When Susan Hval’s brother was diagnosed with lymphoma in 2001, her thoughts turned to the health of her unborn girl and to her three sons. Would they one day face the same life-threatening disease that now plagues two of her siblings?
While watching the television show “A Baby Story,” Hval saw a commercial for a company that stores the umbilical cord blood of infants. Cord blood is rich in stem cells, the building blocks of the body’s blood and immune systems and possibly the key to treating several diseases, including lymphoma. Hval felt that banking her daughter’s blood could give her family a sort of health-insurance policy.
But her husband, Darrol, an emergency room doctor at Deaconess Medical Center, didn’t know much about cord blood banking and questioned the $1,000 cost. Companies charge up to $2,000 for the service today, plus annual fees of $100 or more.
“My husband was kind of skeptical,” Susan Hval said. “But when he read (the research), he said, ‘How can we not do this?’ “
Now, their daughter’s cord blood is kept in a lab in Tucson, Ariz., through a company called Cord Blood Registry, in case the family ever needs it.
The national debate over stem cell research has once again proliferated like germs in a petri dish. The U.S. House of Representatives passed two related bills Tuesday: the Castle-DeGette bill, which would reverse President Bush’s ban on using federal funds for new embryonic stem cell research, and another that would pump $79 million into the research on stem cells found in umbilical cords.
When the controversy over stem cells flares, it’s often related to the use of embryos. Opponents, who usually include abortion foes, argue that it’s unethical to destroy life even if it means possibly saving another. The Castle-DeGette bill would allow researchers to study the extra embryos created when couples undergo in-vitro fertilization – embryos that normally would be discarded. Although the bill’s backers include some anti-abortion lawmakers, Bush has vowed to veto it.
Extracting cells from umbilical cords is less controversial. It’s done after a baby is delivered and doesn’t physically affect the mother or child.
But research proponents say embryonic stem cells offer the most hope for curing diseases, because they are in the most primitive state and could be manipulated to develop into various types of cells. Proponents say turning stem cells into nerve cells could lead to cures for Alzheimer’s disease, for instance. Turn them into pancreatic islet cells, and they could treat diabetes.
Dr. Robert J. Hariri, president of the cord blood company LifebankUSA, argues that stem cells from umbilical cords and placenta are actually more beneficial than those from embryos. Embryos are discarded after cells are taken, so scientists never know whether they would have evolved into healthy human beings.
“Cells from cord blood or placenta are superior because we know they have gone through nine months of nature’s quality control process,” Hariri said. “You can check the cell quality of the donor,” in other words, the baby.
For Hval, who is Catholic, banking cord blood is a “good alternative” to embryonic stem cell research. She’s against destroying embryos for science, and stem cells from cord blood have been successfully used to treat 60 to 80 diseases, depending on the source. Hval only wishes more cord-blood research were being done, which is why the umbilical cord bill in Congress is encouraging to her.
Spokane resident Doug Wolfe said he thinks it’s a waste not to do more with umbilical cords.
“It’s either they’re going to throw it in the trash can or you’re going to use it,” he said.
Wolfe chose to use it – or at least make it available for use if his family needs it. He and his wife, Deanna, banked the cord blood of both their children even though they know of no hereditary diseases in their family.
“I would hate to be in a situation where I look back and say I was too cheap to do it in the beginning,” Doug Wolfe said.
But some physicians say families might be wasting their money.
The American Academy of Pediatrics stated in 1999 that “Families may be vulnerable to emotional marketing …” and that cord blood storage through a private company as “biological insurance” is unwise unless there’s a known need for it. The academy is currently updating its policy, but a spokeswoman couldn’t say how it might be changed.
Expectant parents probably notice the marketing. In one pop-up ad on the Internet, a toddler gazing at her belly button floats down the screen. Click on Cord Blood Registry’s Web site, and a voice that tells you that cord blood banking is a “once-in-a-lifetime opportunity.” A company called Viacord posts testimonials from clients who tout the security they feel because their child’s blood is banked.
Dr. Judy Felgenhauer, medical director of oncology at Sacred Heart Children’s Hospital, said a parent could feel guilty for not banking blood after reading the marketing.
“What they don’t talk about is we have no idea how long these cells are going to last,” she said.
Felgenhauer would tell parents to do it if they, for instance, had an older child with leukemia. At least one of her patients facing that scenario chose to bank their blood through Cord Blood Registry, but they paid a lower rate because of their income level.
But only one in 600 children end up with some kind of malignancy, and 75 to 80 percent of those cases are curable without stem cells, Felgenhauer said.
“You’re getting into pretty small numbers” of children who would need the cells, she said.
Hariri, of LifebankUSA, noted that part of what families invest in is the hope of future research and new uses for cord blood stem cells. He also recalled a physician who phoned him near tears because she had advised a family against cord blood banking, and their child later developed a disease that could have been treated by it.
Whether it’s the advertising or the science, parents are increasingly convinced. LifebankUSA’s client base grows by about 20 percent a year, Hariri said. The number of families enrolling with Cord Blood Registry rose 154 percent in March 2005 compared with March 2004.
There’s an alternative to private cord-blood banking, though. Some public blood banks, including the Puget Sound Blood Center, store cord blood. Parents who choose to donate their baby’s cord blood make it available to anyone in the world who matches it. While private banking guarantees an exact match for people who pay for it, public banking is less dependable, especially for ethnic minorities for whom matches are less likely to be available.
In Washington, donating cord blood can be done only at four Seattle-area hospitals. The Inland Northwest Blood Center in Spokane doesn’t store cord blood, but it is close to raising $58,000 to begin processing adult stem cells. Adult stem cells are extracted here now, but sent elsewhere for processing. Once the program comes together, which will require participation from local doctors, cancer patients won’t have to travel to Seattle for stem-cell transplants.
Cord blood banking in Spokane could be feasible under that program, but plans to do so aren’t in the works, said Bob Purdy, director of community service at the Spokane blood center.