What sustains in utero could heal later
Purchase lab gathers and stores umbilical cord blood
BY JOHN GOLDEN

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., company 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.

A specialist in male infertility and male and female sexual dysfunction, Dr. Werner also operates three other businesses and employs about 24 persons in the Purchase office building. They include his private medical practice; the Medical Center for Female Sexuality and MA.Z.E. Andrology Laboratories, which performs 1,500 to 2,000 semen analyses yearly and processes and banks sperm for the tri-state medical community.

“I have the freezing capacity and I already had the OBs, so it was really a natural to go into this” cord-blood banking, Werner said, referring to his medical practice. “I got interested in it four or five years ago because it seemed like the uses of it were expanding.”

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.

When launching the business, “We made a decision not to do the marketing that other companies do, spending millions of dollars in advertising,” said Anne Young Albanese, M.A.Z.E. director of marketing. “There is a lot of word-of-mouth. We do work a little bit with local OBs. We also tend to work by niche marketing.”

The company’s primary marketing niche is Westchester County with its affluent, educated population. At this stage, private cord blood banking is not covered by health insurers and can be an expensive choice for parents, Albanese noted. Many in the larger population cannot afford it.

“We have to pick places where children are central and where there’s money,” Werner said. “The demographics of who are having babies are many times the people who can’t afford it.”

M.A.Z.E. also offers a gift registry for expectant parents who have chosen to store their child’s cord blood. “We’ve had grandparents pay for it,” Albanese noted. Some of those grandparents have been Werner’s patients.

A corporate OK

M.A.Z.E. Cord Blood Laboratories has partnered with NeoStrata Company Inc., a medically based dermatological company in Princeton, N.J., to bank the cord blood of newborn infants of NeoStrata employees at the company’s expense. Company officials said the added employee benefit was a way to create a “family-friendly culture” that encourages colleagues to return to work after maternity leave.

In Albany this month, Gov. Eliot Spitzer signed legislation that provides for the donation of umbilical cord blood for stem cell collection and storage for public or private use and requires physicians to inform pregnant patients of those options prior to the onset of labor. The law also requires the state Department of Health to conduct a public awareness campaign about cord blood banking and maintain quality ratings on blood banks.

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 results of about 500 stem cell transplants in children with genetic and hematologic disorders indicated that the one-year survival rate may be as high as 73 percent for sibling blood matches but only 29 percent for unrelated donors, according to the APA.

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.

The APA’s position has not slowed the growing business in private cord blood banking, which Albanese said has doubled every year in the last few years and is expected to do so again. “Most of our patients tend to feel that it is possible that the cord blood could be needed,” she said. “You don’t want to take a chance with your kids.”

For Lisa and Mark Gilbert in White Plains, storing their four children’s cord blood “is kind of like insurance,” Lisa Gilbert said. “It’s not something that we think about.”

In 1998, the Gilberts, with an obstetrician’s recommendation, researched what was then a largely unknown subject to most parents prior to the birth of their first child. Their first three children’s cord blood was collected and stored by a Florida-based company. They learned of M.A.Z..E’s local services just before the birth of their fourth child in October 2005.

“In my mind, it provides a certain level of comfort in the way that insurance does,” said Gilbert, an architect who works from her home while raising their children. “It’s risk management, I guess.”

Given the simple collection of blood at childbirth, “It’s a no-brainer,” she said. “It was, why not?”

For parents, “It’s a no-brainer, but it’s very expensive,” said Werner. And free public cord blood banks, which are limited to specific hospitals and are less likely to store blood matches for patients of some ethnic backgrounds, at present do not meet the needs of American society, he said. “Right now, I don’t see any issue between the coexistence of the public and the private banks,” he said.

“I don’t know how the price can come down,” Werner said. “But I think as the science becomes more developed, this will prove to be more and more useful. The more useful it is, the more worthwhile it is.”

“There is a small chance that they’ll come out with a different group of cells that are more useful” than umbilical cord blood, he said. “But this is the best we have right now.

Economically, I’m kind of banking on it being useful.”

 

 

 

 

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