Families bank on a possible new way to fight disease
For most people, the birth of a child is one of the most emotional moments in life. At that time, the umbilical cord that has sustained the baby for nine months is cut.In most cases, the cord is immediately discarded, since it no longer serves a purpose. But for an increasing number of people in Korea, the umbilical cord has one more function ― providing blood that may be used to treat future diseases.
Umbilical cord blood is used to treat leukemia and other blood cancers, as an alternative to a bone marrow transplant, but researchers are expanding their study to its potential use in treating arthritis, spinal cord damage, strokes, diabetes and Alzheimer’s disease. The blood has important medical uses since it contains blood-producing hematopoietic stem cells as well as mesenchymal stem cells that can form various tissues in the body, such as bone, muscle, nerve and cartilage.
The blood is collected and stored at childbirth at the request of parents who want to save it for their children, with a hefty one-time payment of up to 1.3 million won ($1,280) for storage for a maximum of 15 years. Drawn from the umbilical cord through a syringe, the blood is then frozen at minus 200 degrees centigrade.
“These days, even people without a family history of certain diseases are more susceptible to them because of environmental pollution,” said Yun Bo-hyun, a mother who saved the cord blood of her first child in January. “It is not certain whether my baby will be diagnosed with any diseases, but we decided to keep the cord blood as insurance.”
With the growing interest in preserving cord blood, the cord blood bank industry has experienced exponential growth in recent years, with 20 such banks currently operating. One out of 10 women giving birth, or 44,000, participated in the blood bank program last year.
“As soon as I learned about cord blood, I did not hesitate to save it,” a mother who had her first child through artificial insemination after seven years of marriage wrote on the Web site of the Cha Cord Blood Bank. “I have the belief that it can protect my child from the unforeseeable future.”
While most parents initially want to save the cord blood for their children, many are interested in expanding its use.
“These days, more people ask whether cord blood can be used not only for their child but also themselves, and even their parents,” said Kim Jong-yoon, a general manager at the Cha Cord Blood Bank, located in southern Seoul.
Traditionally, bone marrow transplants have been the most effective treatment for blood diseases like leukemia, but cord blood transplants have become a strong alternative.
A cord blood transplant, in which blood-making stem cells are injected into the body, has several benefits over a marrow transplant. It is extremely difficult to find a suitable donor for a marrow transplant because six HLAs, or human lymphocyte antigens, a group of proteins in bone marrow cells that can provoke an immune response, need to match. Only three HLAs need to match for a cord blood transplant. The chance of all six HLAs being identical between siblings is 25 percent while the chance that three HLAs will match is over 50 percent. Bone marrow transplants also are much more difficult, and are painful. In addition, cord blood has 10 times more blood-making cells concentrated in it than does bone marrow.
But there is a drawback. An umbilical cord contains only 100 cubic centimeters of blood, an amount sufficient for a child up to the age of 15. Thus, adults often need blood collected from two or more umbilical cords. It also takes longer for transplanted cord blood stem cells to adjust to their new environment than marrow stem cells.
Even so, the results of cord blood transplants have been positive in many cases. “The survival rate five years after a cord blood transplant is 60 percent, similar to that of a marrow transplant,” said Oh Won-il, the director of research at Medipost, a cord blood bank. Mr. Oh added that 80 percent of the transplants were done on children, who tend to recover faster than adults.
Two professors at the College of Medicine at Pocheon Cha University, Oh Do-yeon and Baek Jin-young, reported last week that after two patients with acute leukemia received injections of stem cells extracted from cord blood, they saw their hematopoietic stem cells recover and actively produce blood cells.
Recent developments in stem cell research, most notably by Seoul National Unversity professor Hwang Woo-suk and his team, who produced stem cells from cloned human embryos in 2004, further heightened interest in cord blood. Unlike hematopoietic stem cells, which are adult stem cells, embryonic stem cells are extracted from embryos within 14 days of fertilization. Now, researchers are studying how to use stem cells in treating various medical conditions by directly applying stem cells to damaged tissues as well as having them grow into fully developed organs.
The Korea Food and Drug Administration has approved more than 100 clinical trials for the treatment of severe conditions such as stroke, paralysis and spinal injuries by using mesenchymal stem cells, including those extracted from cord blood.
Researchers also are trying to find ways to commercialize stem cell therapy. The Korea Food and Drug Administration recently approved a clinical trial of the first arthritis medicine made from cord blood stem cells, Cartistem, which was developed by Medipost. Separately, FCB-Pharmicell, another cord blood bank, is in the final stage of a clinical trial of a stem cell medicine for cerebral hemorrhage.
The high expectations have even spilled over to the stock market. Those seeking to gain a profit from the cord blood trend flocked to the initial public offering by Medipost last week. The local cord blood bank industry leader controls half of this market, and had 17.4 billion won in sales last year. It is currently storing 70,000 units of blood.
Hopeful investors deposited more than 2 trillion won to acquire some of the 274,500 shares offered at 18,000 won per share, meaning that 814 investors competed for every share. The company’s share price increased nearly fivefold recently, and closed at 54,700 won yesterday.
With booming stem cell research and cord blood banks, the cord blood industry is already showing signs of overheating. The number of cord blood banks has risen and the competition has become very intense. As a result, the blood banks now provide discounts to recruit more customers, and are paying high commissions of 100,000 won to 300,000 won to obstetricians to collect blood.
There was even a news report in April that some hospitals sold cord blood to cord blood banks without the permission of the parents. Umbilical cords and placentas are normally discarded or used as material for medicines if the parents do not wish to save them.
To prevent such incidents from recurring, Grand National Party Representative Ahn Myoung-ock recently proposed a bill in the National Assembly to regulate the use of cord blood.
“In the end, the future of cord blood banks lies in public donations as opposed to the current family-based ownership,” said Mr. Kim of the Cha Cord Blood Bank, “so that anybody in need can use [the blood] at a reasonable price.”
by Limb Jae-un
with the Korea JoongAng Daily
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