In family banking, stored units can be used by the donor (child), a compatible sibling and the parents and cannot be given to another non-related person. In contrast, in public banking, the donor does not have access to the unit they donated. The characteristics of each eligible unit are kept in an international data bank and the units become available to any compatible person around the world
Many parents find it difficult to decide whether to bank their newborn’s stem cells for family use or donate them to a public bank for public use.
This skepticism is supported by spurious arguments which are furthermore presented in a confusing way to the general public. To help parents arrive at the right choice for them we will provide an objective picture of the two choices.
Are the Stem cells derived from a sick child also sick?
To begin with, the probability that a child will ever need his own stem cells is mathematically very small, but not minimal. It is however correct that in cases of hereditary blood disorders such as Thalassemia and sickle cell anemia, autologous transplantation is not recommended.
In case a person develops leukemia, there is a possibility that certain factors already present in his/her DNA make autologous transplantations not appropriate. On the other hand, there are cases of leukemia that are caused mainly as a result of environmental factors. In this case autologous transplantation is possible. Doctors have already performed autologous hematopoietic stem cell transplantations to children who had leukemia, after having first confirmed the absence of pre-leukemic agents in the blood. (Cancer Control. 2011;18:222-236; Pediatrics. 2007 May;119:1042-1043.
Moreover, more than 9419 transplants with hematopoietic cord blood stem cells have been performed until today (Blood. 2013 25;122:491-498).
Can I get stem cells from a public bank?
It is worth mentioning that the search for a compatible unit is extremely time consuming. It is also true that only one in three individuals seeking a transplant unit will find a compatible unit. The advantage of the family cord blood unit is evident since it is readily available for transplantation.
Another negative factor associated with public units is the fact that we do not have reliable information on them in terms of prior genetic diseases that may be present in the DNA of the donor, since the grafts are not tested for leuchemic cells On the other hand, we do have this information on units stored in family banking since we can easily conduct a number of additional tests to detect the presence of any genetic factors (predispositions).
Family banking does not interfere or impede the search of a graft from a public bank and does not provide any kind of priority to donors when they seek a unit from a public bank.
If I need a stem cell transplant unit could I find it from peripheral blood or bone marrow?
Peripheral blood and bone marrow are also excellent sources of hematopoietic stem cells. Family banking of a cord blood unit does not prohibit the combination with another graft from bone marrow or peripheral blood. In this case, the cord blood unit will act as “complementary” graft.
The most important application of cord blood units stored in a family bank is the allogeneic transplantation which uses a unit stored in the family bank to treat a sibling. The probability of complete compatibility between siblings is 25%.
A recent publication reports that the survival rate for 500 patients who underwent cord blood transplantation from a compatible sibling donor are indeed very high:
Four-year survival rate of 91% for non-hematological malignancies and56% survival in cases of hematological malignancies.(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208689/)