Life Bank Vs Lottery Ticket of Slim Chance to Win

About ten umbilical cord blood banks are engaged in cutthroat competition. One of them already started to run TV ads and others are waging a war for sales promotion using other various media. Why? This is because the business is likely to produce huge profits. The industry estimates that these banks store 15-20% of all newborn babies’ umbilical cord blood. Against this backdrop, it is a matter of time for the industry to grow as a 300 billion won industry. However, a lot of experts cast wary eyes on this.

These banks extract and freeze 80-150cc of hematopoetic stem cells from umbilical cord blood and later these cells can be transplanted when the child or the family suffer from diseases like leukemia. At present, it costs as much as 8 million won to buy umbilical cord blood while it costs only 1-1.7 million won to store the blood at such banks. Umbilical cord blood transplants started as umbilical cord blood proved to have hematopoetic stem cells, which had been believed to be included only in the marrow. This umbilical cord blood is transplanted usually for children because this blood has only a small number of hematopoetic stem cells.

Companies storing umbilical cord blood explain that patient bodies tend to perceive blood of donors as enemy and attack it after the transplant of umbilical cord blood.

For patients to get marrow transplant, most of six human leukocyte antibodies (HLAs) attached to cell walls, which serve as identification codes used to detect ours vs. theirs, must be matched. The umbilical cord blood transplant, however, requires only four matches of the HLAs. Since it is hard to get marrow to be transplanted, companies store umbilical cord blood to save lives of family members just in case.

“Umbilical cord blood transplant can be a powerful tool in the war with leukemia given the fact that more than a half of patients die while searching for marrow donors,” pointed out Prof. Kim Don-wook at Catholic University Medical Center. “The effects of the surgery, however, are too exaggerated.”

Many doctors argue that there are too small chances of using umbilical cord blood stored for later time, comparing it as medical `lotto.` Umbilical cord blood transplant is only available for those children suffering from leukemia, pernicious anemia, neuroblastoma and some hereditary diseases.

Theoretically, only 7 to 8 out of up to 100,000 patients will be qualified for the transplant. Yet, given that some 60 to 70% of little leukemia patients can get cured only with chemotherapy, there seems to be no need for umbilical cord blood transplant. If umbilical cord blood is not properly store, it cannot be used for a transplant operation.

“Just as marrow transplant first started with leukemia treatment and is now used for cancer, rheumatism and multiple sclerosis, the range of umbilical cord blood transplant will also expand,” said Banks of umbilical cords.

Some of banks of umbilical cords also insist that umbilical cord implantation is a way better advanced treatment method than marrow transplant and stem cells in the blood of umbilical cords will be able to treat diseases in the future.

Professor Kim, however, said, “Umbilical cord implantation has lower success rate than marrow transplant and applicable patients are narrower.”

So far, 900~1,000 patients go thorough marrow transplant while only 50 patients have been through the umbilical cord implantation since its introduction in 1996. The umbilical cord implantation was developed in 1988. Also patients who gets umbilical cord implantation recovers slower than the patients of marrow transplant and stem cells of the implantation have lower chance of multiplication in the patient`s body and higher chance of recurrence. Only 50% to 60 % of the umbilical cord blood implanted children in Korea have lived over one and half years, Professor Kim said. Meanwhile, 70 to 80 % of the marrow transplanted patients survived over 5 years. “Whatever it is, regardless it is umbilical cord implantation or marrow transplant, existing methods almost kill patients before they do any good for the patients. They all have to be eventually disappeared when effective anti-cancer drugs become easily and readily available. It’s obvious that the use of the blood of umbilical cords will decrease,” said Kim Byung-soo, professor at Department of Internal Diseases at the Korea University Hospital. “In the future, it is effective to use stem cells in the marrow rather than in the umbilical cord blood when treating various diseases by injecting stem cells into a certain organ,” explained Kim Yeol-hong, professor in the same university hospital.

Banks of umbilical cord blood claims that they can keep the blood for 15 years.

However, there is a controversy over whether the umbilical cord blood can be used in the actual transplant in five years despite a treatise that it can be kept for 15 years.

“When it comes to the marrow, the stem cells could deteriorate after two years. So we discard the cells after five years,” said Professor Kim. “But the safety of the umbilical cord blood can’t be proved after five years. So doctors are very likely to refuse to transplant the stem cells,” he added. Oh Il-whan, a professor at Catholic University, said that the management of collecting, keeping, and using the stem cells from the umbilical cord blood is extremely poor at the present. Also, if the companies go under, there is no way that victims can receive compensation. Moreover, there are no countermeasures against the medical accidents when damaged stem cells from the umbilical cord blood are transplanted.

Seong-Ju Lee stein33@donga.com