Q: Is cord stem cell preservation for newborns available in India? How can it help a sibling who has a brain injury?

A:Stem cells (or cells quite akin to them) have been identified in many different tissues of the body like neural, pancreatic, epidermal, mesenchymal, hepatic, bone, muscle, and endothelial tissues. Stem cell work is still quite experimental but is very promising as many beneficial therapies are thought to exist with much scientific value being ascribed to cord blood and its cells. Various centres in the world have been reporting their use in Parkinson’s disease, heart disease, endocrine disorders, etc. but this is still not being done routinely or being offered as a therapeutic modality. Human cord blood contains a large number of haematopoietic progenitor cells that can be used as a source of stem cells for treatment of blood disorders and cancers. Clinical efficacy is currently limited to bone marrow transplant, grafting new skin cells to treat burns, regenerating cornea in visually impaired, etc. Its potential use includes cures for cancer and treatment of neurologic, cardiac, renal, and endocrine (diabetes) diseases. There are still many difficulties in the routine use of stem cells and they include problem in identifying stem cells in tissue cultures, which contain numerous types of cells; to coax the cell to develop into a desired cell; integrating the new cells into the patient’s own tissue, both structurally and functionally; preventing tissue rejection and the possible risk of cancer. It is still not known what the effect of storing these cells for several decades would be as there have been no long term studies. There is no national policy to encourage people to store stem cells though several private storage cord blood banks exist that will store a baby’s cord blood for use by that individual or a designated family member but they charge a heavy fee for this. In the West, where stem cell banks have been in existence for several years, doctors advocate public banking for the storage of cord blood but this is not yet available in most areas. Most doctors, therefore, do not recommend going to a private bank because saving cord blood for many years is extremely costly and the odds for its use are low. Estimates of the likelihood of a child needing its own stored cells later in life are low ranging from 1 in 1,000 to 1 in 200,000 by age 18 years. The American Academy of Pediatrics states: “Given the difficulty in estimating the need for using ones own cord blood cells for transplantation, private storage of cord blood as ‘biological insurance’ is unwise. However, banking should be considered if there is a family member with a current or potential need to undergo stem cell transplantation.” The American College of Obstetrics & Gynecology believes that many questions about this technology remain unanswered and recommends that parents should not be sold this service without a realistic assessment of their likely return on the investment. The advertising by commercial cord blood banks stating it as part of doing everything possible to ensure the health of children is unethical as it makes parents feel guilty if they are not eager or able to invest considerable sums in such a highly speculative venture. The following organisations provide online information about running cord blood banking in India:

1. Cord Life Biotech (India) Internet: www.cordlifebiotech.com Phone: +91 20 254 51509 Office: Pune
2. Cord Life Sciences (India) Private Limited Internet: www.cordlife.com Phone: +65 62380808 Office: Kolkata
3. LifeCell India Internet: www.lifecellindia.com Office: Chennai, India
4. Reliance Life Sciences Pvt. Ltd. Internet: www.relbio.com; Office: Sir H.N. Hospital & Research Centre, Mumbai
5. Ruby Hall Medical Research Centre, Pune