Cord Blood and Medical Misinformation: The Big Business of …

Stem cells have become in the past four decades a promising potential medical treatment for certain health problems, though their application remains limited. Scientists have identified various types of stem cells. They function in different ways, although these variations are often conflated in the popular understanding of their role in medical treatments. For the purposes of this case study, it is important to clarify the major distinctions and applications of two types of stem cells: embryonic and perinatal stem cells.

Embryonic stem cells, which come from human embryos, are the most flexible. They have not yet been fated, as scientists put it, to become a specific cell. In their embryonic state, they have the ability to mature into any type of cell in the body. This is called pluripotency. Embryonic stem cells offer promising medical applications for heart disease and diabetes, and research into them continues.

Perinatal stem cells come from birth tissues such as the placenta, amniotic fluid, the amniotic membrane, and the umbilical cord. Of these there are two main subtypes: Cells from the umbilical cord, called cord blood stem cells, which are described as hematopoietic because they have the potential to become blood cells; and amniotic stem cells, which come from other birth tissues and are less well-understood. Amniotic stem cells are believed to have the potential to become bone, fat, and cartilage cells.

The different types of stem cells have specific applications in science and medicine. Embryonic, amniotic, and cord-blood stem cells are not interchangeable in existing treatments, and using one stem cell type where another is called for would be at best useless and at worst dangerous.

This case examines the marketing of perinatal stem cells as a kind of "miracle" medical treatment.

To acquire perinatal stem cells, birth tissues like the placenta, amniotic membrane, fluid, and umbilical cords are processed and stored after births for future use. Because cord-blood transplants have been used for decades, many hospitals offer programs for people giving birth to donate umbilical cords to public banks, which store cord blood for potential blood transplants. Those banks are the only hematopoietic stem cell source to be regulated by the U.S. Food and Drug Administration [(FDA)].

There are also private banking options accessible only to the donors family. Private cord banking is marketed to pregnant people as a potentially life-saving future treatment for their children. Some of these banks hold both cord blood stem cells and amniotic stem cells.

Cord blood stem-cell transplants are of limited use, and rare. For a family to use their privately stored cord blood, they first need to know whether there is a sufficient amount of it and whether the ailment is treatable by a cord stem cell transplant. There are about 70 diseases, including leukemia, lymphoma, and sickle-cell disease, that are treatable. The use of amniotic stem cells is even rarer, and there is no known approved treatment that uses them.

Private banks process and freeze birth tissues without testing, and store it regardless of viability. If the umbilical cord blood does not have enough stem cells (a problem affecting about 75% of donated cord blood), it is used for research, discarded, or sold.If a person giving birth has opted not to donate or store their birth tissues, hospitals that are not affiliated with any public cord banks can choose to sell those tissues.

Sales of umbilical cord blood led to a dangerous industry: umbilical cord tissue therapy.These therapies are not FDA approved.

David Greene and his stem cell therapy empire, which uses perinatal stem cells in unapproved treatments, is one example of this problem. Greene tells his clients that the stem cells his clinics use can morph into whatever the body needs, creating a wide yet scientifically unproven market for the product he offers.

The nuance in types of stem cells (umbilical cord, amniotic, embryonic, marrow, etc.) and the still-developing research around their potential therapeutic value makes the topic confusing for people outside science and health care.

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Cord Blood and Medical Misinformation: The Big Business of ...