Smita Singh, 28, and her husband Amit, a government official, are expecting their first child this July. Ever since Smita’s gynaecologist urged her to think about banking her umbilical cord blood cells at the time of delivery, the conversation at the Singh home has revolved around this issue—the couple is worried about the expenses and confused by other doctors’ scepticism on the issue. At the same time, they don’t want to miss out on this once-in-a-lifetime opportunity.
The premise behind cord blood banking is simple: Research has revealed that the umbilical cord is a rich source of stem cells, which are the building blocks of our body. With medical science betting on stem cells to regenerate ageing or diseased tissues, it makes sense to store your cord blood rather than throw it away.
Delhi-based Divya Mittal left the decision till the very last minute—enrolling just two days before her delivery. But now 16 months later, as she reads more and more about the issue, and watches her son Abhay gambol in the park, she says she is happy with her decision.
Garima Jain, a Gurgaon-based dentist, had no such apprehensions. The day someone dropped a flyer at her clinic and she learnt about umbilical cord banking facilities in India, she was sure she would go in for it. “At that time, I was not even married,” she exclaims, “but being a doctor, I had read enough about it to be convinced.” She kept the leaflet handy and called up the company concerned, LifeCell, the minute she learnt that she was pregnant. “For me, health comes first, before money or property,” she says firmly.
Garima is not alone. And it’s not just the much-publicized likes of actor Raveena Tandon, politician Priya Dutt or cricketer Ajit Agarkar’s wife who are choosing to deep freeze their babies’ umbilical cord blood in cryogenic vaults. More and more women from all walks of life are opting for it.
A global trend —though slow to reach Indian shores—is now catching up in the country, with a host of players offering private banking facilities. Currently, four players—Reliance Life Sciences, LifeCell (a tie-up between Asia Cryo-Cell and Florida-based CryoCell International), Cryobanks International India (a joint venture between US-based Cryobanks International and RJ Corp) and CryoStemcell—offer a nation-wide network of cryogenic vaults, where the cord blood is stored in temperatures of minus 196 degrees.
Dr Suman Kher, senior consultant gynaecologist, Max Healthcare, says the awareness level, especially among the well-heeled clientele that Max caters to, is so high that rather than the gynaecologist telling expectant parents about the facility, they first ask her opinion about it.
Between the four players mentioned above, they have already mustered about 10,000 cord blood samples.
Some Delhi-based haematologists have a different viewpoint and say cord blood banking is all hype right now.
They say there is no data to show that cord blood is superior to bone marrow. Another limitation they cite is that the quantity of cord blood that can be extracted is so low that it can serve only a limited purpose.
LifeCell CEO V.R. Chandramouli points out that there are fewer chances of infections from cord blood stem cells as opposed to bone marrow transplants.
Even a body like the Indian Council of Medical Research says that patients with cancer, heart disease or Parkinson’s can become potential beneficiaries of stem cells-based therapies, whether from cord blood or from bone marrow. Dr C. Nerikar, CEO, Cryobanks India, says, “At present, worldwide there are about 75 medical conditions for which stem cell therapy has been used successfully and improvement has been proven.” He adds that many of these therapies are available in India.
Though Dr Suman Kher is still conservative about stem cell research, and does not wholeheartedly recommend umbilical cord blood banking to her patients, she does advise it for those with a family history of haematopoietic diseases such as leukaemia and thalassaemia. In India, since cord blood banking is a recent phenomenon and it is as yet difficult to find actual beneficiaries, one cord blood banking company says there has been a case of a client withdrawing the stem cell for use and they are still awaiting the outcome.
Some storage firms offer discounts to those parents-to-be who have family members suffering from these diseases (see box). Says Dr S.G.A. Rao, CMD, CryoStemcell: “In all those cases where there is a possibility that another sibling will use it, (e.g. in thalassaemia) they would get a discount. However, that is dependent upon the doctor’s recommendation.
