Our son is due in a couple of months, and we were wondering if the potential benefits for umbilical cord blood banking outweigh the significant cost. What advances have been made in which cord blood would be beneficial to treating or curing an illness or disease? What gives the cord blood its potential for future treatment of diseases? I want to do what is best for our son and I know you only get one shot at it. Any insight into this would be greatly appreciated.

I am assuming that your expected son will have a first degree relative with type 1A (autoimmune) diabetes and that you would like to be prepared for the possibility that advances in stem cell technology might make an actual ‘cure’ possible.

First of all, the chances of this child himself developing this form of diabetes are only about 1:20, and the position with regard to stem cells, as I understand it at the moment, is that these cord blood cells have already become differentiated into ‘mesodermal’ stem cells and as such are only of value in treating certain congenital aplastic anemias and in situations where the bone marrow may have had to be irradiated. They would not with present knowledge be useable for islet cell replacement. At the same time, there is some evidence that this may not always be the case.

There is also some recent evidence also that growth of unfertilised ova discarded from fertility clinics can now be induced to start dividing and thus be a source of totipotential stem cells. If the stem cells were to be used in anyone other than your son, some period of immunosuppression would be needed, although here too there look like significant advances in the simpler induction of permanent tolerance. Another aspect of this is that there is now some early evidence that the transplantation of precursor lymphocytes from cord blood rather than stem cells can change the character of an autoimmune response from destructive to protective.

My own personal view is that although we seem to on the brink of a major advance in this approach to treating diabetes, that we still don’t know in exactly which direction success is going to lie and whether perhaps some form of genetic engineering will win the race. So, I would hesitate about cord blood preservation.

DOB