Thursday, July 13, 2006

StemLife: International Journal of Biotechnology Publication

There is a certain sense of surprise and delight that comes with knowing that one's organization is recognized and mentioned in international publications.

I came across a link to a paper entitled "Regenerative Medicine: New Opportunities for Developing Countries by Greenwood et al" whilst browsing the University of Toronto's website.

Initiated by Heather Greenwood for her Masters thesis under the guidance of Professor Daar and collectively written by 4 authors of various backgrounds but clearly a keen interest to understand where this area of medicine is heading, they have compiled an interesting summary of what's going on in the developing world with respect to stem cell therapy. Most of the data seems to have been obtained from the internet search engines (Google acknowledgement) and is taken more or less at face value as an indication of what is available in the country (ranging from Argentina to Uganda). Their research was probably conducted in 2005 for this early 2006 publication, but I hope they'll consider updating it every year and possibly include some interviews on what impact the work being done locally has had on patients in each country or their surrounding neighbours and the successful implementation of each project (announcement can be many, but so can the lack of forward momentum).

Gajen and James, you're welcome to drop me an email or call if you get another go at the document. StemLife has lots of updates on the social impact that stem cell therapy through our organization has had in Malaysia. Unlike other banks which have a heavy commercial slant and approach to their clientele, we believe in offering value added services and, very importantly, a more personalized and human touch.

Click here to download a copy of the publication.

Tuesday, July 11, 2006

StemLife for Malay Readers: Director of Operations explains Cord Blood Stem Cell Banking

Not that long ago, one of my colleagues provided an interview to a local Malay news daily known as the "Berita Harian" (The Daily News). I thought it might be nice to share it with any of our readers who prefer to view it in the local language. The article largely refers to the umbilical cord blood side of our services but touches on the salient points. There isn't too much on the web on this topic in Malay, so it falls on StemLife's mantle to disseminate information in this medium.


Kesihatan Anak: Darah tali pusat penawar ajaib
Oleh: HAFIZAH ISZAHANID

Berpotensi merawat lebih 70 jenis penyakit termasuk barah darah, penyakit jantung, kecederaan saraf tunjang dan parkinson

SECARA tradisi, tali pusat bayi yang baru dilahirkan akan diserahkan kepada bapa untuk dibasuh sebelum ditanam. Berdekad lamanya, tiada siapa mengetahui keistimewaan darah dari tali pusat dan keupayaannya sebagai penawar ajaib untuk lebih 70 jenis penyakit.

Hanya kira-kira 20 tahun lalu, saintis dan penyelidik mendapati, darah tali pusat mengandungi banyak sel dan satu daripadanya sel stem. Pada 1988, sekumpulan ahli perubatan Perancis berjaya melakukan pemindahan sel stem bagi pesakit Fanconi Anemia.

Di Malaysia, sejarah tercatat sekitar 1997 apabila Hospital Universiti (ketika itu) melakukan pemindahan sel stem darah tali pusat kepada seorang kanak-kanak pesakit talasemia major. Sel stem berkenaan didermakan adiknya yang baru dilahirkan.

Bagaimanapun sejarah itu tidak banyak kesannya kepada penduduk Malaysia secara keseluruhan. Dalam satu kajian rambang di kalangan penduduk Lembah Klang baru-baru ini, hanya 42 peratus responden tahu mengenai darah tali pusat. Jika dibandingkan dengan negara luar, Malaysia sebenarnya agak ketinggalan dari segi kesedaran dan kemudahan penyimpanan darah tali pusat.

Selain Pusat Darah Negara yang menubuhkan Bank Darah Tali Pusat pada 2002, yang menyimpan darah tali pusat untuk kegunaan awam; hanya ada dua bank darah swasta menawarkan perkhidmatan ini. Satu daripadanya StemLife Bhd yang sudah beroperasi sejak empat tahun lalu.

Pengarah Operasi StemLife Bhd, Zahrein Redza, berkata sehingga ini walaupun mereka memiliki 6,000 pelanggan, kebanyakan mereka bukan Bumiputera.

