By Hallie Levine
Excerpted from Redbook
December, 2002

Who knew a tiny amount of frozen cord blood could cure a child of a deadly disease? Read on for the lifesaving move that every parent needs to know about. By Hallie Levine

When Lisa Farquharson gave birth to her son Jesse, in June 2000, she did something most parents would never think of: On the advice of her mother, a retired nurse, she saved the cell-rich blood from her baby's umbilical cord.

"If ever there was a family that should never have had to use it [cord blood], it's us," says Farquharson, 31, who live outside Toronto. "My husband, Gary, and I had no history of health problems in either of our families, but we figured it would buy us a little peace of mind."

Yet four months after he was born, Jesse woke up from a nap with what seemed to be a white cloud in his right eye. Lisa and Gary rushed their son to the hospital, and soon their lives were in chaos. The doctor had grim news: Jesse was suffering from a rare form of cancer called bilateral retinoblastoma.

"When they told me that the cancer had spread from his eye to his spinal cord, and that his chances of recovery were zero, I just cried," Lisa recalls. "Even the doctors and nurses were crying. No one thought Jesse would live past Christmas."

Jesse's only hope was to be treated with an aggressive form of chemotherapy that would kill every cancerous cell in his body. But it would also kill many healthy cells, destroying the child's immune system and leaving him helpless against germs-even mild ones, such as those of the common cold. To survive the chemo, he would require a bone-marrow or cord-blood transplant to infuse his body with lifesaving and immune-system-repairing stem cells.

Because of Lisa's foresight, the Farquharsons would be spared the agonizing race against the clock to try to find a bone-marrow donor. Their doctors could use Jesse's own frozen cord blood for the procedure. On April 19, 2001, after seven months of chemotherapy, Jesse underwent a transplant at Toronto's Hospital for Sick Children that used the stem cells from his own umbilical-cord blood. Thankfully, the transplant was a success. Jesse's healthy umbilical cells regenerated swiftly, rebuilding his immune system. Today he's a healthy, happy 2-year-old.

"Everyone says Jesse's a miracle child," says Lisa. "I can't tell you the agony I saw parents go through as they watched their children die while waiting for bone-marrow transplant. Every day I thank God our family decided to bank Jesse's cord blood."

The thought of their unborn child being struck by a rare cancer or generic disorder is enough to terrify even the most stoic expectant parent. Is it any surprise, then, that Jesse's success story and others like it are sparking a mini revolution in medical care as tens of thousands of parents store powerful regenerative cells from their babies' umbilical-cord blood as "biological insurance" against future disease? A new generation of private blood banks is springing up across the U.S. to enable parents to bank umbilical cells for a guaranteed match should their children ever need blood or bone marrow transplants.

There's no doubt that most new parents go to great lengths to give their babies the best possible start in life. They buy life insurance, set up savings accounts, even prepay college tuition. But is it really worth it for them to also spend up to $1,500 to bank their new baby's umbilical cord blood as well as $100 in yearly storage fees, costs that are rarely covered by insurance?

Some experts say yes. "I've made sure my own grandchildren had their blood banked," says Richard H. Schwarz, M.D., past president of the American College of Obstetrics and Gynecology and chairman of obstetrics and gynecology at the New York Methodist Hospital in Brooklyn. "While your chances of needing it are very small, there are also all the future potential uses for these stem cells. Scientists are experimenting with cord-blood stem cells for treating everything from diabetes to brain injuries. The possibilities are truly astounding."

Lisa adds: "Imagine how devastated you would be if you passed up the chance to save that cord blood and something happened. A blood storage system costs about the same as a personal computer. And if those stem cells are there when you need them, you will never regret your decision."

WHY CORD BLOOD IS SO PROMISING
Medical researchers discovered the potential of human umbilical-cord blood back in the 1970s, when they realized it contains the same kind of stem cells found in bone marrow. (Stem cells get their name from their ability to develop into three types of blood cells: oxygen-carrying red blood cells, infection-fighting white blood cells, and platelets, which are necessary for proper clotting.) Because stem cells from bone marrow had already been used to successfully treat patients with life-threatening blood diseases, researchers soon learned that stem cells from cord blood could also be used for this purpose. "The stem cells essentially rebuild the immune system and bone marrow of people whose own cells have been destroyed by chemotherapy treatment," explains Joanne Kurtzberg, M.D., director of the Pediatric Stem Cell Transplant Program at Duke University Medical Center in Durham, North Carolina.

Although the amount of cord blood collected at birth is minuscule (it's usually around three ounces), it can be a lifesaver. For example, the stem cells from a single umbilical cord are enough to rebuild the blood and immune system of a child with cancer whose own white blood cells must be wiped out by intense chemotherapy. In the past, a physician's only option was to seek a living donor to provide these children with bone marrow transplants. Unfortunately, many children die while waiting for a suitable donor or of complications if their own bodies reject the donated marrow.

The great advantage of cord blood is that it doesn't have to be as closely matched to the recipient's tissue as bone marrow. "A newborn's immune cells are more pure than those found in adult bone marrow, because they haven't had a chance yet to be exposed to viruses and bacteria and develop antibodies," explains Pablo Rubinstein, M.D., director of the National Cord Blood Program at the New York Blood Center, a public blood bank. "Because of this, it's less likely to cause 'graft versus host disease,' in which the transplanted tissue actually attacks the recipient, thinking it's a foreign body."

Since patients who receive stem cells from newborns' cord blood are less likely to have this complication, there's less need for an exact match. On the other hand, for a bone marrow transplant to succeed, the donor and recipient (regardless of whether they're related) must match on six out of six genetic traits used in tissue typing. Cord-blood transplants can work when only four or five traits match.

With cord-blood transplants-as with bone marrow transplants-the donor and recipient do not have to be related. Still, strong evidence exists that there are advantages to keeping cord blood in the family: A 1997 study published in the New England Journal of Medicine reported that in an analysis of 143 patients, the survival rates for certain diseases more than double when transplanted cord blood came from related donors rather than from unrelated donors. Patients who receive cord blood transplants from relatives also have significantly less graft-versus-host disease, which is the leading cause of death following stem-cell transplants.

If parents do decide to privately bank their child's blood, the process is very easy. Most private blood-banking companies send parents a cord blood collection kit in the mail that contains test tubes, syringes, and anti-clotting drugs. Parents brig the kit to the hospital when their baby is due, and their ob/gyn and the nurses use the equipment to collect the blood immediately after the birth, when the umbilical cord is severed. Then the child's cord blood is shipped to the banking company for safe storage.