The collection process is simple. Once you have enrolled, the cord blood storage company keeps frequent tabs. When they are notified that delivery is about to take place, they send a technician with a collection kit. Either the technician or the gynaecologist does the collection of the cord blood, usually just before the placenta is delivered. The process takes 10 minutes or so. The cord blood and a sample of the mother’s blood are taken immediately to the storage facility where they are processed, tested, separated and cryogenically stored.
Some of the storage companies have already started moving into the next step: solutions. Reliance Life Sciences, for instance, is into stem cell research. According to K.V. Subramaniam, president and CEO, Reliance Life Sciences, “We are developing stem cell therapies for cardiological, neural, ophthalmological and metabolic disorders. Some of these therapies are in the stage of clinical trials.” Meanwhile, LifeCell has announced its plans to set up India’s first exclusive stem cell transplant centre in partnership with Sri Ramachandra Medical Centre in Chennai.
Action is also hotting up with foreign players announcing plans forcord blood banking services in India either alone or through tie-ups with local hospitals or pharma companies.
Later this year, Singapore-based CyGenics (now called CordLife) will open its cord blood bank in Kolkata in collaboration with Strassenberg Pharmaceuticals. Others are waiting for some concrete legislations from the Indian government before venturing in. With legislation on the issue expected—the four existing players are in discussions with the Drug Controller General of India and the Indian Council of Medical Research on this, and some guidelines have emerged—observers in the health-care segment are betting that cord blood banking in the country is all set to take off.
Frequently Asked Questions
When can one enroll?
One can enroll any time during the pregnancy. Early enrolment, however, enables the mother-to-be and her gynaecologist to be prepared well in advance for the process of cord blood collection.
Are there any special discounts?
Cryobanks and Cryostemcell offer discounts to prospective parents who have a documented history of an illness in the family, where a stem cell therapy cure is possible and can offer relief to the family member. LifeCell offers a 5% discount in the processing fee to such cases and, in addition, has corporate tie-ups whereby the company picks up the cord blood storage banking tab of employees. Hindustan Unilever Ltd and Starcom are two such companies. Cryobanks is also finalizing such organizational tie-ups. Reliance Life Sciences offers discounts to Reliance employees.
Who holds the ownership?
The mother is the legal owner of her baby’s stem cells till the time the child attains legal age. In case of a divorce, the father has no rights.
What happens after 21 years?
The ownership passes to the child, who has the option to renew it by paying storage fees annually. Stored at minus 196 degrees, the umbilical cord blood cells can be preserved forever.
You can also shift the cord blood cells to another bank if you feel you are getting a better rate or better services there!
What are the medical conditions for which cord blood stem cell treatments are currently available in India?
According to K.V. Subramaniam of Reliance Life Sciences, “Cord blood stem cells have been successfully tried in haematopoietic diseases like thalassaemia and leukaemia. Their use in regenerative medicine is being developed rapidly—with many research centres coming up in India.
What are the advantages of private banking versus public banking?
The biggest limitation in public banking is of finding matching stem cells. According to Dr C. Nerikar of Cryobanks: “Public banking is similar to the process of voluntary blood donation. Public banking involves banking stem cells from people, which are made available to anyone who is in need of them —for a fee.” Typically, in public banking, the Human Leukocyte Antigen (HLA) typing (a profiling analysis) of all the samples in the bank has to be made available in the public domain and those needing stem cell transplants can check with the registry for a match in the genetic markers.
Private banking guarantees parents that their child, whose stem cells they have banked, would have a 100% match if the child requires them in his/her life time. Further, it has been proven the world over that the chances of stem cell transplants being successful are much higher in related donors than in unrelated donors. It’s also more cost effective when compared to sourcing stem cells from a public bank. Sometimes, the cost of processing the transplant material and analyzing it for genetic markers at public banks — especially those abroad— can run up to Rs 2 lakh.
Are there any public cord blood stem cell banks in India?
As of now, there are no publicly-funded, non-profit public banks as in the US and Europe. However, both Reliance Life Sciences and Cryobanks have public banking services, wherein they have collected samples from voluntary donors, and offer these to needy patients for a fee. There have been periodic reports about the government entering into joint ventures to set up a non-profit public bank.
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