“Kesedaran Bumiputera untuk menyimpan darah tali pusat bayi masih rendah. Mungkin maklumat tidak sampai atau mereka tidak tahu ‘keajaiban’ darah tali pusat kerana jika diambil kira dari segi kos, menyimpan darah tali pusat hanya berharga RM250 setahun,” katanya.

Dari segi perubatan, tubuh manusia memiliki 200 jenis sel seperti sel hati, sel lemak, sel saraf dan sel kulit, tetapi setiap sel ini bersifat tersendiri. Sel kulit tidak boleh menjadi sel hati begitu juga sebaliknya.

Sel stem adalah sel ‘kosong’. Ia memiliki keupayaan untuk terbahagi dan menghasilkan lebih banyak sel ‘kosong’ dan merangsang pembentukan sel-sel lain seperti sel darah merah dan sel darah putih. Keupayaan itu menjadikannya sangat istimewa.

Sel stem dewasa berbeza dengan sel stem bayi. Sel stem matang bersama usia justeru menyimpannya dengan teknik yang betul, mampu mengelakkannya ‘matang’ dan berupaya menyelamatkan bayi atau ahli keluarganya di masa hadapan.

Dari mana datangnya sel stem embrio? Manusia memulakan kehidupan sebagai sel tunggal yang dikenali sebagai zigot. Sel ini boleh terbahagi dan membentuk dua sel. Dalam tempoh lima hari, pembentukan ‘blastocyst’ terjadi. ‘Blastocyst’ lebih kecil daripada pasir dan mengandungi dua sel, ‘trophoblast’ dan ‘inner cell mass’. Sel stem embrio adalah sel yang membentuk ‘inner cell mass’.

Apa perlunya menyimpan darah tali pusat? Lebih 70 jenis penyakit berpotensi dirawat menggunakan darah tali pusat. Antaranya barah darah, penyakit jantung, kecederaan saraf tunjang, parkinson dan jumlah itu bertambah dari saban tahun.

Zahrein berkata, di Malaysia penyakit talasemia major semakin meningkat. Malah dianggarkan 4.5 peratus penduduk Malaysia adalah pembawa.

“Keperluan pemindahan darah sangat mendesak untuk pesakit talasemia major. Tetapi mungkin mereka akan bertemu penawar yang mujarab jika pesakit atau ahli keluarga terdekatnya ada menyimpan darah tali pusat,” katanya.

Darah tali pusat yang disimpan tiada tarikh luput. Selagi teknik penyelenggaraannya betul (disimpan dalam nitrogen cair dengan suhu beku - 196 darjah selsius) ia sentiasa berupaya menjadi penawar kepada bayi. Jika mungkin bukan bayi itu yang memerlukannya, ayah, ibu atau adik beradik kandungnya yang berhadapan dengan penyakit kritikal masih boleh mengambil manfaat.

Begitupun, keberkesanan darah tali pusat terhadap saudara jauh atau individu di luar keluarga berkenaan bergantung kepada keadaan penyakit yang dihidapinya. Darah tali pusat yang datang dari bayi yang berhadapan dengan penyakit tertentu seperti sindrom down hanya boleh digunakan terhadapnya saja.

Keberkesanan pemindahan darah tali pusat juga bergantung pada ‘keserasian’ penderma-penerima, jumlah sel stem yang ada dalam darah tali pusat dan tahap penyakit yang dihidapi seseorang.

Zahrein berkata, di StemLife kos penyimpanan darah tali pusat pada kadar RM2,500 untuk proses pendaftaran, ujian, pemprosesan dan penyelenggaraan manakala RM250 untuk tahun kedua dan seterusnya. Jumlah itu katanya, lebih murah jika dihitung dengan harga segelas teh tarik yang dinikmati rakyat Malaysia saban pagi.

