A Canadian stem cell bank account?

There is method in the madness, the desperate rush for ontogeny. Cells huff and puff, some listening for instructions, others heading off in all directions like missionaries to new and just-discovered worlds. It is a busy place, the initial blastocyst turning into a multicelled embryo, as ontogeny recapitulates phylogeny, organs materialize out of apparent chaos, and form supersedes scaffold. Supervising all this, becoming all this, the Stem Cell quietly goes about its business of transformation: idea to blueprint to structure. Each starts off undifferentiated -uncommitted yet full of potential, a virtual library of plans; it then turns itself into whatever specialized cells the developing organism requires. It’s more complicated than that, of course, but a building usually is: walls hide a plethora of complexity, not to mention mystery.

And that these pluripotential cells, these nascent republics, hide in open view in the umbilical blood of every newborn baby -probably every newborn organism- should be grist for the just-so tales told to those same children years hence. It is truly a once-upon-a-time event that should thrill not only the wide-eyed child in the bed, but even the more sceptical adult storyteller. The Stem Cell is not just a progenitor, it is a gift almost too good to be true -an Aladdin’s lamp not to be ignored, nor, for that matter, to be trifled with. More -much more- needs to be learned before we rub it the wrong way, rub it roughly and are disappointed. Expectations too often outstrip reality. Much is promised, and no doubt much will be forthcoming. Currently, stem cells offer ‘promising treatments for leukemia, lymphoma, sickle cell disease and other blood, bone, immune and metabolic disorders’. But the path is unpredictable, tortuous, and meanders into the labyrinthine forest…

Stem cells were first discovered in the mid 1960ies in a type of cancer -a teratocarcinoma- that arose, not surprisingly, from cells that would ordinarily have formed gametes (germ cells). And the concept, the dream of pluripotentiality took off from there -more helpfully when a rich source of stem cells was found in umbilical cord blood. This eventually led to cord banks that would contract with parents to store the umbilical cord blood from their babies for their own future use -a relatively costly arrangement that charged more for potential than actual use. And anyway, not everybody could afford to store their baby’s blood. http://www.theglobeandmail.com/life/health-and-fitness/why-banking-on-cord-blood-isnt-necessarily-a-good-idea/article4209835/?utm_source=Shared+Article+Sent+to+User&utm_medium=E-mail:+Newsletters+/+E-Blasts+/+etc.&utm_campaign=Shared+Web+Article+Links  In other words, in Canada at least, a parent may pay as much as $1000.00 to start the process and then a premium each year to keep it stored in case it might be needed. And how often might it be needed? Well, apparently not very often at all. A 2007 American Academy of Pediatric policy statement on cord blood banking estimated that the use frequency was only one in a thousand to one in two hundred thousand! Other estimates have suggested higher usage rates since that statement was issued, but the point is that for an individual child, it is a substantial investment with a minimal yield.

So it has always seemed more appropriate to me that there be a national cord blood bank -one from which all in Canada could draw as the need arose. Other countries have done this… But until this year, only for-profit private banks were available in Canada. Now, at last, there is a national cord blood bank opening -albeit with limited branches at first: http://www.ottawacitizen.com/health/canada+first+national+cord+blood+bank+opened+doors+monday/8979216/story.html

Like adult blood donations in this country, cord blood should be donated free of charge. I don’t think profit should have any role in humanitarian projects. Health should not be something you have to purchase. Of course there is nothing stopping a parent from paying to store their infant’s cord blood for its own exclusive -or the family’s- use, although the above-linked 2012 article from the Toronto Globe and Mail, suggests that it is sometimes difficult to ensure a match for a family member even with that genetic kinship.

A national cord blood bank also offers a ready source of material for ongoing research. The ethics of using privately banked -reserved- blood for research is at the very least questionable, and unless agreed upon at the start, probably a breach of contract. And since the yield from any one umbilical cord is variable, but not excessive, if the parent is paying to store that limited quantity, it is cheeky to suggest they should not get all they’re paying for…

No, I applaud the new and national resource and wish them a speedy growth. And like the cells they guard, may the centers offering banks bloom like violets in the sun.

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