A Cure for All That Ails You? 

Despite the healing powers of umbilical cord blood, those who pay thousands to bank it for the future may be the least likely to benefit. By Kara Platoni

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Industry advocates insist the conventional wisdom is based on a narrow interpretation of what the stem cells can do today, as opposed to possible future applications, particularly in regenerative medicine. "We believe that everyone who banks their cells will someday use them for themselves or a family member," says David Zitlow, a spokesman for the for-profit Cord Blood Registry, officially called CBR Systems, Inc. "It may not be until they are forty and are out on the soccer field and have a cartilage injury or are in need of a cornea replacement for one of their eyes or develop diabetes later in life."

If that's accurate, then banking a baby's cord blood might be the best birthday present imaginable. If time doesn't bear out this claim, though, the banked blood may end up as yet another expensive gift no one ever plays with — even when it might have saved some other kid's life.

Public and private cord-blood banks dislike being portrayed as opponents. After all, they say, with four million births in the United States annually, there should be more than enough blood to go around — their common goal should be boosting the number of parents who bank at all. "The biggest competition," as Zitlow puts it, "is the trash can."

In truth, because cord-blood banking is so new, banks compete for a tiny slice of the expectant-parent market. Some resort to the hard sell. "Some companies have used sales approaches that appear focused on making the family feel that they are not being good parents if they don't store their baby's cord blood for future use," notes a 2006 policy statement from the World Marrow Donor Association. Furthermore, it continues, "Some companies also provide financial incentives to healthcare professionals who recruit their potential customers, and bonuses based on the number of successfully collected units."

Such marketing tactics give parents conflicting messages, even on the most basic question of all: Will my kid ever need this?

The odds that children will someday need their own cord blood are low — various studies have estimated odds anywhere from one in one thousand to one in two hundred thousand, according to guidelines issued in January by the American Academy of Pediatrics. Cord Blood Registry's Web site, by contrast, claims there's a one in four hundred chance people will need their own cord blood before age seventy, and a one in two hundred chance they will need a transplant from a sibling. That's a dramatic difference — and quite a sales pitch.

The company couldn't say much about the one in two hundred figure, except to say that it's taken from an as-yet-unpublished study coauthored by Frances Verter. She's the founder of the Parent's Guide to Cord Blood (ParentsGuideCordBlood.org), a nonprofit foundation and Web site. Launched as a memorial to her daughter, Shai Miranda, who died of cancer in 1997, Verter's site has information on cord-blood banks worldwide. While she's clearly a banking advocate, Verter says she neither endorses particular banks nor accepts advertising, and that her board includes representatives from both public and private banks (including CBR's Zitlow).

Verter says she can't make the full study available prior to publication, but notes that her numbers are based on the frequency with which the seventy currently treatable diseases were diagnosed in the United States in the early 2000s. "These numbers do not include future regenerative medicine applications, such as ongoing clinical trials for cerebral palsy and juvenile diabetes," she explains.

In truth, both figures are just projections. A more informative, albeit less flashy, metric is to compare how often banked blood is actually released for transplant.

Here's how three of the biggest for-profit banks are doing: Cord Blood Registry, with 125,000 banked units, has released 53 for transplant in 17 years. ViaCord, based in Cambridge, Massachusetts, stores units from 110,000 families and has released 27 over 9 years. Cryo-Cell International, a Florida company with 135,000 clients, has released 17 over 5 years.

By contrast, in the last year alone, the National Marrow Donor Program, which helps patients find a donor match from within the nation's public cord-blood supply, has made nearly 450 matches from an estimated reserve of around 50,000 units.

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