Is the popular theory that “umbilical cord blood is useless” or even “harmful” true?

Umbilical cord blood is the blood that remains in the placenta and umbilical cord after the fetus is delivered and the umbilical cord is cut off. In 1974, human beings first discovered hematopoietic stem cells from umbilical cord blood. In 1988, French doctors successfully used umbilical cord blood to cure a patient with Fanconi anemia for the first time. Medicine continues to develop and advance. Today, umbilical cord blood can be used to treat more than 80 diseases, and more than 47,000 cases have been treated worldwide. The reason why umbilical cord blood is so magical is that it contains rich hematopoietic stem cells and a variety of cytokines.

In our body, various cells have their own abilities and functions, such as nerve cells can transmit signals, red blood cells can transport oxygen, and muscle cells can make muscles contract and stretch. Stem cells are a type of undifferentiated cells. They do not show special functions, but have the ability to differentiate into cells with certain functions. Hematopoietic stem cells are one of them. They have the potential to self-renew for a long time and differentiate into various mature blood cells.

Hematopoietic stem cells (Photo source: Beijing Cord Blood Hematopoietic Stem Cell Bank)

Hematopoietic stem cell transplantation is to inject normal hematopoietic stem cells into the patient's body. They will home to the patient's hematopoietic tissue and differentiate into blood cells and immune cells that can function normally, thus reconstructing the patient's hematopoietic and immune functions and achieving the effect of curing the disease. This process is equivalent to sowing new and vibrant "seeds" in the "soil" used for hematopoiesis in the patient's body. These seeds grow, develop, and reproduce, and are rejuvenated with new vitality.

At present, hematopoietic stem cell transplantation can be used to treat more than 80 diseases, including some blood system diseases, immune diseases, metabolic diseases and solid tumor diseases. Blood system diseases can be divided into malignant diseases and benign diseases. Common malignant blood system diseases mainly include various types of leukemia, multiple myeloma, malignant lymphoma, etc. Benign blood system diseases include aplastic anemia, myeloproliferative diseases, red blood cell diseases and platelet diseases. Even if these diseases are benign, they are difficult to treat. Hematopoietic stem cell transplantation provides an effective solution for curing these diseases.

Hematopoietic stem cells can be extracted from bone marrow, peripheral blood, umbilical cord blood, placenta, teeth, menstrual blood, etc. However, the main sources of hematopoietic stem cells that are abundant and can be used for clinical treatment are bone marrow, peripheral blood and umbilical cord blood.

So what are the characteristics of umbilical cord blood compared to other sources?

First of all, in terms of quantity, the source of umbilical cord blood is abundant. Unlike before, when umbilical cord blood was mostly discarded as waste, it is now increasingly valued and stored. At present, there are 7 umbilical cord blood banks and some autologous banks in my country, which can store donated or personally stored umbilical cord blood. In addition, unlike the bone marrow bank, which stores a card information, after a successful matching, it is still necessary to contact the donor and collect hematopoietic stem cells, and there is a possibility that the donation will be destroyed. The umbilical cord blood bank stores a physical object, which can be used for treatment after a successful matching.

Second, in terms of rejection reaction, umbilical cord blood hematopoietic stem cells have low immunogenicity, which means that the patient's body is unlikely and to a low degree not to recognize these foreign cells, so the incidence of rejection reaction is low and the degree is mild.

Third, in terms of anti-tumor properties, for some malignant diseases, hematopoietic stem cell transplantation also requires anti-tumor effects, such as anti-leukemia properties, and umbilical cord blood performs more prominently in this regard. We can understand it this way: the younger the donor, the younger the hematopoietic stem cells, and the more vigorous they will be. During the transplantation process, these cells gradually mature from very young, and their ability to resist tumors will be stronger. Umbilical cord blood hematopoietic stem cells can be said to be the youngest. They have basically not been contaminated by any external factors and can be called "zero-year-old cells." They have stronger regeneration and repair capabilities than adult stem cells.