Jenis Sel Stem

a) Sel stem totipotent boleh menjadi apa saja jenis sel dalam tubuh termasuk placenta.

b) Sel stem pluripotent - terhasil dalam tempoh empat hari selepas proses penyuburan boleh menjadi apa saja jenis sel termasuk sel stem totipotent dan sel placenta.

c) Sel stem multipotent warisan daripada sel setm pluripotent dan sel lain dalam tisu.

d) Sel progenitor boleh menghasilkan satu jenis sel.

Penyakit yang boleh dirawat menggunakan sel stem

* Barah darah
* Penyakit darah (talasemia)
* Penyakit metabolik
* Keimunan
* Jantung
* Diabetes
* Parkinson

Mengapa perlu menyimpan sel darah tali pusat anak anda?

* Ia adalah aset biologi yang berpotensi menyelamatkan nyawa bayi atau ahli keluarga.

* Proses pengumpulan darah tali pusat tidak invasif, tidak menyakitkan dan tiada risiko pada ibu dan bayi

* Berbanding sel stem daripada sum-sum tulang dewasa, sel stem darah tali pusat lebih mudah diterima badan dan mempunyai risiko penolakan yang rendah

INFO:

Jika dibandingkan dengan pengambilan sel stem tulang sum-sum, proses pengambilan darah tali pusat tidak menyakitkan dan tiada risiko untuk bayi dan ibu. Ia hanya memakan masa lima minit selepas bayi dilahirkan.

Sel stem darah tali pusat tidak memiliki tarikh luput, boleh diwarisi asalkan disimpan dengan teknik yang betul. Ia lebih bagus daripada sel stem tulang sum-sum kerana tidak terdedah pada kuman (kerana diambil sebaik saja bayi dilahirkan) berbanding sel stem tulang sum-sum.

Jika anda ingin menderma sel stem darah tali pusat bayi anda, sila berhubung dengan Pusat Darah Negara. Sekiranya ingin menyimpannya untuk kegunaan peribadi ada dua bank swasta yang boleh anda hubungi.

Saturday, July 08, 2006

Heart Muscle Stem Cells Update: The Gary Schaer Trial

I blogged about the Schaer trial before but here's an update that tells us that the recruitment for the trial is almost complete. Its exciting because it will be the first trial for heart disease to use allogeneic bone marrow derived stem cells- ie from a healthy young donor and not your own. It'll be interesting if the whole concept of HLA matching goes away for anything apart from whole bone marrow transplants for cancer or blood disease.

Dr. Schaer: how is Reverend Eugene Carter doing? :)


BACKGROUND: According to the National Institutes of Health, coronary heart disease is the number one cause of death for men and women in the United States. It's caused by a narrowing of the coronary arteries that supply blood to the heart and often results in a heart attack. About 1.1 million people have a heart attack every year in the United States. Nearly half of those are fatal -- with death occurring within one hour of the start of symptoms before the person ever reaches the hospital. Pre-existing heart diseases can increase the risk of having a heart attack. Your age also ups the ante. Heart attack risk increases in men after age 45 and after age 55 in women. The risk factors for a heart attack that are within your control include smoking, high blood pressure, high cholesterol, being overweight, a sedentary lifestyle and diabetes that is not well-controlled.

FIXING THE DAMAGE: Currently, there is no way to fix the heart muscle once it's been damaged by a heart attack. Gary Schaer, M.D., from Rush University Medical Center in Chicago, says, "What happens in a heart attack is that part of the heart muscle dies and essentially becomes a scar and none of the muscles supplied by that artery function anymore." The earlier a heart attack is treated, the less damage will result. But time is of the essence. Many times, patients do not present to the hospital right away. The longer they wait, the more damage is being done to their heart muscle. Dr. Schaer says, "Once it is dead, it does not come back. The heart muscle doesn't have any great ability to repair itself once it has been damaged." But new science may soon change that…

RE-GROWING HEARTS: Researchers at about 16 sites across the United States are involved in a study on adult donor stem cells to repair the heart muscle after a heart attack. Stem cells are premature cells that can grow and develop into a variety of different tissues. In the study, patients are infused (through a simple IV line) with either adult donor stem cells or a placebo. They are infused between three and nine days after they have a heart attack. Dr. Schaer says, "The theory behind using stem cells to help patients that have had a recent heart attack is very simply to try to repair the part of the heart muscle that has been damaged by that loss of blood supply." When the stem cells are infused, they hone in on the damaged area of the heart muscle and go to work repairing it.

