Stem Cell Transplants for Peri-anal Fistulas

I'd like to nominate this article for one of the top ten most interesting stem cell applications to date.


The background

Crohn's disease is an inflammatory bowel disease which can cause swelling anywhere along the digestive tract but mostly affects the small intestine. The most common symptom leading to its diagnosis is diarrhea. The most common complication leading to its diagnosis is the blockage of the intestines. Due to the thickening of the intestinal wall, the passage narrows and may also cause sores or ulcers involving surrounding tissues and organs such as the bladder, vagina, and the anus and rectum.


Anal Fistulas

The anal glands which drain into the anal canal can become blocked and infected, resulting in an abscess formed in an abnormal tunnel called a fistula. The fistula can cross the anal sphincter, and if infected, may present the patient with a painful and problematic condition.

Crohn's disease is typically diagnosed in people (males and females) between the ages of 15-35, but can strike at any point in their life.


Phase II Clinical Trials

The article described a clinical study conducted in Madrid, where patients with Crohn's disease (or a similar glandular condition) and symptomatic anal fistulas were treated with and without stem cells complementing the existing therapeutic strategy.

Previously, patients with perianal fistulas were provided with the option of surgery. However, while this cures the fistula, it leaves behind a scar which can cause incontinence problems. What they were performing in Madrid, were fibrin glue injections which involves the injection of a biodegradable glue into the fistula to close the tunnel and prevent any bacteria from entering to form an abscess. This procedure provides minimal risk of incontinence (no surgery to damage muscle tissue) and also much less stress for the patient.

Disappointingly, fibrin glue treatment only cures 16% of conditions and this prompted the doctors to explore a more definitive method of curing the fistula internally and externally (closing the fistula completely).


Plus Stem Cells

In this phase II clinical trial led by Prof. Damian Garcia-Olmo of La Paz Hospital, patients were treated with fibrin glue and stem cells derived by liposuction from their own fatty tissue. The cells were grown in the lab to an order of 20 million and re-injected into the internal opening of the fistula 3 months later. Control patients only got the fibrin glue.

The patients were monitored for 8 weeks and if the fistula still was not healed, the patients got a second dose of 40 million stem cells + fibrin glue or fibrin glue alone depending on which group they were in (note that the second dose of stem cells was also a double dose).

The stem cell treatment was apparently effective and recorded a significant difference and the patients are now leading a better quality of life with no further fistulas.


I wonder if Prof. Garcia-Olmo will try this procedure with stem cells from other sources which may be able to avoid surgical intervention for extraction of stem cells altogether. I'm not sure what the incidence of Crohn's disease is in Malaysia, but as it seems to be a condition which might be related to urban lifestyle (and possibly poor diet) there might be an undiagnosed population out there who are too embarrassed to seek help unless its very severe. Well, at least now there is way to improve the chances of removing an uncomfortable part of the problem altogether with stem cells.

There is no cure for Crohn's disease at this time and treatment involved medication and/or surgery.

Umbilical Cord Blood Stem Cell Transplant Saves Singapore Baby

It's always nice to have good news, and children who have had successful outcomes with stem cell therapy is always good news to me.

Last night, Singapore's Channel News Asia announced that a 2 year-old baby boy has recovered from a fatal disease (exactly what wasn't named) after fighting against viral and fungal infections, which are often associated with poor immune systems in transplantation.

The transplant was performed by A/Prof. Dr. Tan Ah Moy, head of KK Women's and Children's Paediatric Haematology Unit in May last year.

The little boy's name and nationality has been withheld for now -probably for privacy reasons- but I hope we'll get to hear more about his condition, whether it was genetic or spontaneous and the factors that led to the successful transplant.

We have transplant facilities in Kuala Lumpur at the University Hospital and also at the Kuala Lumpur General Hospital, but I have to admit that Singapore's hospitals do a much better job at marketing themselves online. KK states on its website that the paediatric haematology team has performed 35 transplants to date, and I'm sure that with a fairly homogenous population and the Singapore cord blood bank in its basement, there will be many more babies that can be saved.

If you need a transplantation specialist, here's a short who's who list:

Clin A/Prof Tan Ah Moy
Head & Senior Consultant
Appt. tel: +65 6294 4050

Prof. Chan Lee Lee
Head and Senior Consultant
Appt. tel: +603-79502275

Cord Blood Stem Cells for Broad Range of Medical Conditions

This news is interesting and reveals what cord blood stem cells are being used for on the other side of our planet. Cord Blood Registry (CBR), one of America's top 3 (or perhaps the top) cord blood stem cell storage companies has just announced the release of five units in the first quarter of this year for autologous infusions/ transplantation.


