Pregnancy & Baby Care Newsletter

Stem Cell Banking: Fact, Fiction and Folly?

Dr Hollands continues his information to the public series on Stem Cell Technology. Since the first article, there has been a steady rise is discussions in our baby scan clinics around the country.  In today’s article, Dr Hollands discusses the stem cell big business across the world and the competing technologies within this sector. In particular, he contrasts Cord stem cell application and other technologies that have yet to be proven. He cautions families to think carefully where they invest their hope and money.

Hardly a day goes by without a new revelation in stem cell technology. When I first worked in this field nearly 30 years ago there was little interest in stem cells beyond the highly specialized experts working on bone marrow transplantation. Today we hear about stem cells coming from cord blood, placenta, embryos, the fat collected during liposuction and even from baby teeth!

All sorts of claims are made for the current and future clinical applications of these cells based sometimes on fact and sometimes on wishful thinking. The contributions of politicians, the media and perhaps worst of all self-interested ‘celebrities’ just help to confuse the debate. Whatever the present and future applications of stem cell technology may be it is becoming increasingly obvious that stem cell technology is big business in particular in the field of private banking of stem cells.

Private banking for umbilical cord blood stem cells began in the USA and is now an international multi-million dollar industry. Cord blood stem cells do have tried and tested applications in the treatment of hematological malignancy with over 10,000 transplants to date in the treatment of 45 different blood disorders. Cord blood stem cells have also been shown to have the capacity to repair other tissues.

Cord blood is therefore a very good source of stem cells and private banking for family use and is arguably a useful and cost effective procedure. The future of cord blood stem cells in the emerging field of ‘regenerative medicine’ is particularly promising. The drawback with private banking is first of all the cost, which happens to be the highest of all in the USA, and also the fact that private banking takes cord blood away from the public banks where it is potentially most useful.

Public banks store cord blood and offer it for transplant to anyone in need and this is by far the most clinically effective way to collect and store cord blood stem cells. Nevertheless, public cord blood banks need large investments to set up and run such a service.

The success of the private cord blood banking industry has stimulated the growth of other private cell banking industries including cells taken from the umbilical cord itself, the placenta and baby teeth.

The problem with these services is that at present there are no known clinical applications for these cells. Clients are therefore currently paying for a service which has no immediate practical use. The companies involved will of course argue that their services have great potential (which they may do) and they provide ‘biological insurance’ for the future. I do not believe in the ‘biological insurance’ concept which is the product of marketing executives rather than scientists and clinicians.

Some people even undergo a peripheral blood stem cell harvest involving a drug regime followed by connection of the patient to a machine to collect the peripheral blood stem cells which are then frozen. These cells do have clear, current clinical uses but the objection here is the questionable process of collection from healthy individuals when collection at the time of illness, if required, is tried and tested technology.

The very latest development in the private stem cell storage industry is a US company offering the private storage of embryonic stem cells. This service is offered to people who have excess frozen human embryos stored in infertility clinics. Such embryos are thawed, embryonic stem cells extracted and the resultant cells re-frozen for possible later use by the clients.

On the face of it this might sound like a useful service but there are many objections to such a service including:

• Embryonic stem cells have no current clinical applications. There are no plans at all for clinical trials involving embryonic stem cells.
• The current technology for the derivation of embryonic stem cells will no doubt improve with time making derivation at this point in time potentially damaging
• Much more research is needed before there is any justification at all for such a service
• In the event that the clients need their frozen embryos (for example the death of a child) then this option will have been taken away from them and the creation of further new embryos might not be possible
• There are still many technical problems to be resolved not least the problem of cell stability and tumor formation by embryonic stem cells
• Current adult and cord blood stem cell technology is providing current therapy and clinical trials in regenerative medicine

Stem cell banking is clearly an area where clients must ask themselves very careful questions. Caveat emptor!

Dr Peter Hollands
Senior Lecturer in Biomedical Science
University of Westminster
London, UK