Thinking about cord blood banking...

*Cross-posted from From Stilettos to Ballet Flats.

Smartie update: I'm 28 weeks and 2 days preggo today! I praise God for bringing me and Smartie this far! We've had a couple of rough times along the way (preterm labor + subacute appendicitis in my 6th month), but everything's a-ok now! Hallelujah!

As I approach my last trimester (how fast!), I've begun revisiting the idea of cord blood banking. Cord blood banking is the collection of blood left in your newborn's umbilical cord and placenta, and storing it for future medical use. Cord blood contains potentially lifesaving cells called stem cells.

In my first pregnancy, Julz and I thought hard about this. We weighed the pros and cons. I also consulted our doctors. In the end, we decided not to have it. Here's why:

1. Our doctors were quite ambivalent about it. No one discouraged us, but neither did anyone encourage us. It was more like, "Oh, it is a good option if you have some extra cash... but in reality, it won't do you serious harm if you choose not to save your cord blood."
2. It has yet to stand the test of time. Cord blood banking is pretty new, so research & actual testing are not as extensive as we'd like them to be.
3. It treats relatively rare illnesses. In general, the stem cells in your cord blood can treat blood cancers, other blood disorders, and some immunodeficiency disorders. Not very common, right? As kidshealth.org observes, "the likelihood of a healthy person ever needing stem cells is rare, and research has never confirmed that self-donated cells (rather than cells from a relative or stranger) make transplantations safer or more effective".
4. It is not an exclusive treatment to the illnesses it can address. To be honest, this is the deal-breaker for me. I'd take cord blood banking in a heartbeat for all my children if someone could tell me it is the ONLY chance to treat the diseases it claims to treat. However, the truth is that blood cancers, other blood disorders, and immunodeficiency illnesses are curable by other means. And, even if stem cell is the only therapy, research has shown that stem cell transplants do not need to be a perfect match. So, there is actually no real necessity to use only the child's stem cells. Again, I quote kidshealth.org: 

   Stem cells from cord blood from both related and unrelated donors have been successful in many transplants. That's because blood-forming stem cells taken from cord blood are naive (a medical term for early cells that are still highly adaptable and are less likely to be rejected by the recipient's immune system). Therefore, donor cord-blood stem cells do not need to be a perfect match to create a successful stem cell transplant.

5. It is not cheap and requires yearly payments possibly for a lifetime. For cord blood banking, parents would need to shell out P50,000 to P80,000 as a one-time fee*. Then, every year that your cord blood is in storage, parents need to pay P8,000 to P10,000 annually. Hence, in theory, if you want to save your cord blood for at least 10 years, you gotta set aside P100,000 for your cord blood banking. Once you reach the 10th year, chances are, you'd want to continue it, (sayang ang investment). Thus, the yearly payments could go on until... well, like I said, for the rest of your child's life (eg, for a lifespan of 70 years, that's P700,000--assuming no inflation and assuming your storage facility will NEVER raise its fees)! In other words, cord blood banking requires money and a whole lot of solid commitment. Two years ago, I found that too daunting for an "investment" that has yet to quiet some doubts on its effectivity and reliability.

Frankly speaking, the same doubts hang on my head today. Our doctors haven't really changed their professional opinion on the matter. And two and a half years isn't exactly enough for further research and empirical data. Plus, cord blood banking still operates on the same payment scheme. I wouldn't be surprised if it's even more expensive now.

There is, however, one thing that changed for this pregnancy. And that is Smartie may be our youngest. May lang kasi syempre baka kainin ko sinabi ko after a few years! Hehe. Kidding aside, Julz and I really just want 2-3 children in our brood. The third, kung bibiyayaan kami, would be a huge bonus :)

This pregnancy could therefore be my LAST chance to do cord blood banking, which could save my baby's--and immediate family's--life.

Obviously, I don't want to throw away this final chance.

As a result, I feel I'm more receptive of the benefits of cord blood banking, which include:

1. One in 200 individuals may need stem cell transplant by the age of 70.
2. Sixty percent higher chance of match vs bone marrow in a family.
3. Lower chance of complications from stem cell transplants.
4. Some of the common cancers, like leukemia, are treatable by stem cell transplants.
5. Umbilical cord blood stem cells are younger, have a higher rate of engraftment and are more tolerant to tissue mismatches, compared to other types of stem cells, e.g. bone marrow. 
6. Pain-free and risk-free collection.

Furthermore, the medical field has started clinical trials on stem cell treatment of diabetes and stroke--two illnesses that run in our family. (I just hope these trials will turn out successful just in case anyone in my immediate family needs it.)

In short, napapaisip talaga ako. I've scheduled an appointment with a CordLife representative two weeks from now. I'll bet a million dollars he will strongly recommend it (duh).  But I think I'm pretty much well-read on the matter, so I'm confident I can throw some, uh, challenging questions to him, like:

1. There are studies that show that when a child needs a transplant – for example, if a child has leukemia – it's usually better not to treat him with his own cord blood. The sick child's stem cells probably carry the same defect that caused the cancer or the genetic disease, and you'd be transplanting the seeds of the disease back into the patient.  
   • Pano ngayon yan? Effectively, the very purpose of cord blood banking is defeated, diba?
2. According to Be the Match (a nonprofit organization that maintains the largest public listing of donated cord blood units available for transplantation in the U.S.), there's a 25 percent chance that siblings will match each other; 7 in 10 people have to look outside their family to find a match.
   • I don't know about you, but I am definitely not happy with that 25% chance! If I'm doing this for Smartie, I want to at least have the assurance that there is good probability that my son Jaden and my hubby Julz can benefit from it, too. 
3. In most cases, these transplants are done only with children or young adults. That's because the volume of a cord-blood donation usually isn't enough for an adult's transplant. The larger a person is, the more blood-forming stem cells he or she needs for a successful transplant.
   • If this is true, then is it truly worth it to invest all that money for life?! Hindi naman pala sapat yung cord blood na maitatago.

Clearly, I am still doubtful about this whole thing. My parents are doctors, and by virtue of that, all our doctors are our family-friends. So when they don't highly recommend it, we really take it to mean that we're not missing all that much. We trust them to give us their unbiased opinion on it.

Moreover, my own research shows that for every pro, there is a con. Right now, I'm not sure how to weigh them. For example, while stem cell therapy treats relatively rare diseases, these are diseases that are serious and life-threatening. Surely, I wouldn't be able to forgive myself if, albeit (hopefully) far-off, anyone in my family needed stem cell therapy and cord blood is out of the options.

So what now?

What do you think, mommies/doctors/anyone who has an opinion? Should we do this?


*Figures may not be up-to-date or accurate. These are just the amounts/estimates I've gathered from my research and from asking around ;)


References:
www.cordlife.ph
www.kidhealth.org
www.babycenter,com