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What are the odds that we will need our cord blood?
The odds of using your baby's cord blood are the same as the probability that your baby or a close family member will have a disease that can be treated with cord blood.
Family cord blood banks tell parents that there are 80 diseases for which stem cell transplants are a standard treatment. That is a true statement, but it can be misleading. Most of those 80 diseases are rare among children. In the United States, the net probability that a child will need any type of stem cell transplant by age 20 is 3 in 5,000 or .06%. So the odds of use for transplant of a child are only 3 in 5000 for all of the 80 diseases combined!
When does cord blood stored in family banks have significant odds of use?
Family members: The graph on the left illustrates that, as people get older, rates of cancer increase, and the cumulative probability of having a stem cell transplant increases. In the United States, 1 in 217 people, or .46%, will have a stem cell transplant (not just need one, but have one) by age 70. Hence the cord blood that parents store from their baby might be of help to an immediate family member years from now. The cord blood is most likely to match first degree relatives: full siblings and parents.
Inherited disorders: The odds of use quoted for the average person in the United States do not apply to some families and do not apply at all in other countries.
For example, some parents want cord blood banking because they have many relatives with an auto-immune disorder like Multiple Sclerosis, and they know that stem cell transplants show promise for auto-immune diseases.
In Asian countries where the inherited blood disorder Thalassemia is prevalent, family cord blood banks are filling a public health need. Families can bank cord blood from a healthy baby to provide a sibling cord blood transplant to an older child with thalassemia. In Thailand some families are using assisted reproduction technology to conceive a matched savior sibling for an older child with Thalassemia.
Regenerative medicine: Parents are most likely to need their baby's cord blood to treat neurological disorders that are diagnosed in the first few years of life. These include autism, cerebral palsy, hypoxic-ischemic encephalopathy (HIE), apraxia, ataxia, hydrocephalus, in-utero stoke, traumatic brain injury, and similar conditions.
No one wants to imagine that their child might be born with a brain injury, but the reality is that cerebral palsy (CP) occurs in 2 of 1,000 full term births, and among premature births it is 10 times more common at 2 in 100 premies or 2% have cerebral palsy. Another relatively prevalent condition that may benefit from trials of cord blood therapy is autism spectrum disorders (ASD), which impact 1 in 44 US children as of 2018. As a public service, we have made available for download a spreadsheet of all clinical trials treating CP or ASD with cell therapy that were registered worldwide from 2017 to 2021.