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Aishwarya Rai Bachchan, unveiling the stem cell company Lifecell and stem cell preservation advertisements having a tag of INR 19999 had made many think that stem cell preservation had finally become affordable for the middle income group. But the truth is different from the ad.
Also, there are about 5-6 companies (LifeCell, Reliance Relicord, Cryo Stemcell, Cryobanks, Stemcyte to name a few) in the market vying for this small market segment. The information available online are not to the point and are a source of confusion for many. The amount of blood collected will have an influence on the amount of cells. However, when you go to use the cells, the cells have to have been extracted from the plasma and red blood cells. The processing method of the cells determine how many cells are available for use, as different methods will produce different results.
As for accessing cells, there are two types of transplant autologous(requiring one’s own cells) and allogeneic (using someone else’s cells). If you need the cells for an autologous transplant, you cannot go to a donor bank for a sample. The treatments with the highest likelihood of use currently all require autologous transplants.
NHS, UK does it by default in the west. Hoever, it is different – they store the cells in a public bank from where anyone else can take the cells as well and your child can take someone else’s cells and chances are high they will be used before “expiry” i.e the 26 years promised. In all cases the facility is provided free, the user of the cells (not the donor) has to pay at the time of use. This is not the advertised case in India.
There are two kinds of techniques used for storage: Plasma Depletion and Plasma + Red Cell Depletion. Plasma Depletion only removes the Plasma. Red Cells must also be removed before transplantation. Hence, red cell depletion process has a better recovery of stem cells and provide better samples. If you only remove the plasma prior to storage, you may have more stem cells being stored at the time of storage. However, when you release the cells for transplant, you have two issues. RBC’s have a tendency to rupture during cryogenic storage. You therefore have to wash samples of the RBC’s prior to transplant. With a higher volume of RBC’s in samples that are only plasma depleted, you will lose more stem cells during the washing process. When you are trying to find the highest possible yield, you want to look at RBC depleted samples.
When a bank states that they will find other sources, the question to ask is does finding a sample include the cost of the sample. Most donor samples are not free to retrieve and have very high cost involved. One more thing to note is if they are searching only their own database or they search a public database too.
Most cord cell storage banks test for viability before storing and will not charge if they are not able to store a viable sample. If the sample is not viable on release, then the bank should take on some liability in regards the sample they stored. This should be included as a part of the agreement and you have to read the agreement prior to joining and clarify all questions you might have. Some companies provide unto 6 lakhs in case of a future transplant and 10 lakhs if they cannot provide you back with a viable sample. Some companies like Stemcyte India have plans to cover siblings and parents as well. Lifecell offers a yearly payment plan with a initial joining fee of INR 19999 where as Stemcyte offers a 21 year plan for INR 75000 and 26 year plan covering siblings and parents for 1.5 lakhs. They provide you a kit which you need to carry at the date of delivery to collect the samples. Sometimes in hospitals like Apollo where Stemcyte India has a tie-up, the doctor doing the delivery will collect it. If the hospital does not have a tie up, Stemcyte India will send a collection nurse to the hospital.