What is it?
Cord blood is special. "Cord blood is different to regular blood for
several reasons," he says. "It's different because it isn't aged; it
hasn't been exposed to the environment. That makes a difference because
all cells in the body have an internal clock that ticks down. So when we
collect cord blood, we are collecting cells at the early stages of
life, when that clock is set at the earliest possible stage. The
factory-default setting, if you like. Cord blood also has cells in it of
a type that we don't see at any later stage of life and has immune
cells which are totally unique."
What is it used for?
The
current use for cord blood is for bone marrow diseases such as
leukaemia. In the future, however, scientists are expecting that cord
blood may well be used for a variety of other diseases, such as cerebral
palsy and diabetes – two current areas of active investigation.
"The
beauty of cord blood is that factory-default setting, particularly when
it comes to the immune system" says Professor Kirkland. "The immune
system develops throughout childhood. But of course if anything goes
wrong during that period then at the moment you are stuck with it. A lot
of diseases such as Type 1 diabetes, for example, occur where something
goes wrong with the immune system, and the current thinking is that
these cord blood cells represent the child's immune system prior to
that. So the hope is that in the future it may be possible to use the
cord blood cells to restore the immune system."
Is it worth the cost?
It
does cost around $3,000 to have your baby's cord blood collected and
stored for eighteen years (you can then opt to pay for further storage).
Essentially it can be seen as an insurance policy; a medical "just in
case" type of thing.
"It's a bit controversial, the idea of
storing cord blood now, because these new applications for it are still
under development an some people say well, how can you ask people to pay
to store cord blood when most potential applications aren't proven
yet?" Says Professor Kirkland. "But I often turn that question around
and say, well, what are the chances that there won't be uses for these
cells in thirty years time. And frankly the chances that there won't be
uses for them are close to zero. And some of those uses will be things
that we haven't even thought of yet."
"Parents can see it as
being similar to an insurance policy. Diabetes affects 1 in 250
children; cerebral palsy is 1 in 500. A recent estimate said that the
chances of needing a bone marrow transplant (which you can use cord
blood for) throughout you life is around 1 in 400. Storing cord blood
from one child can also potentially benefit a sibling; there is a 25%
chance of cord blood from one child being a match for their sibling."
Of
course if you do fall ill you can access cord blood from a public bank
and generally the wait is only around two months. However the
difference, according to Professor Kirkland, is in the quality of the
match. "If you access cord blood from a public bank then it's coming
from an unrelated donor and most unrelated donor transplants are a
partial mismatch," he explains. "So to be technical, there are six main
antigens and blood from a public bank might yield a four or five out of
six match. With cord blood you can get away with not having a complete
tissue match but the better the match, the better the outcome. If it's
your own blood, it's a perfect match and even the benefit of using a
sibling is that about 25% will be a complete match. It can be a
seriously better outcome."
And while the technology and take up
in Australia is still fairly new, it should be seen as a long-term
proposition, with the current medical thinking being that cord blood
will hopefully be available throughout life. "People have been storing
cord blood for around 23 years; the last study that I looked at examined
cord blood that had been stored for twenty years and there was no
change to the blood," says Professor Kirkland. "So at this stage, as far
as we know, you can store cord blood indefinitely."
"I suspect
that in thirty or forty years it will be even more important to have
stored your cord blood because of course by then you have forty or fifty
years of aging on you and have access to blood which still has the
characteristics of when you were born.
I think it's sensible. I
am a bit biased of course, because I've been a stem cell researcher for
twenty years and when you start reading the scientific papers about cord
blood, every second paper is talking about the enormous therapeutic
potential of cord blood cells.
If you think about where the technology will be in thirty years time... the potential is enormous."
