The American Academy of Pediatrics (AAP) favors public cord blood banks and emphasizes the importance of parental education in its new policy statement on cord blood banking for potential future transplantation. The study is published in online in Pediatrics.

“Education of parents in understanding the nature of cord blood stem-cell therapy and the new development that has made it easier to locate suitable families for the donation of their infant’s cord blood (deserve emphasis),” Dr. William T. Shearer from Baylor University and Texas Children's Hospital reported.

“An example is the newborn screening that is now spreading across the United States that identifies infants with serious lymphocyte deficiencies that require cord blood stem-cell therapy.”

Hematopoietic stem cells from umbilical cord blood have the potential to treat a variety of malignant and nonmalignant diseases. More than 30,000 hematopoietic stem-cell transplants have been performed using cord blood as the source of stem cells worldwide.

The AAP's revised policy statement provides information to guide pediatricians, obstetricians, and other medical specialists and healthcare providers in responding to parents' questions about cord blood donation and banking, as well as the types (public vs. private) and quality of cord blood banks.

It identifies six educational points to share with parents:

  1. Public cord blood banking serves the entire world, but private cord blood banking serves the needs of one family.
  2. Public cord blood banking facilitates the U.S. and international searching for cord blood stem cells that match a patient's HLA antigens.
  3. Public cord blood banking is highly regulated; private cord blood banking might not meet some accreditation bodies’ strict requirements.
  4. Families donating their infants' cord blood to public banks are free, while private cord blood banks have placement fees as high as $2,300 and annual maintenance fees ranging from $100 to $175.
  5. Use of previously banked cord blood stem cells is at least 30-fold greater in public, compared with private, cord blood banks.
  6. Deciding whether and where to bank cord blood should be made early in pregnancy rather than after labor has begun.

“The best time is at a prenatal visit of the expectant parents with their pediatrician or obstetrician,” Dr. Shearer said. “This gives the family time to understand the potential use of cord blood stem cells for treatment of serious immune deficiencies.”

The authors note that it's up to physicians to convey accurate information about the potential benefits and limitations of cord blood banking and transplantation to parents.

Doctors should also clarify that no scientific data prove the claim that autologous cord blood is a tissue source of value for regenerative medicine purposes, although researchers are actively examining this possibility.

Parents need to understand that a child's cord blood cannot be used to treat that child's leukemia, should it develop, because the child's stored cord blood already contains premalignant cells. The child would need cord blood from an unrelated donor.

The AAP strongly supports an active role for regulatory agencies in providing oversight of the cord blood program, and it recommends that those who recruit pregnant women and their families for for-profit placental cord blood stem-cell banking need to disclose to patients any financial interest or other potential conflicts of interest they have relative to the procedure.

“There is a great need for cord blood donations to public cord blood banks in minority communities, since the need for such stem cells is high, whereas the supply is low,” Dr. Shearer added.