What sustains in utero could heal later

To bank or not to bank? To bank publicly for free or privately for a fee?

With stem cells increasingly used in a range of experimental treatments and medical research, a growing number of parents are confronted with those questions at childbirth.

A growing number, too, of private and publicly traded companies seek to profit from a social and family practice still in its early stage: umbilical cord blood banking.

In Purchase, a commercial medical laboratory has ventured into that field, the emergence of which has aroused debate in the national and international medical community about public blood banking for common use versus private fee-based banking for families.

At M.A.Z.E. Cord Blood Laboratories, a three-year-old offshoot of a company founded 10 years ago by Dr. Michael A. Werner, parents are storing in deep freeze their newborns”™ stem-cell-rich umbilical cord blood as a hedge against life-threatening diseases. The processed blood contains hematopoietic or blood-forming stem cells, which have been used in transplants instead of bone marrow to treat leukemia and other diseases of the blood and immune system.

More than 70 different diseases to date have been treated with cord blood transplants, according to the National Cord Blood Program of the New York Blood Center. Launched in 1992, the New York Blood Center’s program is the largest nonprofit public cord blood bank in the world, having served more than 2,000 transplant patients. It collects more than 5,000 units a year at six collaborating hospitals in the nation, including four in metropolitan New York.

At the M.A.Z.E. labs at 2975 Westchester Ave., the volume of business in stored cord blood is more modest than that of more established competitors such as Cord Blood Registry in San Bruno, Calif., which reports more than 180,000 collections, and ViaCord, a Cambridge, Mass., companyÂ that has stored more than 130,000 cord blood units since the early ”™90s. Werner, the Westchester company”™s medical director, said it is on pace for 400 collections this year. “We seem to be increasing by about 50 percent every year,” he said.

Into other lines?

“My eventual hope down the line is that they may be able to make these (cord stem) cells go into other cell lines” that will, for example, rebuild heart muscle in a heart attack patient or nerves damaged by spinal cord injury.

The blood collection process is simple. Immediately after the newborn”™s umbilical cord is clamped, blood is drawn from the mother”™s placenta through a syringe by the attending physician or nurse. The bagged blood, which is stable at room temperatures for up to 48 hours, is transported by a medical courier service.

Werner said the cord blood is processed at the New York Blood Center in White Plains. In Purchase, the stem-cell-rich result is stored in liquid nitrogen tanks at minus 186 degrees Centigrade.

M.AZ.E. offers customers two price options: a $1,890 package for collection, processing and 18-year storage; and a $1,185 package that includes one year of storage, followed by an annual $85 storage fee.

“We kind of pride ourselves on being both local and less expensive” than the competition, said Werner. Cord blood banking companies such as ViaCord and Cord Blood Registry typically charge a $2,000 collection and processing fee and $100 annual storage fee.

In the medical community, private cord blood banking has its skeptics despite its growing popularity among parents. The American Pediatric Association (APA), in a 1999 policy paper for physicians, called “unwise” the private storage of cord blood as “biological insurance,” given the lack of accurate estimates as to the likelihood that a child”™s own blood will be needed in transplantation. The APA cautioned that parents “may be vulnerable to emotional marketing at the time of the birth of a child.” The medical group did encourage cord blood donations to free public banks.

Yet, seeming to offer a compelling reason for family blood banking, the APA noted that a sibling”™s cord blood might be needed in transplants for patients with leukemia and other blood diseases.

The medical community, however, has almost no experience with transplants of a child”™s own blood. Dr. Werner said none of the cord blood stored at M.A.Z.E has yet been used in a transplant.