Can umbilical cord blood save lives at a critical moment? Is there any scientific basis for the saying "give birth to one and save one"?

Following the success of "The World", "Dear Child", which premiered on April 10, won the first place in the national ratings. Although I haven't watched it, it has been flooded with comments on Weibo, Xiaohongshu, Douyin and other platforms for many days. Netizens commented that this drama is "real to the point of panic"!

The climax of the drama begins in episode 14 (spoilers ahead), when the heroine's daughter is diagnosed with leukemia. After waiting for a bone marrow match in vain, the doctor finally reveals another "shocking secret," suggesting that the heroine and her ex-husband have another baby and use the newborn's umbilical cord blood to save their daughter's life.

Screenshots of TV series

This scene sparked heated discussions among many netizens and mothers, and there is a lot of controversy about whether umbilical cord blood can really save lives.

Check out the hot discussions among netizens

So, what exactly is cord blood? Can it really save lives in a pinch? Is it worth preserving cord blood?

Umbilical cord blood is actually the blood that remains in the placenta and umbilical cord after the baby is born and the navel is cut, about 100 mL.

Umbilical cord blood, Image source: REUTERS file

The reason why umbilical cord blood is precious is that, on the one hand, each child has only one chance to store umbilical cord blood when they are born, and on the other hand, umbilical cord blood contains powerful hematopoietic stem cells.

Why are hematopoietic stem cells so powerful? Because they can self-renew for a long time and differentiate into various mature blood cells, just like "rebirth".

Stem cell transplantation can not only treat a variety of metabolic diseases (leukemia, lymphoma, etc.), blood diseases and immune diseases, but is also used in the field of regenerative medicine.

Umbilical cord blood can treat a variety of diseases. Image source: pexels

However, treating diseases through hematopoietic stem cell transplantation needs to be based on "equal status", otherwise rejection reactions will occur, and not only will the hematopoietic stem cells fail to play their role, but they will do more harm than good.

Before transplantation, the "matching" issue must be considered, which is much more difficult than blood transfusion matching.

According to some marketing accounts, you can save your child's umbilical cord blood and use your own blood when needed, without having to worry about matching failure!

With this said, it seems that umbilical cord blood is super powerful and it is really worth saving a portion for your child!

The child basically has no use for umbilical cord blood

In fact, umbilical cord blood can save lives, but the chance of using it on yourself is very low! How low is this chance? Data shows that the chance of a child using their own umbilical cord blood to treat an illness is no more than 1 in 2700.

For patients who actually use umbilical cord blood to treat diseases, the umbilical cord blood they use almost all comes from public umbilical cord blood banks (accounting for about 99.9%).

Why is this?

First of all, hematopoietic stem cell transplantation is mainly used to treat diseases caused by hematopoietic dysfunction, and the occurrence of these diseases may be caused by genetic factors. In this case, autologous umbilical cord blood stem cells are likely to have the same genetic defects and will not work even if transplanted.

In addition, the number of stem cells in umbilical cord blood is very limited. As we mentioned earlier, each unit of umbilical cord blood is about 100 mL, and the hematopoietic stem cells in it are theoretically only enough for the treatment of children weighing less than 30 kg.

For children or adults weighing more than 30 kilograms, it is basically impossible to complete bone marrow reconstruction relying solely on the hematopoietic stem cells contained in a single umbilical cord blood.

So, if we rule out the problem of genetic genes, can autologous preserved umbilical cord blood be used?

Not necessarily!

Although matching in public cord blood banks is very difficult, once matching is successful, it can be used directly for treatment. However, this is not necessarily the case with autologous cord blood. Although there is no need to worry about matching failure, the cord blood may lose its therapeutic value due to long storage time.

The American Academy of Pediatrics points out that whether umbilical cord blood that has been frozen for ten, twenty or even longer years still has value is highly debatable. Therefore, the claim by marketers that "self-stored umbilical cord blood can save lives" is really not based on much evidence.

Rather than storing your own cord blood, donate it

Should we just throw away such precious umbilical cord blood? Of course not! You can choose a better way to preserve it: donate it to a public blood bank.

Image source: cedars-sina

There are many advantages to doing this. First, donating umbilical cord blood to a public blood bank does not cost anything. However, private umbilical cord blood banks are for-profit institutions, and storing umbilical cord blood is expensive.

Private cord blood banks usually cost 20,000 to 30,000 yuan and can store blood for about 20 years.

Secondly, donating umbilical cord blood does not cause any loss to an individual, but may even benefit from it, because the national public blood bank is open to the whole society and has more abundant resources. If you have successfully donated umbilical cord blood, you can enjoy priority when you or your family needs to use umbilical cord blood in the future.

If more people are willing to donate their umbilical cord blood and the resources of the public umbilical cord blood bank are continuously improved, the chances of successful matching will become higher and higher.

Steve, a leukemia patient who was cured and discharged from hospital in 2016 with double umbilical cord blood. Image source: bethematch

In short, umbilical cord blood is indeed precious, but everyone must rationally choose the method of preserving umbilical cord blood to maximize its value.

Is it a waste of time to have another child to save another one?

The little girl He He in the play suffers from acute lymphoblastic leukemia (ALL), which is a blood disease caused by abnormal proliferation of lymphocytes in the body. The disease is most common in young children and the elderly, but the cure rates vary. For childhood acute lymphoblastic leukemia, the cure rate for children aged 1 to 5 is about 80%, but the cure rate for infants under 1 year old and children over 10 years old is significantly lower.

Screenshots of TV series

Children's leukemia experts said that for this disease, the general treatment plan is to first give patients chemotherapy to relieve pain, because chemotherapy has a good effect on this type of leukemia. After about two weeks of chemotherapy, most people will have a significant improvement. If there is no recurrence within 5 years, then it is very likely that they will be completely cured.

Of course, some patients cannot be relieved by chemotherapy and need bone marrow transplantation for treatment. However, the medical community does not recommend choosing a sibling with a fully matched HLA (human leukocyte antigen, half inherited from the father and half from the mother) type as a donor.

The reason is that lymphocytic leukemia is a cancerous change of lymphocytes, and the functions of lymphocytes themselves are anti-tumor, anti-inflammatory, anti-bacterial, and anti-viral, so after transplantation, lymphocytes can recognize the remaining cancer cells in the patient's body. But if the donor is a sibling, then because the cells are too similar, the lymphocytes may not be able to recognize the cancer cells, so even if the transplant is successful at the time, there is a great risk of recurrence.

Therefore, "whether to store umbilical cord blood" and "whether it is necessary to give birth to one child to save one child" are issues that many parents of sick children need to consider carefully. With the continuous development of modern medicine, I believe that more and more diseases will be cured, and there will be one more happy "He He" in this world!

Review expert: Liu Huiyun, deputy chief physician of obstetrics department of the First Affiliated Hospital of the Third Military Medical University

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Editor/My Neighbor Totoro