Stem Cell Banking

Every pregnant patient is faced with the question “To bank or not to bank? “And this question then gets posed to me. Unfortunately the answer is not as simple as a yes or no.

First thing first, what are stem cells? They are cells which are precursor cells, which are sort of the basic cells from which other complex tissues can be formed. For example as an adult we have stem cells in the long bones of our legs and our breast bone and these are responsible for making blood cells on a continuous daily basis.

If we already have stem cells in our body, why do we need it from a child? For this I need to give you an example. As a child, our mind and character is malleable, it can be shaped and transformed. However as an adult, it becomes more difficult and sometimes impossible to mould ourselves. Similarly the stem cells which are obtained from the cord blood are so pure and nascent, that they can be transformed to other cells and tissues. What it means is that we can use these cells to make other tissues for example pancreas, nerve cells, skin cells etc. This is almost a revolution wherein if it is actually possible, we might tomorrow even have a cure for all kinds of diseases. Imagine walking into a store and buying a new liver off the shelf.

Another reason why the new born stem cells are better is because for stem cell therapy, HLA or genetic matching is necessary. It’s like a kidney transplant where the donor must be related. As compared to an adult stem cell, the newborn stem cells are capable of being used not just for the child in question but even parents and sometimes even other blood relatives.

If all is so well and rosy, where lies the confusion with banking then? Part of the answer lies in marketing and part in the technology itself.  World over there have been Public banks set up by the government so that the public can benefit as and when they require. Obviously its wishful thinking to expect such things in India. Am jotting down some of these points which I feel still need answers:

  • 2 years ago we were saying keep cord blood; today we say keep blood and cord tissue as well. Will there be a time 10-20 years later (when we actually might need to use the cells) when this source might be obsolete and new better sources might be available? It’s like investing a new cell phone today and expecting it to be still the best years later.
  • Steam cell therapy is still not popular, not easily available, done presently only for few diseases while the rest are experimental yet and expensive. Consider the fact also that even if you bank, you may not be, as of today be able to afford treatment.
  • Even if you bank, you may still require steam cells from anonymous donors for some treatments.
  • Why do companies promise to increase cell numbers before banking when we don’t even know how many cells might be required for therapy and whether the treating doctor will accept pre amplified cells or will he want to do it in his own facility?
  • Why if you have a single pregnancy, they will say it can be used for many blood relatives but if you have twins, they say the steam cells of one may not be useful for the other, so bank for both?
  • Why bother banking steam cells and menstrual blood? That way you should be banking from all other sources too; fat, pulp of teeth etc.

Don’t think that the purpose of writing this article is to dissuade you from banking. Honestly, if this facility was present when my children were born, I would bank too. The purpose of this article is to help you make an informed decision. You must be aware of what you are getting into. Stem cell banking and therapy may be the best thing which happened to medical science or it may, like some other developments die down. Remember that you are investing in the future and once done, you must never look back with regret and definitely don’t abuse me as your Obstetrician for having suggest wrongly.

 

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