Frequently

Asked
Questions

Questions that you might ask

as you explore the option of
umbilical cord blood stem
cell preservation
Questions that you might ask as you explore the option of umbilical cord
blood preservation:

Umbilical cord blood preservation: An Introduction

1. What is umbilical cord blood?

Quite simply, cord blood is the remaining blood from your baby’s umbilical cord
and placenta after birth. Cord blood is loaded with “stem cells” which are origins
of the body’s immune and blood system and may be the origin of other organs
and important systems in the body. Stem cells are important because they have the
ability to regenerate into other types of cells in the body.

2. What are my options regarding the use of my baby’s umbilical cord blood?
a) Collect and preserve the stem cells from umbilical cord for the potential future
medical benefit of the family
b) Donate the blood for research or use by an unrelated third party - in which
case neither do you incur any cost nor does Asia CRYO-CELL compensate you
for your contribution to cord blood collection and research.
c) Allow the hospital to discard the newborn’s blood

3. What is umbilical cord blood collection?

The procedure of drawing blood from the umbilical cord immediately after the
birth of the baby is called umbilical cord blood collection. It can be performed
with either vaginal or cesarean section deliveries.

4. Why should I have my baby’s cord blood collected and preserved?

Your baby’s cord blood is rich in stem cells normally found in the bone marrow.
Stem cells are the master cells responsible for producing all of the mature cells in
our blood and immune system.
They form:
a) The white cells that fight infection,
b) The red cells that carry oxygen,
c) The platelets that promote clotting and
d) The cells of our immune system.
During childbirth these stem cells can easily be
collected and cryo-preserved in case they are
needed later in life.
5. How can cord blood stem cells be used?
Cord blood stem cells are preferred over bone marrow stem cells (for
transplantation) and have already been used to treat numerous types of
malignancies including certain kinds of leukemia, Hodgkin’s disease and other
types of lymphoma. It has also been used for the treatment of a variety of anemia,
inherited metabolic disorders and deficiencies of the immune system.
For a detailed list of all the illnesses and diseases that can be treated using stem
cells, Please view Cord Blood Banking: an OB’s Perspective (Page 3).

6. What are the benefits of collecting and preserving my baby’s cord blood stem
cells?
Collecting and preserving your baby’s cord blood stem cells is a security blanket
for your baby and immediate family members too. Most importantly, cord blood
stem cells from your baby are a perfect match for your child (in the unlikely event
it should ever be needed) and have a 25% chance of matching a current or future
sibling. Its effective use in the treatment of certain diseases makes it a better and
more efficient option as opposed to bone marrow transplants.

7. In what ways is cord blood stem cell transplantation better or more efficient than
bone marrow transplants?
Cord blood stem cells have a number of significant advantages over other sources
of stem cells (i.e., bone marrow) because,
a) Cord blood stem cell has a high rate of engraftment,
b) It is more tolerant of tissue mismatches,
c) It results in a lower rate of severe graft-vs-host disease (a major complication in
stem cell transplants), and
d) Is rarely contaminated with latent viruses.
e) It is easier to collect
In addition, cord blood is “privileged” or unexposed to most diseases, as opposed
to bone marrow from an adult, which is more difficult to use in transplantation.

8. What is the history of cord blood stem cell transplantation?

Umbilical cord blood stem cell was first used for transplantation in 1988, in
France, for a patient with Fanconi’s anemia. Since that time, cord blood stem cell
has been increasingly used as a substitute for bone marrow in thousands of
successful transplants.

9. How successful are cord blood stem cell transplants?

Cord blood stem cell transplants are known to be as successful as bone marrow in
the cases in which they have been used. Moreover cord blood has other
advantages over bone marrow, including ease of collection and better tolerance of
HLA mismatches.
Stage 1 : Pre natal procedures

10. How many days/months prior to the expected date of delivery do I need to decide
on the collection and preservation of cord blood stem cell?
As soon as possible! It is never too early to start planning for cord blood stem cell
banking. Even before you get pregnant you can register with a stem cell bank.
Once your pregnancy is confirmed it is best to decide as quickly as possible,
whether or not you want to bank your baby’s cord blood stem cell. There are a
number of forms that must be completed by the expectant mother, father and
physician. However, you can decide to opt for this procedure and avail our
services between one to six months prior to the expected date of delivery.

11. Is the collection and preservation of cord blood stem cell expensive?
Yes, but seen in comparison to the benefits, the cost incurred is insignificant. Cord
blood stem cell preservation simply adds an element of protection against some of
the most devastating possibilities that could occur in the future.

12. What if I come across and decide upon this procedure just a few days before the
expected date of delivery?
In the unlikely event that you decide to avail our service just a few days prior to
the birth of your baby, you will have to notify and register with us at least 48
hours before delivery.

13. Will there be any additional fee or surcharge in the above case?
Yes, you will be charged an additional fee towards the express courier, handling
and processing charges as applicable. For further details, refer our section on
tariffs.

