Cord Blood donation: Public or private bank?

More parents prefer to donate their child's cord blood to a public bank, believing it will help others

By Eve Yap, The Straits Times, 4 Nov 2012

When national powerboat racer Laurence Wong cut the umbilical cord of baby Jayden last month, he was doubly proud.

Jayden is his first child and Wong, 39, was proud that the infant has done a good deed at birth - by donating his cord blood to the Singapore Cord Blood Bank.

The baby's Chinese name is Jie Ren, which means outstanding and benevolent.

"Donating the cord blood reflects the second part of his name, which I hope he will value," says the proud father, who is married to Ms Sabrina Chan, 28, an assistant advertising and promotions manager.

The Wongs are among about 400 couples each month who donate their infants' cord blood to the public pool, going against the trend of those who favour storing their babies' cord blood in one of two private banks here.

The public bank says the number is a 20 per cent increase from March, when it chalked up its 100th unrelated cord-blood transplant. Since then, it has helped 11 more transplants.

The two private banks here, CordLife and StemCord, which were established in 2001 and 2002 respectively, have about 70,000 samples. The seven-year-old public bank has about 8,000 units.

Between them, the two private banks have assisted in about a dozen transplants.

Cord blood is rich in stem cells that can go on to become different blood cell types, says the public bank's medical director, Dr William Hwang.

These stem cells can be used to cure patients of severe blood disorders and of blood cancers such as leukaemia.

However, the chance of a donor's cord blood being used to treat his parents should they fall ill is "extremely low", says Dr Hwang.

Each child gets only half of his genetic material from each parent and cord-blood transplants need a 67 per cent match, he adds. And there is only a one-in-four chance of a match among siblings.

"The donation of cord blood is even more urgent when we know that ethnicity plays an important role in finding a stem-cell match," adds Dr Hwang.

What do medical professionals advise their patients?

An obstetrician and gynaecologist in a restructured hospital, who declines to be identified, says: "My practice is to give them the information about the uses of cord blood and the pros and cons to cord- blood collection and storage if they have not thought about cord-blood banking.

"If they have already made a decision, I do not pursue the subject further."

The two private cord-blood banks here store units for a family's private use only.

StemCord charges a one-time enrolment fee of $1,580 and an annual storage fee of $275. CordLife charges $1,950 and $250 respectively.

Ms Gwendolene Yeo, 37, general manager of CordLife Group, says: "We believe the Singapore Cord Blood Bank and CordLife will continue to serve the varied medical needs of families who may need a cord-blood transplant."

The public bank's cord-blood samples are made available to any matching patient in need of a transplant.

The cost of the stem cells are only a portion of the total transplant cost, which can go up to $150,000, without complications.

For international cord-blood transplants, the bank releases the units at US$32,000 (S$39,100) for one unit but for Singaporeans, the rate is $27,000.

Customer service agent Anisah Abdul Hamid, 30, and her technician husband Mohd Affian Abdul Rahman, 29, gave away the cord blood of all their three children, aged one to four.

Ms Anisah says: "Instead of paying the charges, I might as well donate and let others use the blood as they need it."

Hotel catering sales manager Priscilla Phua, 44, has gone the private route as "insurance" for her two daughters aged seven and one. She likes the idea of the cord blood being readily available if needed.

"The $300 or so yearly for storage comes up to less than $1 a day. It's like an insurance for the kids and family members in case we need to use it," she says.

For scientist Hannes Martin Hentze and his wife Charlotte Goh, a part-time marketing consultant, both 41, it was a no- brainer. They donated when their son was born almost two years ago because of the medical evidence.

Research shows that it is most unlikely that the donor should ever need his own cord-blood unit as most transplant physicians may not feel that the patient's own cord-blood unit is the best choice.

This is because it may already carry the genetic abnormality that led to the blood or immune system failure or cancer in the first place. "So, we wouldn't be able to use the stored cord blood for our child even if we needed it," says Ms Goh.

The donation is a painless three- to five-minute procedure after delivery, says Dr Hwang.

"Rather than discard the umbilical cord after delivery, which is done frequently, you can donate it to give someone a chance at a cure," he says.

If the process is that easy, why not make it an automatic opt-in - unless the parent opts out - as in the Human Organ Transplant Act? "This is a very tempting suggestion but international requirements for cord-blood donation currently require a very detailed, informed consent and counselling process," says Dr Hwang.

This makes automatic inclusions difficult.

Parents who have given away their infant's cord blood say more publicity is needed to raise awareness of the pluses of donation.

Private banks, on the other hand, have the financial resources to market their services at parenthood fairs and talks.

Engineer Kelvin Chan, 34, and his teacher wife Eunice Tan Baofen, 30, attended a baby fair last year when they were expecting their daughter Ariel, now 15 months old.

He recalls: "A consultant for one of the private banks said if we signed up during the fair weekend, there would be a discount. The discount was substantial enough to sway us but we didn't feel we knew enough then to make an informed decision at the time."

After doing their own research, they chose to donate. "If everybody banked privately, the benefits of cord blood would not be exploited," he says. "If everybody donated, then it's not just a few who would benefit."

How to donate to a public bank

Every day, more than 6,000 men, women and children around the world are searching for a life-saving stem-cell unit.

These patients suffer from leukaemia, lymphoma and other life-threatening diseases that can be treated by a bone marrow or cord-blood transplant, says Dr William Hwang, citing statistics from the National Marrow Donor Program, the largest stem-cell registry in the United States.

Cord blood is taken during childbirth. The umbilical cord is clamped and cut, and a needle inserted into the cut cord to draw the blood into a collection bag.

About 30ml of blood, or three soup spoonfuls, is bagged. The blood is then assessed in a laboratory for volume, quality and purity. Ninety per cent of the counted cells should be "alive" and the sample free of infectious diseases.

The samples that make the cut are cryo-preserved in minus 180 deg C tanks, ready for a patient who needs them.

Women who wish to donate to the Singapore Cord Blood Bank, the only public one of its kind here, can indicate so after the 32nd week, when the pregnancy has stabilised and scans and amniotic tests are completed.

The public bank has only 8,000 samples, compared to the two private ones here which have a total of 70,000 samples. You can donate at nine hospitals, including KK Women's and Children's Hospital, National University Hospital, Singapore General Hospital, Mount Alvernia Hospital and Thomson Medical Centre.

For details, call the Singapore Cord Blood Bank on 6394-5011, e-mail info@scbb.com.sg or go to www.scbb.com.sg