WHAT ARE THE STEM CELLS BEING USED TO TREAT?

3 of the infusions are for autologous use, namely Cerebral Palsy, Type 1 Diabetes, Auto-immune disorder related Autism.

2 of the infusions are for family members to treat Acute Myeloid Leukemia and Diamond Blackfan Anemia.


Statement from CBR's Scientific Director and Transplanter at University of Arizona

"The growing number of requests CBR is receiving for release of samples to the families who stored them is an important indication that the medical community is increasingly using autologous and genetically-related cord blood stem cells to help save lives," said David Harris, Ph.D., CBR scientific director and professor of immunology at the University of Arizona. "It is particularly encouraging to see the benefits of cord blood stem cells extend to patients with diverse unmet medical needs. This includes a number of regenerative medicine therapies which require a patient's own cells."


Interesting? Given the conventional options available, I'm certainly keen on knowing the patient outcomes.

Adult Patient gets Cord Blood Stem Cells for Transplant

I found this video pretty interesting as the interviewee highlights the plight of many patients today who aren't told or advised about the uses of cord blood stem cells. Eric Drew was only told about bone marrow transplantation (but didn't have any full siblings) and wasn't informed of any other options. It was on his own initiative that he found out about cord blood stem cells and followed up with a successful transplant. So, another adult has been successfully cured with cord blood stem cells... don't let anyone tell you that cord blood stem cells aren't useful for adults.

At StemLife, we do advise parents that while their children may not need it within the first few years of their life (touch wood), it is affordable and reasonable to bank the stem cells so that the resource is available for possible later use.

The video is a little bit heavy to download but its worth hearing his optimism and it's good listening to a patient who has been through the procedure.


"Don't take NO for an answer"

Installation of Malaysia's 13th King & Launch of StemLife's New Services

Malaysia's new king from Terengganu, Yang di-Pertuan Agong Tuanku Mizan Zainal Abidin was installed last week on the 26th of April and it was declared a bank holiday. There are beautiful yellow posters all over Kuala Lumpur paying tribute to the new King, with words "Daulat Tuanku", which I think means "Long live the King" in Malay.

The King and the Queen look really resplendent in their royal gold outfits and as my colleagues and I drove by the signs, we were commenting on how complementary they were in terms of their looks and how attractive the Queen is.

A GOOD DAY FOR A LAUNCH

It was also a good day for StemLife as we launched our new services in the presence of our guest of honor -Malaysian jazz singer, mother and StemLife client- Sheila Majid. She rang us to ask about StemLife's newborn umbilical cord blood stem cell banking service for her newest addition to her family and we asked her if she would kindly grace our event as a client and guest-of-honor. She said to us: " I am happy to do it because it's a good thing, doesn't hurt anyone and certainly important that other parents should know about it" (she missed the previous baby's stem cells as she delivered early).

If you're a StemLife client already or a mum-to-be who's considering stem cell banking, I'm really excited to share news on our latest stem cell services with you.


StemGuard

Parent Question: " Can I afford transplantation if it comes to pass?"
StemLife Answer: Yes, you can with StemGuard. A specially designed transplant insurance policy that allows parents to cover the costs of transplantation should it be required in the future. Parents are offered very affordable rates (from 20 cents per day) for transplantation costs in Malaysian hospitals. It covers most major transplantable disorders todate.


StemAssured

Parent Question: " Will my baby's stem cells be alright after years of storage?"
StemLife Answer: "Yes, StemLife is confident that your baby's stem cells are safe with us and we're willing to provide a money back guarantee."


Stem21

Parent Question: "What will happen to my baby's stem cells if we're not around?"
StemLife Answer: "Not to worry, we'll still take care of them for you. Some of StemLife's parents have asked us what will happen to their babies' stem cell unit should they no longer be around and the minor be unable to pay . StemLife takes a compassionate stance and offers to bank the unit at no further costs to the child until they are 21."


The news was reported in several papers, Business Times carried an article, as did the Star newspaper.

If you're already a StemLife Parent, you'll be receiving a mailer pretty soon explaining how the programs work. Please bear with us, but we're working on making our services better.

As for everyone else, look out for StemLife's new service logos and let me know if you think they're nice :).