14. How do I receive the Collection Kit I need to take to the hospital or nursing
home?
i) Enrollment forms are available on request. Upon enrollment, you will be given
information regarding cord blood collection and its uses.
ii) Two months prior to the expected date of delivery you will be couriered the
collection kit along with instructions for its usage
iii) For parents ordering the Kit between a maximum of 14 days to a minimum of
48 hours before the expected due date, Expedite Service is mandatory, or for
any situation that requires the Kit more quickly than the standard delivery
service, we offer an expedited (overnight) delivery service for an additional
Rs.1000. This fee is also non-refundable.
15. What do I have to do after the Kit arrives, but before we go to the hospital to
have the baby?
i) Your cord blood collection kit comes with a set of unique bar coded labels. As
soon as you receive the kit, stick these labels on the collection bag. Detailed
instructions to this effect are included in the Instruction manual included in
the Kit.
ii) It is very important that you read through all the printed material included
with the Kit as soon as you receive it so that your questions may be answered
before you arrive at the hospital/nursing home to have your baby.
iii) Your doctor or midwife has been mailed the Umbilical Cord Blood Collection
Instructions. For convenience, an extra copy is included with the kit and
should be brought to the hospital/nursing home.
iv) Store the Kit in a cool dry well ventilated place with at an average temperature
of 22 to 25 degrees Centigrade at all times to avoid exposure to temperature
extremes. Do not leave the Kit in your car.
v) Review the Courier Instructions and the Expectant Parent Checklist. Fill out
portions, in advance.
vi) Make sure to take the Kit, and all paperwork to the hospital/nursing home
when the time comes to have your baby.

16. In case I forget to carry the kit to the hospital during delivery, what do I do ?
Firstly, try and obtain the kit from where it is currently stored, that is, your home.
In case this is not possible, please inform the doctor/physician, (overseeing the
birth of your baby) who will have a spare collection kit.
If you do use the spare collection kit available at the hospital, the collection bag
must still have your unique bar code label sent along with the Kit you have
received upon enrollment.
In the eventuality that you have misplaced the original bar code labels given to
you, a spare set of labels will be available at the nearest Asia CRYO-CELL
Collection Centre where have you registered. You may also call us for any
assistance or emergency.

Stage 2 : During Childbirth

17. When and how is cord blood collected during childbirth?

Cord blood is collected from the umbilical cord (after it has been cut and
clamped) immediately after the birth of the baby. This procedure can be
performed with either vaginal or cesarean section deliveries.
Also, maternal blood is collected in a separate tube for infectious disease testing.
18. Is the procedure risky, painful or time consuming?
The entire procedure is completed within ten minutes after the baby has been
delivered. There is absolutely no pain or risk to the mother or child during the
collection process since the blood is harvested from the cord once it has been
clamped and cut.

19. Does it have any side/after effects or other implications?

No. It has no known side effects and other implications.

20. Who will perform the collection procedure?

Your doctor, nurse or caregiver overseeing the birth of your baby can easily
perform this simple procedure.

21. Will the doctor/nurse overseeing the birth of my baby charge a fee for the
collection of the cord blood?
Many doctors/nurses/caregivers charge a fee for the procedure of collecting
umbilical cord blood. We suggest that you discuss this procedure with them prior
to enrolling in our service to verify their agreement to perform the collection; at
that time you may determine their policy regarding a collection fee.

Stage 3 : Post natal

22. What happens after the cord blood is collected?

The cord blood is packaged with the mother’s blood in the special shipping
materials provided in the Kit. The parents then call a courier to arrange for pick
up, delivery and payment of the cord blood to Asia CRYO-CELL’s laboratory
within 36 hours of collection, where it is processed, tested, separated and the stem
cells are cryogenically stored.

23. How soon does the collected specimen have to reach the labs of Asia
CRYO-CELL?
The specimen needs to arrive at our lab to begin processing within 36 hours of its
collection. It should not be refrigerated. The parents should make arrangements
for couriering of the blood to the lab. For the name of a courier company that will
undertake the task of delivering the sample to the labs of Asia CRYO-CELL.
24. How do I notify Asia CRYO-CELL that my baby’s cord blood is on its way to
their labs?
It is necessary to contact us directly after the birth of your baby. Simply tell us the
following particulars to find out if the sample has reached our labs.
i) The mother’s name
ii) Home telephone number
iii) Client ID and
iv) The baby’s date and time of birth.
You will receive written confirmation of lab results from Asia CRYO-CELL within
2-3 weeks of processing, testing and storage.

