Is it necessary to preserve umbilical cord blood? What is the use of umbilical cord blood?

In the past, when giving birth, mothers generally did not care about the role of the umbilical cord and placenta, or whether to keep them. But now, some businesses, in order to make profits, promote the preservation of umbilical cord blood, which may save the child's life in the future. So is it necessary to preserve umbilical cord blood? What is the use of umbilical cord blood?

Is it necessary to store umbilical cord blood?

When my foreign friend's child was born, American doctors did not recommend saving the umbilical cord blood for their child. In China, such propaganda is encountered during the birth process. Does saving umbilical cord blood really "leave life insurance for the child" as the umbilical cord blood preservation organization advertises?

Stem cell transplantation is an extremely hot topic in modern medicine. For many blood and genetic diseases, stem cell transplantation may be a life-saving means. The umbilical cord blood that would otherwise be discarded contains a considerable number of hematopoietic stem cells, and there is no matching problem because it is considered a precious "byproduct" when the baby is born. (Stem cells from others have the risk of "matching failure". The probability of a person successfully matching with his brothers and sisters is 25%, and the probability of successfully matching with others is even lower.)

"Your own umbilical cord blood will never fail to match, save your own umbilical cord blood for future emergency" has become the "theoretical basis" for preserving umbilical cord blood, and has also become the propaganda appeal of many commercial preservation agencies. The marketing of "preserving umbilical cord blood" by commercial agencies mainly uses the fragile emotions of parents when their children are born to gain recognition, and conceals many facts in the process.

The amount of umbilical cord blood is limited, usually only a few dozen milliliters. The number of stem cells contained in these few dozen milliliters of umbilical cord blood is only enough for transplantation in children. This means that this insurance can only be effective when the child is young, and it is not as "insured" as described in commercial propaganda. Although future medical developments may reduce the demand for umbilical cord blood, this is also just a "hope" that has not yet been supported by scientific progress.

Most importantly, there is no scientific data to support that "using one's own cord blood is definitely effective." The promotion of commercial organizations focuses only on "one's own cord blood has no risk of matching", but avoids another problem: if the disease comes from genetic factors - which is very common in blood diseases (such as leukemia) - then one's own cord blood stem cells will also carry the same genes, so it cannot really solve the problem.

Logically speaking, scientists may be able to solve this problem in the future - because we don't know how far medicine will develop in the future, and we don't know whether and when this possibility will be realized. However, commercial organizations have exaggerated "possibility" into "reality".

In theory, some diseases may be treated with one's own preserved umbilical cord blood. However, different institutions have different estimates of how likely this is, ranging from one in a few thousand to one in two hundred thousand. More importantly, one's own umbilical cord blood is not the only effective alternative, and may not even be the best alternative. Based on the current status of biomedical development, the World Marrow Donor Association, the American Pediatric Association, and the European Union do not encourage ordinary people to preserve umbilical cord blood as "life insurance."

There are many reports of successful cord blood stem cell transplantation in the world, but these stem cells rarely come from one's own cord blood, but from public cord blood banks. The significance of public cord blood banks is to allow most of the cord blood in society to enter the public "cord blood bank". Although the probability of successful matching of unrelated people is very low, as long as the number of selectable samples is large, there is still a great chance of successful matching. This is a very simple arithmetic problem: even if the probability of successful allogeneic matching is as low as one in ten thousand, as long as there are 100,000 selectable samples, the chance of successful matching is still considerable.

Unfortunately, when donating umbilical cord blood has become mainstream abroad, we are still stuck in the false propaganda of "leaving hope for ourselves".

One-time payment of 19,800 for cord blood storage

On January 17, the outpatient hall of Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University was bustling with people. The consultation counter of "Beijing Umbilical Cord Blood Bank" in the hall was very eye-catching. Three or four publicity staff greeted the pregnant women and their families with smiles and introduced the storage of umbilical cord blood in detail.

"Cord blood storage can be paid in one lump sum, a total of 19,800 yuan." The publicity staff said that cord blood storage is generally for 18 years, or it can be paid in installments, with the first installment payment of 7,780 yuan, and then 980 yuan per year for the next 17 years, for a total of 18 years. After 18 years, it is up to the child to decide whether to continue storing cord blood.

According to the publicity staff, umbilical cord blood banks are divided into public banks and autologous banks. Autologous banks are exclusive to the individual and cannot be used by others. According to the staff, the umbilical cord blood of newborns can be used for the child or the family, and can be used to treat more than 80 diseases, including tumors and diabetes.

In the obstetrics department's fetal heart rate monitoring room at Jishuitan Huilongguan Hospital in Changping, there are also staff from the umbilical cord blood bank who promote to pregnant women the benefits of storing umbilical cord blood at their own expense.

While the publicity staff was answering questions from pregnant women, a call came into the fetal heart monitoring room. The publicity staff picked up the phone and said, "Hello, this is Jishuitan Huilongguan Hospital. What's the matter?" He sounded like a medical staff.

"Storing cord blood is a once-in-a-lifetime opportunity." This slogan is prominently written on the cord blood storage materials provided by the publicity staff. The inner page details the indications for umbilical cord blood hematopoietic stem cell therapy. "Look, these tumors, leukemia, diabetes can all be treated. Now more than 1,000 diseases can be treated."

The statement of "curing thousands of diseases" is very different from the above-mentioned propaganda staff's statement that "umbilical cord blood can cure more than 80 diseases". In response to the reporter's questions, the propaganda staff did not give an explanation. It was not until the reporter asked whether he could donate umbilical cord blood that the other party said that umbilical cord blood can be stored in a public bank, without paying for storage, and enjoy priority matching rights. "But once you donate it, it is not yours. If it is used up, it will be gone. You have to decide whether to store it or donate it."

The reporter noticed that the company name on the last page of the cord blood brochures of the above two hospitals is "Beijing Jiachenhong Biotechnology Co., Ltd." The staff said, "This is the only state-approved autologous cord blood bank in Beijing." The cord blood bank was established in 1996 and was approved in 2002 to start storing the first autologous cord blood.

Is it useful to store umbilical cord blood?

I don't think it's necessary.

1. The scandal of Shanghai Umbilical Cord Blood Bank exposed last year makes people wonder what Chinese businessmen will not do for money.

2. The number of hematopoietic stem cells contained in cord blood is limited and can generally only meet the transplant needs of children. As the storage time increases, the number and activity of stem cells decrease year by year. It is difficult to say whether the cord blood is still useful after being stored for 10 years.

3. There is no successful case of autologous umbilical cord blood transplantation in the world.

4. In Europe and the United States, the government spends a lot of money to establish national public umbilical cord blood banks, while in China, it is strongly advocated to spend money to establish autologous umbilical cord blood. These blood banks that store private umbilical cord blood are not directly managed by the national health department, but are contracted to private individuals. It is conceivable that we spend so much money, how much of it is used for storing our own umbilical cord blood, and how much of it is used by unscrupulous businessmen for advertising and bribery.