Cord Blood Transplant: Cord Blood Storage
Guest: Dr. Michelle Hudspeth – Pediatrics
Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: This is Dr. Linda Austin. I am interviewing Dr. Michelle Hudspeth who is Director of Pediatrics Blood and Marrow Transplant program here at the Children’s Hospital of MUSC. Dr. Hudspeth, you have a lot of different areas of interest. But, in this podcast, let’s talk about cord blood transplant. What is that? I know nothing about that.
Dr. Michelle Hudspeth: Cord blood simply refers to the blood that is taken from the umbilical cord at the time a baby is delivered. This has been an area of immense growth over the past few years, of learning about the potential applications of cord blood to different diseases. We now know that, in children particularly, we can use cord blood as a source of stem cells for diseases that we need to do a transplant for. So, we can use cord blood to help treat leukemia, which is a cancer of the bloodstream, as well as other immunodeficiency problems and neurometabolic problems.
In particular, I would like to talk about an area that is always of interest, cord blood storage. Because people are often hearing things in the news about new applications and new uses of cord blood, we often get asked, well, should I store my baby’s cord blood? This is a very important area. So, in general, the recommendation from the American College of Obstetrics and Gynecology as well as the American Academy of Pediatrics and the American Society of Blood and Marrow Transplantation is back. Unless you have a first degree relative, meaning, a brother or sister, or mother, dad, that has been affected by a disease that can be cured by transplantation, you should not privately store your own cord blood. What we have are public cord blood banks. So, almost everyday, or certainly several times a week, we have a child who has been diagnosed with leukemia or another very serious problem. We need to do a search to see if we can find a match to treat them with a transplant. So, these cord blood registries, where people have publicly donated cord blood, are very important to us, to help treat these children.
Unless you have a first degree relative, again, meaning a brother or sister, or mom or dad, that has been affected by leukemia, or one of these metabolic diseases, the chance of you needing to use that cord blood is substantially less than even a half a percent, so, substantially less than even 1 in 100 have needed to use that. I think that is often not realized. The other concern is that, say, your child was to, unfortunately, go on and develop something like cancer, we would certainly not want to use that child’s cord blood because it is very clear, we know, that children are actually born with many of those predispositions to leukemia, they are already there. So, we would not to give those abnormal cells back to them. Again, if, unfortunately, your child was to have a neurologic condition or a metabolic condition that can be treated by transplant, say, sickle cell disease, again, we would not be able to give their own cells back to them because they have that defect already present. So, sometimes I think there is a misconception about what we can actually use those cells for.
The other thing is that we really do not know the life of these cells past 15 years. It has simply just not been seen. So, we do not even know. Often, people will say, well, I am banking for the future, maybe in 30, 40 years, there will be another application. But, quite simply, we do not know if these cells are actually viable, if they can be used, past 15 years of age. So, you can actually publicly bank your cord blood for free. You can go online at: www.marrow.org and it will guide you through the process of having the cord blood collected and stored in a public bank available for public use, all at free of charge. It may be the missing link that provides a cure for another child who has leukemia, or another problem.
Dr. Linda Austin: So, then, is it routine for obstetricians to ask expectant mothers if they would like to participate in this?
Dr. Michelle Hudspeth: In general, it is. I think the public is becoming more knowledgeable about this area and is asking about it. For private cord blood storage, it actually can be quite expensive and people should be aware of that. And, again, it is just not recommended unless you have the first degree relative that has an affected condition. Actually for those patients, there is actually a program available so that they can bank cord blood for free. The Children’s Hospital of Oakland, through Viacord, has a program that, for free, will store the cord blood of siblings who are born to families who have an already affected child.
Dr. Linda Austin: Can you tell a vignette of a patient whose life has been saved by getting the cord blood from another child?
Dr. Michelle Hudspeth: Absolutely. We had a precious little boy. He was diagnosed at three months of age with leukemia. This little boy had leukemia rampantly. He had it on his skin, in is eyes, in his blood and bone marrow and in his spinal fluid. He had a very serious case. We knew that the chance of this child doing well was just not good, unless he had a transplant. We were able to find a cord blood unit that was perfectly matched for him and this patient is alive and well and thriving, and doing beautifully, and has been given a second chance at life from a very serious condition.
Dr. Linda Austin: How old is he now?
Dr. Michelle Hudspeth: He just celebrated his first birthday.
Dr. Linda Austin: Oh, how exciting.
Dr. Michelle Hudspeth: We are very excited.
Dr. Linda Austin: What a wonderful story.
Dr. Linda Austin: Thanks so much for talking with us today.
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