Pediatricians say more cord blood is needed now

WASHINGTON — Fliers in upscale doctors offices portray it as the hot new baby-shower gift: a registry where friends and family chip in almost $2,000 to start privately banking a newborn's umbilical cord blood, in case of future illness.

That idea of biological insurance is a long shot that most mothers-to-be can safely ignore, say new guidelines from the nation's pediatricians that urge more parents to donate their babies' cord blood so that it might save someone's life today.

The guidelines come as the government begins setting up the first national cord-blood banking system, aiming to prevent about 12,000 deaths a year — if public banks can compete with private firms that now store most of the world's preserved cord blood.

Cord blood is rich in stem cells, the building blocks that produce blood. These same stem cells make up the bone-marrow transplants that help many people survive certain cancers and other diseases. But cord blood has some advantages: These younger stem cells are more easily transplanted into unrelated people than bone marrow is, and they can be thawed at a moment's notice, much easier than searching out a bone-marrow donor.

There should be plenty for both private and public banking, says Dr. Elizabeth Shpall of the public M.D. Anderson Cord Blood Bank. After all, cord blood from most of the nation's 4 million annual births is discarded.

The chief hurdles are improving consumer awareness, and the small number of hospitals that allow donations.

Today, about 50,000 cord-blood donations are stored in more than 20 public banks around the country. The new National Cord Blood Inventory aims to triple that number, enough that virtually anyone who needs stem cell treatment could find a match — especially minority patients who today seldom can because most bone-marrow donors are white.

Private banks have an estimated 400,000 units stored.

What's the controversy? Deciding who really needs to store cord blood for that child's later use. Private storage costs $1,500 to $1,900 up front and about $125 a year thereafter, although some facilities offer special programs for lower-income families.

Guidelines published last month by the American Academy of Pediatrics say that parents should consider private storage only if an older sibling has cancer or certain genetic diseases that cord blood is proven to treat. Everyone else should consider donating their child's cord blood, they say. The odds that a child would need an infusion of his or her own cord blood later in life are slim, between one in 1,000 and one in 200,000.

Private banks vehemently disagree, arguing that as scientists learn more about stem cells, the blood could create personalized treatments for heart disease or other more common killers.

"That's still considered very experimental," counters Dr. Mitchell Cairo of Columbia University Medical Center, who co-authored the new guidelines.