Miracle Blood

By Christine Gorman

Are you doing everything you can to protect your children? What if, God forbid, your daughter developed leukemia and needed a bone-marrow transplant? What if neither you nor your spouse could offer a close enough match to donate marrow? If you'd had the foresight to preserve some critical blood cells found in the umbilical cord and placenta that nourished your other children in the womb, you might be able to save your daughter's life.

Or at least that's the sort of pitch that has motivated more than 10,000 parents in the past three years to pay $1,000 to private companies that freeze and save their children's cord blood. (Although cord-blood transplants work best in children, they have also been used to treat adults.) Should you store your next child's cord blood? The short answer is, probably not. But there are important exceptions, so please read on.

First, it helps to understand that bone-marrow transplants are the most unforgiving of all transplant operations, requiring closer matches in tissue types between donors and recipients than for, say, hearts or kidneys. Because the immune system comes from the marrow, a transplant of that reddish pulp is, in effect, an immune-system transplant. There's the usual possibility that the body may reject the graft as "foreign." Then there's the almost surreal danger that the transplanted immune system will attack and kill its host.

Cord blood, which is painlessly harvested after birth, seems to be an ideal solution. The placenta is teeming with the all-important stem cells that can generate a new immune system. Even better, these cells are, as doctors put it, "naive," making them less likely to attack their new host. As a result, a cord-blood transplant doesn't have to match a recipient quite so closely as a bone-marrow transplant. This experimental treatment could prove especially helpful to African-American patients and other minorities whose greater genetic diversity often means they have trouble finding a good bone-marrow match.

So, in light of all this, do you need to bank your newborn's cord blood? Again, probably not. The odds that you would use it are on the order of 1 in 100,000--compared to a 1-in-30,000 lifetime risk of being killed by lightning. In addition, you can't use a child's own cord blood to cure him. If he had a genetic condition, you'd be giving him back his old disorder. If he had cancer, you'd be giving him the same immune system that failed to defeat the cancer in the first place.

The only cases in which it clearly makes sense for you to bank cord blood are if you already have a child with leukemia or lymphoma or there's a family history of a genetic condition like severe combined immunodeficiency (the Bubble Boy disease). Here the chance that you will use the cord blood is much greater, and it's more likely to be used successfully.

Otherwise, if you have the opportunity, you should donate your child's cord blood to a public bank, like the one at the New York Blood Center. (Most hospitals are not yet equipped to handle donations.) You could save someone's life, at no cost to you. With almost 9,000 units of cord blood on hand, the New York center can find a suitable match for 60% of the 20 to 30 patients from around the globe who each week ask it to find them a donor. The center estimates it would take just 100,000 units to have matches for 85% to 95% of all patients worldwide who need them.

For more on cord-blood transplants, visit www.nybloodcenter.org You can e-mail Christine at [email protected]