it.We also agreed on this.
When was her last menstrual period ?
>>November 20 ,2014
And why has a C section been planned ?
>>Cord around the baby.
Also , please upload the LFT report and the latest ultrasound scan.
>>Last LFT done :
AST(SGOT) 310 U/L <35(bio-Ref Level)
ALT(SGPT) 481 U/L <35
GGTP 111 U/L <38
ALP 278 U/L 30-20
Bilirubin Total 1.30 mg/dl 0.30-1.20
Bilirubin Direct 0.61 mg/dl <0.20
Bilirubin Indirect 0.69 mg/dl <1.10
Total Protecin 6.20 g/dl 6.40-8.30
Albumin 3.00 g/dl 3.50-5.20
A:G Ratio 0.94 0.90-2.00
we did the LFT test day before yesterday and the SGPT,SGOT levels comes out to be 481 and 310 respectively as shown above ,prior to that on last Friday the SGPT,SGOT levels were ~600-700 respectively.
We dont know the reason of such a high figure and then dropping after two days.She started udliv 150 from saturday morning.
I do not see any indication for such an early delivery.
May I know whom are you consulting ?
>>Gynaec at XXXXXXX from a reputed Medical Hospital.
Also, what were her symptoms, why was the LFT Done ?
>>Itching,scratching on body(previous 1 month),restlessness.She has never any liver issue by God's grace.We did the FibroScan at Gastro Specialist as well but it was fine.
Is this the first pregnancy ?
>>Yes
What is her age ?
>>30
Any other medical issues apart from the LFT report ?
>>None
>>I was not able to upload the Ultra sound report but according to doc, after doing Some Doppler Test, baby seems to be fine in every-sense.
Please write in detail so that I can give you my detailed feedback.
Best Rgds
Brief Answer:
As below
Detailed Answer:
Thank you for the update.
The condition that your wife is having is called ICP - Intrahepatic Cholestasis of Pregnancy.
This is characterized by itching and deranged LFT due to pregnancy hormone effects.
There is risk to the baby in this condition hence delivery is indicated at 38 weeks.
GOing by her LMP, her EDD - expected date of delivery comes out to be 27th of August, so she can be delivered by elective C section by 12th of August, but I do not see any reason for an earlier delivery.
Also, she can go for induction of normal labour , and if trial of vaginal birth fails, C section can be done.
This is my XXXXXXX opinion, you can seek more clarifications from your doctor.
LFT levels are improving, as Udiliv has been started, they may fluctuate in this condition.
She has to keep strict watch over baby movements.
After breakfast ( 1 hour ), after lunch ( 1 hour ) and after dinner ( 1 hour ) she should lie on her left lateral side and count baby movements.
If the total is more than 10, it is fine, if less, contact your doctor.
Bi weeks NST ( non stress test - tracing of heartbeat of baby ) should be done.
I would have liked to look at the scan to know the weight of the baby, if you can upload it, it will be nice.
This liver condition will spontaneously improve after childbirth, do not worry.
Hope my inputs have helped you.
Will be glad to discuss further.
As below
Detailed Answer:
Thank you for the update.
The condition that your wife is having is called ICP - Intrahepatic Cholestasis of Pregnancy.
This is characterized by itching and deranged LFT due to pregnancy hormone effects.
There is risk to the baby in this condition hence delivery is indicated at 38 weeks.
GOing by her LMP, her EDD - expected date of delivery comes out to be 27th of August, so she can be delivered by elective C section by 12th of August, but I do not see any reason for an earlier delivery.
Also, she can go for induction of normal labour , and if trial of vaginal birth fails, C section can be done.
This is my XXXXXXX opinion, you can seek more clarifications from your doctor.
LFT levels are improving, as Udiliv has been started, they may fluctuate in this condition.
She has to keep strict watch over baby movements.
After breakfast ( 1 hour ), after lunch ( 1 hour ) and after dinner ( 1 hour ) she should lie on her left lateral side and count baby movements.
If the total is more than 10, it is fine, if less, contact your doctor.
Bi weeks NST ( non stress test - tracing of heartbeat of baby ) should be done.
I would have liked to look at the scan to know the weight of the baby, if you can upload it, it will be nice.
This liver condition will spontaneously improve after childbirth, do not worry.
Hope my inputs have helped you.
Will be glad to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks for your kind response and the frankness in your answers.
I have attached the report.
Rgds,
Thanks for your kind response and the frankness in your answers.
I have attached the report.
Rgds,
Brief Answer:
As below
Detailed Answer:
Nowhere can I see the date of the scan and the gestational age / weight of the baby.
Can you correct the attachments ?
As below
Detailed Answer:
Nowhere can I see the date of the scan and the gestational age / weight of the baby.
Can you correct the attachments ?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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