Umbilical cord blood stem cells
As my wife and I are on the cusp of parenthood, a little bit of Googling pointed us to cord blood banking. The umbilical cord, that is usually discarded at the time of delivery, contains stem cells that can specialise into different kinds of blood cells. It was this that led me to write an article on stem cells sometime back. The idea is that these stem cells could be preserved at a “bank”, so that in case the child (or even the parents) have a blood related disorder in future, these cells could be used. The cells will be a direct match for the children, but for the parents it will match with a 50% probability.
When I enquired further, I learnt that banking cord blood for a child costs somewhere in the range of 60,000 to 70,000 rupees. Though I am generally optimistic on what science will achieve in future with stem cells, Prabha and I felt this was something that we could not afford now. But we were also worried if we are putting pecuniary concerns ahead of the child’s welfare, even before it was born.
All is not lost though. It is not that you always need your own cells. There is a very small chance (somewhere in the range of 1 in of tens of thousands) that cord blood cells of another unrelated person matches yours. What I mentioned in my last paragraph, was about private banking, where you store cord cells for your own possible use in future. There is also the concept of public banking, where you just donate your cord blood to a bank. They will store this free of cost. Anybody who needs such stem cells, can search the public banks to find a match. And when they do find it, they can pay for it and get it.
What is more, if I donate my cord blood today to a public bank, and if I need it tomorrow, I can get my own cells back on payment, assuming it has not been given out to others in the meanwhile. It is not as if everybody will need their stem cells. So rather than wasting it, why not give it to a public bank, where it might end up being useful for others.
Considering all this Prabha and I went to Jeevan Blood Bank and Research Centre which has a public stem cell bank. It looks like this is the only public bank in India. There we met a person Kishore, who explained to us the details of the cord blood bank. When we talked to him, we learnt about the dismal donation levels of cord blood cells. He told us that every month, about 15 people donate cord blood, and that the bank now has about 400-500 samples. Considering the staggering odds of finding a match, this number looked insignificant. It is true that there is still lot of progress yet to be made on using these Stem Cells, but there are some disorders, like leukemia, where this is already being used for treatment. Kishore told us that today, if one has to get a unit of stem cells from abroad after finding a match it would cost about 14-15 lakhs, whereas if a match is found with Jeevan, the cost would be around Rs.50,000. Jeevan also donates the stem cells free of cost for people who cannot afford the payment.
He then showed us around the centre. We were shown the machine the extracts the stem cells from the blood, the huge cylinders, as wide as 2 people and reaching up to my shoulder’s height, which stores the cells at ridiculously low temperatures (I don’t remember the numbers now). It was all fascinating for us.
The key obviously is to build up a huge repository. This can be achieved only by increased awareness. Science has today achieved, what it could not have imagined 30-40 years ago (no doubt there have been some disappointments too). So I feel 30-40 years from now, we would be capable of using these stem cells really well, and it would be a shame if the only reason we are not able to cure somebody of , say, blood cancer is because we do not have a compatible sample. True, it could turn out that 40 years down the lane, not much progress has been made (I think that is very unlikely), but even then what do you lose? You would have anyway discarded the cord blood. Why not save it?
Private banking, is still dicey, as you are expected to invest so much on something that you are not sure will be useful to you. But I don’t see a reason why anybody would say to no to Public Banking. The procedure is safe and non-invasive. After the umbilical cord is removed from the mother, the blood from it is collected, and stored separately. There can absolutely be no harm to anybody involved. So if you know somebody about to have a child, spread the message, ask them to consider this. It is in some sense a social insurance policy we are taking out for our next generation.