25. What are the tests carried out on the collected cord blood?
Following tests will be performed on every specimen:
Maternal blood is tested for:
a) Syphilis
b) Hepatitis B&C
c) ALT
d) Malaria
e) Leptospirosis
f) HTLV 1&2
g) HIV Antigen and Antibody
h) CMV.
The collected cord blood is tested for:
a) RH grouping/typing
b) Blood cultures
c) CD 34 counts
This testing regimen determines the infectious disease status and allows the
collected stem cell to potentially be used for “autologous (self) use”. In the event
that any of the infectious disease screening tests is positive, confirmatory tests will
be automatically performed.
The cost for the initial screening tests are included in Asia CRYO-CELL’s fee; the
costs for confirmatory testing, if required, will be billed separately.
Each cord blood sample is also tested to confirm the absence of microbiological
contamination.
HLA typing is not routinely performed at the time of processing but only when
required in the future.
26. Is the mother informed in case any of the tests performed on her blood sample are
positive?
Yes, the mother will be informed and suitable action will be taken.

27. What is the technique used to process cord blood and separate the stem cells for
preservation?
We use a density gradient separation process. This technique depletes the red
blood cells and plasma, isolating the mononuclear white blood cell fraction, which
contains the stem cells.

28. When and where are these tests carried out?

These tests are carried out in our labs after the arrival of the samples from your
hospital or nursing home.

29. Where will the collected cord blood stem cell be preserved?
After the testing is performed, the stem cells are treated with DMSO, the
cryoprotectant, and stored in special cryovials with autologous plasma and sterile
media at our lab in Keelakotaiyur in Tamil Nadu.

30. For how long can cord blood stem cell be preserved?
It is believed that stem cells can be successfully stored long term, perhaps decades,
in a cryopreserved form.
A recent study of cord blood stem cell at the University of Indiana demonstrated
its viability after 15 years of cryogenic storage. Bone marrow has been stored for
decades and has remained viable; there is no reason to believe that the same
would not be true of cord blood stem cell.

31. How will I know that my baby’s cord blood will not be mistaken for some other
baby’s cord blood during collection or at the preservation centre?
The moment you register for umbilical cord blood stem cell preservation you are
given a registration number and the bag with the kit is given a unique ID number
on a bar coded label. When your baby’s cord blood arrives at our laboratory it is
checked against the number allotted to you on the computer before separating the
stem cells and cryo preserving them for long-term storage.
Also, as the testing, sorting and storing process is almost completely automated
the chances of your baby’s cord blood stem cell being mistaken for another is
negligible.

32. Who controls the use of the preserved cord blood stem cell?
Until the child is of legal age, the parents, as the child’s guardians, have control
over the stem cells. No stem cells will be released by Asia CRYO-CELL without
the parents consent initially and later the child’s consent once they reach legal age.
33. Who can use the preserved cord blood?
The preserved cord blood stem cells are, of course, available as a perfect match for
the child from whose umbilical cord they were collected. Because there is a 25%
chance of a perfect match with a sibling, parents may choose to make the cord
blood available to siblings or other family members who may need them. That
decision is theirs alone.

34. Is there a cost to retrieve my newborn’s cord blood stem cell if needed in the
future?
No. Since you own the preserved specimen, there is no charge for retrieval. There
is, however, a shipping and handling fee, as the specimen would require transport
in a special container to the transplant location in order to maintain cryogenic
temperatures.
When you require the preserved stem cells, all you have to do is contact us. When
the appropriate documentation is in place, your baby’s stem cells will be given to
you in the shortest time span possible.

Asia CRYO-CELL and you:

35. Should I opt for this procedure?

That is a decision you must take.
The decision to bank your baby’s stem cells is an important one and can only be
made by you, the parents.
If you think you might look back and regret not having saved your baby’s stem
cells or feel that you want to take advantage of emerging new therapeutic
approaches utilizing stem cells, or you simply want peace of mind, then you
should certainly consider banking your baby’s umbilical cord blood stem cells.
To further explore this unique opportunity of saving your baby’s umbilical cord
blood stem cells, please visit us or contact us, and our friendly staff will walk you
through our simple registration process.

36. Why should I trust Asia CRYO-CELL when I opt for this procedure?
Asia CRYO-CELL is committed to providing superior customer service and the
highest quality standards for its service. Our mission has always been to offer this
important medical technology service to expectant parents with the highest quality
and value.
Additionally Asia CRYO-CELL has a Licensing and Technology agreement tie up
with CRYO-CELL International.,Inc,US. [An organization accredited by the AABB
(American Association of Blood Banks) and registered with the FDA] gives us an
edge over other organizations offering the same service.
37. Am I in safe hands with Asia CRYO-CELL?
Asia CRYO-CELL employs only qualified personnel and uses the best equipment
and processes available in order to process, test and preserve your baby’s cord
blood stem cells. Overseeing our program is an impressive Clinical Services
department staffed by nurses and working round the clock to answer your
questions or the questions of your clinician.
Asia CRYO-CELL Private Ltd.
Corporate Office
5 Vivekanandha Road, Srinivasa Nagar
Chetpet, Chennai 600031
Tel: 9841028180 / 9884034562
[email protected]
www.cryo-cellasia.com