A PROMISING FUTURE: Earlier studies have shown promise for stem cells to treat heart failure by improving the heart's pumping ability. Those studies have used the patient's own stem cells, which were extracted from their hip bones. Dr. Schaer says the use for donor stem cells to treat heart attacks is the next frontier. The benefits of using donor cells are many. One, they are ready right away, and there is no need to perform any procedure on the patient to extract his/her own stem cells. Two, a single donor could supply enough stem cells to help an endless number of people. The donor's cells are taken and multiplied in a lab where they are then frozen for future use. Three, the donor stem cells come from a young, healthy adult. Dr. Schaer says, "These healthy young stem cells may be more efficacious. They may be more able to … help restore the heart muscle pumping function [than the patient's own stem cells]." Dr. Schaer says there is no risk of rejection with donor stem cells as the cells are too premature to trigger rejection. He says, "The promise of stem cells is the promise that these cells could be given to grow new parts of the body that have been damaged." At this time, results of the study are not known as the study is still ongoing. Recruitment for the study is nearly complete.

Wednesday, July 05, 2006

Back Surgery: Healing improvements with Adult Stem Cells


In relative discretion, articles like this one make me think that stem cell work is going on for patients all over the US and it doesn't have to be classified as a clinical trial, especially if there isn't much risk with the route of administration and the cells are the patient's own.

Hailed as a new technique, an orthopaedic spinal surgeon Dr. Robert Johnson at San Antonio's Methodist Hospital performed a surgical procedure for a 66 year old patient who suffered from disc degeneration and arthritis which has led to a narrowing of his spinal canal- leading to nerve compression and consequent debilitating back and leg pain.

The procedure involved the fusion of 3 vertebrae in the patient's back and placing in stem cells which will help the spine to fuse successfully (like a bone graft, but its constructed by stem cells). The stem cells are obtained from the patient himself, from the bone marrow where a large-bore needle is inserted into the patient's pelvis and 2 large syringes of marrow are extracted. The marrow is spun in a centrifuge to obtain the stem cells, which are then soaked into a synthetic, spongy collagen pad and placed on the vertebra to aid grafting of the cells onto the bone (which might otherwise float away).

It is already well known that stem cells originating from bone marrow have the capability to form blood, nerve and bones. The doctor is harnessing this knowledge to help his patients recover faster and hopefully, better. The doctor is optimistic that the stem cells will provide reliable and consistent fusion and reduce the chances that the patient will require future surgeries (nice!). He also notes that since it is the patient's own cells, the likelihood of problems is small and the operation itself is straightforward for him.

Given that the surgeon has already performed this procedure on more than 30 patients in the last 3 months, I think that this is interesting work and should be continued. 3 months of follow-up on the patient's condition is significant. If the healing is improved then it would be great if the doctor would share the technique and which brand of collagen pad he is using.

It would be great if we could use the collagen pads for other types of surgeries too, where stem cells need a little help to stick to the site of injury.


Dr. Johnson's Bio and Contact Details are as follows:

ROBERT G. JOHNSON, MD
DR., Orthopedic Spinal Surgery

Office:
4410 Medical Dr
Suite 610
San Antonio, Texas 78229
Phone: 210-614-2453
Fax: 210-614-4907


Status: Active
Facilities: Methodist Hospital
Organization: Neurosurgical Associates of San Antonio, P.A.
Medical school: University of Toronto, Toronto, Ontario, Canada
Internship: St Michael's Hospital, Toronto, Ontario, Canada
Residency: University of Toronto, Toronto, Ontario, Canada
Board-certified: 1986
Gender: Male
Memberships: American Academy of Orthopaedic surgery, American College of Surgeons, North American Spine Society, TMA, Bexar County Medical Association, Physicians Who Care
Special practice interests: Spine
Insurance accepted: Most Medical Insurances accepted, please call office to verify.
Additional languages spoken: English, Spanish

Tuesday, July 04, 2006

Help me, Obi wan Kenobi; you are my only hope


What does Star Wars have to do with Stem Cells? Well, not much except that when I read this article, the title reminded me of a plea from Princess Leia and that a stem cell transplant is very much like an internal war in all parts of the body.

