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In response to a glut of confusing and sometimes incorrect information about public and private banking of umbilical cord blood, the American Academy of Pediatrics (AAP) has issued new recommendations that seek to clarify the options available to parents. Among several recommendations, the report encourages parents donate to public cord blood banks and discourage parents from using private cord blood banks – unless they have an older child with a condition that could benefit from transplantation.

Published in a recent edition of the journal Pediatrics, the report was co-written by Dr. Mitchell Cairo, director of pediatric blood and marrow transplantation at Morgan Stanley Children's Hospital of NewYork-Presbyterian; and professor of pediatrics, medicine and pathology at Columbia University College of Physicians and Surgeons.

"We want to encourage parents to donate to public cord blood banks because this cord blood contains stem cells that can be used to treat a variety of serious conditions," says Dr. Cairo, a member of the first AAP Work Group on Cord Blood Banking.

Morgan Stanley Children's Hospital offers several innovative treatment programs utilizing unrelated and sibling cord blood for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, Hodgkin's disease, non-Hodgkin's lymphoma, sickle cell anemia, thalassemia, aplastic anemia, as well as immunodeficiencies and genetic disorders.

The first public cord blood-banking program was started at the New York Blood Center in 1991. Subsequently, Dr. Cairo was one of three recipients of NHLBI (National Heart, Lung and Blood Institute) grants to fund a cord blood bank and establish standard operating procedures for consenting donors, collection processing cryopreservation, screening and storage. In total, between 60,000 and 70,000 units of cord blood units have been donated to U.S. public cord blood banks; of these, only 6,000 have been used for transplants. An estimated 400,000 units have stored privately, with only 35 to 40 used for transplants. Public cord blood banks exist for the benefit of the general public, and most U.S. banks coordinate matching cord blood to patients through the National Marrow Donor Program (NMDP). Private cord blood banks are for-profit organizations that store cord blood for the exclusive use of the donor or donor's relatives.

The report, which is the first revision of guidelines first offered by the AAP since 1998, includes the following recommendations:

• Donating your child's cord blood to a public bank is encouraged as it might someday help treat someone in need. An additional benefit is that most cord blood banks, public and private, will disclose to parents any abnormal findings in the harvested blood, giving them a better picture of their child's health.
• Parents of an older child with a condition that could benefit from transplantation are encouraged to save their newborn's cord blood in a cord-blood bank. There are private programs available for donation to a first-degree relative.
• Parents are discouraged from banking with a private company as "biological insurance" for later personal or family use. There is currently no scientific evidence to support the benefit of cord blood banking for the individual whose blood was donated (autologous); estimates on the chance of a child needing his or her own cord blood in the future varies widely from between one in 1,000 and one in 200,000.

"We also want to encourage institutions involved with cord blood banking to be sensitive to the possible emotional vulnerability of pregnant women and their families and friends, to fully inform them about the limitations of cord blood banking, and to abide by the highest standards of ethical conduct and confidentiality," concludes Dr. Cairo.

For more information, patients may call 866-NYP-NEWS.

Morgan Stanley Children's Hospital of NewYork-Presbyterian

Ranked by U.S.News & World Report as one of the top six children's hospitals in the country, Morgan Stanley Children's Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics – including the most complex neonatal and critical care, and all areas of pediatric subspecialties – in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City's only hospital dedicated solely to the care of children and the largest provider of children's health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children's Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians and Surgeons, the College of Dental Medicine, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. For more information, visit www.cumc.columbia.edu.