Is this where science fiction meets everyday life? Is that most sacred bond - that between a mother and her newborn child - being invaded by the new technology of genetic engineering? Or is stem cell storage going to be like a routine blood test in the near future?

In what seems like an incredible leap in medical and genetic research, India is advancing towards the infinite possibilities offered by stem cells grown from Umbilical Cord Blood (UCB). And a new kind of choice faces mothers-to-be as they decide what is best for their infant...

What is Umbilical Cord Blood?

Blood contained in the umbilical cord is UCB. It is collected at the time of delivery of a baby. The reason it is of medical interest is because 16 years ago, researchers found that UCB contains a very rich source of 'stem cells'.

How is UCB collected?

Usually, after a baby is delivered, the umbilical cord is clamped in two places and while the baby is removed for cleaning after being cut away from the umbilical cord, the placenta and the remaining umbilical cord are waiting to be expelled by the mother. It is at this stage that we insert a needle into the umbilical vein and collect the foetal blood via gravity into the blood collection bag. After a while, the vein naturally collapses. We are not taking anything extra either from the baby or from the mother. The process is not painful and the mother is not even aware of the procedure most of the time, since she is recovering from the larger process of delivering her baby.

How does a stem cell bank work?

A sample of blood (it varies from 15 to 20 ml of blood) from the mother is collected once labour starts for the purpose of screening. Once the cord blood and the mother's blood are collected, they are transported to the lab within 48 hours. The samples are maintained at temperatures that range between five and 25 degrees Celsius. Once it reaches the testing lab, there is parallel processing of the mother's blood (for infection) and the baby's blood, which will be harvested for the stem cells. The process of harvesting the stem cells takes about three to four hours and it is then stored under liquid nitrogen at minus 195 degrees Celsius. The sample of the mother's blood is also stored at minus 80o Celsius. Explaining the complexities of this type of storage, Dr Saranya says, "The amount of chord blood we collect is 10 ml and it is divided into two portions and stored in two different storage facilities. This is done because in the event of any natural calamity, this is a unique sample that cannot be replaced."

What are 'stem cells'?

Stem cells are those cells which have the remarkable potential to develop into many different cell types in the human body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells, as long as the person is still alive. When a stem cell divides, each new cell has the potential to either remain a stem cell or become another type of cell with a more specialised function, such as a muscle cell, a red blood cell, or a brain cell. Until recently, these stem cells have been collected from the bone marrow and have been used widely and successfully in the treatment of cancer and thalassemia.

Do you need to store stem cells?

There are essentially two ways of evaluating one's need for this type of bio insurance. For those who do not have a history of genetic problems in the family, there is a slim chance of using or needing this technology. The chances of requiring stem cells for a medical condition vary from one in 200 to as high as one in 20,000! But again, even as recently as five years ago, there was very little information available on the exact applications and diverse uses of stem cell research. There was no question of using stem cells in the treatment of stroke, diabetes, Alzheimer's, Parkinson's Disease and so forth. Very little was known of the diverse applications for stem cell growth. Today, anyone is susceptible to ailments like diabetes and Parkinson's and if you are going to bank the cells at the time of a baby's birth, one hopes, they will not have to be used. But having said that, if you do need it, then this is the best possible option to have, if you want access to a compatible genetic stem cell source.

Real life success

An oncologist in Chennai tells us about a family in which the older child had a medical condition called Thalassemia Major. The child needed routine blood transfusions on an average of one every six months. The parents, while having the second child, banked the UCB. This younger sibling had the condition Thalassemia Minor, which does not manifest itself. While banking the UCB of the younger child, a transfer of stem cells was made possible for the older child. As a result, the elder child's condition was reversed from Thalassemia Major to Thalassemia Minor, making the elder sibling no longer dependent on blood transfusions.

How much does this procedure cost?

At Asia Cryo Cell Private Limited, you have three payment options to choose from, the simplest being a single or one-time payment option of Rs 59,000 for a storage period of 21 years.

Finally, the choice to bank a baby's UCB rests with the parents. "I do not think that UCB collection can, or even should, be made mandatory. It is, and must remain, up to the parents to make this choice. But I think a few years from now, stem cell therapy will be very common. The many medical possibilities of using the blood in stem cell applications in diverse treatments are growing each day and while it might seem outlandish to store it today, it could become as commonplace as doing an ultrasound scan, in a decade from now," says Dr Nandakumar.

How long can the cells be stored?

The viability for storing umbilical cord blood for 16 years has already been proved. At minus 195o Celsius, there is little chance of deterioration or contamination. In the past 16 years, there's been no incident of deterioration and the cells have been successfully thawed, re-grown and transplanted into humans without any loss of potency.

Are there any controversies about umbilical stem cell research?

The ethical issues surrounding this embryonic stem cell research should not to be confused with umbilical stem cell research, which is responsible, ethical and non-controversial. The government of India however, does not yet have any laws governing these research practices though some legal guidelines on therapeutic cloning that are pro-life are expected to come soon.