I've already reviewed stem cell transplants extensively in this blog, but I thought this article was interesting as it highlights some of the important points in stem cell therapy:


The Function of the Bone Marrow: Home of Stem Cells in the Body

"Bone marrow's the factory that makes blood. It's also where all kinds of mistakes can be fixed. It may even cure some people who have cancer, aplastic anemia or other life-limiting conditions. Manipulation or replacement of marrow may combat auto-immune disorders like multiple sclerosis or rheumatoid arthritis or fix genetic metabolic defects."


Why your Stem Cells are your very own Obi wan Kenobi

"You may be your own best match, depending on why you need a transplant. Self-donation, called autologous, is most often used when cancer responds to chemotherapy. Some of the patient's stem cells are removed, then the patient receives even stronger doses of chemotherapy (which kill marrow, along with the cancer). Then the stored marrow (stem cells) is returned. It requires functioning stem cells to do the job, though.
With self-donation, doctors may collect enough stem cells for as many as three transplants, before allowing the rest of the marrow to be destroyed."

StemLife provides adult stem cell collection and banking services. We have banked and released peripheral blood stem cells for adult patients with cancers, heart disease and diabetic foot ulcers. In the case of cancers though, most patients utilize all of the stem cells, whilst in heart or diabetic foot ulcers, it does depend on the individual's condition and there may be sufficient cells for two or even three doses.

Interested patients are invited to give us a call anytime to discuss the possibilities of stem cell therapy for their own condition. Reach us at 603 2163 8800 or call our hotline at 6012 2050165 (24 Hours).

Monday, July 03, 2006

Another wonderful Lupus story, patient saved by a stem cell transplant

Since the announcment that stem cell transplants can be performed successfully for lupus at Northwestern University Hospital, it looks like they'll announce each case as they proceed. I think that's a great way to keep everyone up to date.

In this latest story, a patient by the name of Edjuana Ross suffered the serious symptoms of lupus which include immune system failure, severe joint pain, facial scarring, heart damage and three strokes. Her medication of cortisone (steroids) caused her to put on more than 100 pounds which would probably have caused other complications. Her doctor, an immunotherapist by the name of Dr. Richard Burt recommended an adult stem cell transplant to fix her immune system.

Ms. Ross underwent mobilization by GCSF to harvest her stem cells, then chemotherapy to destroy the existing immune system and the transplant by her own stem cells to "reboot" her immune system.

Half the patients who have undergone the procedure are now lupus free and patients like Ms. Ross say that it has changed their life and removed their suffering. She has also slimmed down, which I am sure does a great deal for her own self confidence.

Whilst there are risks to transplantation, like the possibility of infection, or sterility (unable to concieve), with all the suffering that these patients go through, I just wonder why doctors don't start informing their patients about it earlier. If the procedure is well managed (right training and facilities are important) then I think that patients would be happy to know that this is an option to relieve their suffering earlier rather than later.

In this vein, perhaps doctors can find a way to keep re-booting that immune system should it malfunction again. I wonder if Ms. Ross has any stem cells leftover...? She'd be able to re-boot her system back to that date!


If you have lupus or know someone who does and would like to get in touch with the doctor, his contact details are as per below.*

Richard Burt, M.D.
Physician Referral
240 East Ontario St.
Ste 450
Chicago 60611
(312) 926-8400
rburt@northwestern.edu


*I received a letter recently from one of our clients who asked if we had a resource available with information on where stem cell treatments are performed and whom by. From now on, I'll do my best to start putting that down as a reference in this blog.