It was only when Krishna Satyarthi’s nephew was undergoing treatment for myelodysplasias at a leading hospital in Hyderabad did he learn that a child’s own cord blood is useless. The information hit him like a ton of bricks. For several years, he had been paying through his nose for the storage of the cord blood of his own child, believing that it was beneficial in treating many medical conditions in future. He was wrong. In 95 per cent cases, an individual’s own cord is impotent.
Satyarthi, who is the manager of a huller unit at a rice mill on the Guntur-Chennai highway, hadn’t ever felt this cheated. Nobody told him that the practice was nugatory. He later realised that in most blood-related disorders, transplant specialists recommend Umbilical Cord Blood Transplant (UCBT) to be of another person (allogenic) and not their own (autologous).
Because of lack of proper dissemination of information on the subject, thousands of parents are considering the cords as the holy grail, protecting their child from diseases. “Nothing is farther from the truth. Over 90 per cent blood-related disorders are from the time of birth, and the cord blood stem cells of the child carry the same mutated gene. If transplanted to the child again, it will contaminate the body,” says Dr A Kannan, Head of Paediatrics, Meenakshi Mission Hospital, Madurai.
Even though private cord blood banks store child’s cord blood for 20 years, the volume of cord blood stored for transplantation purpose may not guarantee the effective weight per kg requirement of stem cells for a diseased child’s need. In such a scenario public cord blood bank can combine one or more cord blood unit for transplantation which has been recommended for hematopoietic blood transplantations.
Private banks continue storing umbilical cords, with no one questioning its futility. This kind of singular banking systems is reaping little gain but with the general lack of awareness, parents are falling into deep traps. The reserves should be turned into pools of sharing resource, suggests Kannan. Patients can be treated by choosing the closest match from the available pool.
There are a total of three public and seven private banks in India but the quantity of units remains grossly under the mark. Just 5,000 cord blood units are available in public banks and that reduces the chance of obtaining a suitable match. Private banks collectively store around five lakh cord blood units. The number is growing at a rate of 6,000-7,000 cord blood units. “If the current system of private banking is adhered to, these cord blood units may never serve anyone in times of need,” says Lalit Jaiswal of CelluGen, Gurugram, a first-of-its-kind community cord blood banking service.
It is indeed beneficial to have pooled cord blood and cord as it can serve a wider population, but this will have a wider reach only if we encourage altruistic, non-directed cord blood banking. “Routine non-directed cord blood and cord banking as a form of ‘biological insurance’ against future disease should be discouraged,” says senior obstetrician and gynaecologist, Dr Prathima Reddy, who is the Director, Fortis La Femme, Bengaluru.
Restructuring the way umbilical cord blood is stored and shared will present new paradigms of treatment. Filling the large gap between what’s available and what’s usable is now the need of the hour.