Fourth, in terms of matching, the non-blood-related matching degree of umbilical cord blood hematopoietic stem cells is higher. If 6 sites are required in the matching, then the transplant can be carried out conditionally when 4 sites match.

Fifth, ethically, umbilical cord blood has already left the human body, which is more ethical, and waste recycling is a more optimized solution.

(Photo source: Beijing Cord Blood Hematopoietic Stem Cell Bank)

So, is the popular theory that "umbilical cord blood is useless" or even "harmful" true?

Misconception 1: Collecting umbilical cord blood is not conducive to fetal development and may cause anemia.

Umbilical cord blood collection is a process of collecting the residual cord blood in the umbilical cord and placenta after the newborn is delivered. The umbilical cord is ligated with two hemostats at the 3-8cm end of the baby, and the umbilical cord is cut at the hemostats near the newborn. After the newborn is taken away, the hemostats are disinfected at the placenta and the needle is inserted into the umbilical vein to collect the cord blood. Therefore, in a regular hospital and under regular operation, cord blood collection is performed after the placenta, umbilical cord, mother and fetus are completely separated. Therefore, it will not cause adverse effects on the mother and child. It is a process of "waste utilization, turning waste into treasure". In addition, with the continuous improvement of medical and collection technologies, the amount of cord blood collected has gradually increased from 70ml-80ml to 110ml-120ml.

Misunderstanding 2: Umbilical cord blood cannot be used for congenital diseases, the probability of autologous use is extremely low, and there is no point in storing it.

Autologous transplantation is indeed mainly used to treat acquired blood system diseases, but the low probability of autologous use is also because the incidence of blood system diseases is very low. However, with the continuous development of medicine, some diseases that were previously thought to be untreatable by autologous transplantation, such as aplastic anemia in children, have also had more and more successful cases.

Moreover, some congenital genetic diseases may have some problems with their genes at birth. Therefore, gene therapy requires the use of mobilization agents to mobilize and extract cells, and then edit and repair genes in vitro before transplanting them back into the body. However, if umbilical cord blood is stored, this process can be omitted and it can be directly trimmed, edited, treated, and then transplanted into the body. Therefore, with the development and progress of medicine, umbilical cord blood will definitely have more uses and significance.

Misconception 3: Umbilical cord blood can only be used to treat children weighing less than 27 kg.

Generally speaking, for patients weighing less than 45 kg, a single unit of umbilical cord blood containing 1×107 hematopoietic stem cells can meet their transplantation treatment. It is also entirely possible to treat patients with larger weight values ​​by improving and optimizing the program. In Europe and the United States, the number of adult umbilical cord blood transplants has long exceeded that of children. In my country, more and more adults are using umbilical cord blood transplants. Statistics from the Sichuan Umbilical Cord Blood Bank show that adults account for 56.26% (age>18 years old) of the umbilical cord blood users in its blood bank, of which the oldest patient treated is 74 years old; patients weighing more than 50 kg account for nearly 56.50%, of which the largest patient weighs 110 kg. This is also reflected in other umbilical cord blood banks. Therefore, umbilical cord blood can not only be used to treat low-weight children, but with the continuous development of technology, it will also be more used in adults.

Some application cases of umbilical cord blood in Beijing (Photo source: Beijing Umbilical Cord Blood Hematopoietic Stem Cell Bank)

Therefore, umbilical cord blood can be said to be a "potential stock" with great potential in the future. At present, in the field of regenerative medicine, including cerebral palsy, autism, hearing loss and type 1 diabetes, umbilical cord blood treatment has also achieved certain results, providing a new treatment method for such diseases. In addition, umbilical cord blood contains a large number of other stem cells and immune cells, such as mesenchymal cells, endothelial progenitor cells, natural killer cells, killer T cells, dendritic cells, regulatory T cells, etc. I believe that with the development and progress of science, umbilical cord blood will be able to better exert its potential.

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