Just when you've heard from other news sources that:
a) cord blood stem cells are useless;
b) that you'll never ever need it;
c) that cord blood units contain too little to be used in a transplant or;
d) that it is only used in cases of small children
Bravo to Singapore's marrow transplant doctors for their successful case of 19 year-old Nanyang Polytechnic student Candy Yeow. She had Philadelphia positive acute lymphoblastic leukemia which had very poor prognosis of survival. However, she was very lucky because the medical team was able to find 2 HLA matching (or near matching) units of cord blood stem cells from an overseas cord blood bank. Her transplant went well and at her one-year transplant anniversary, she's in complete remission and off all immuno-suppressants.
Her doctor at the Singapore General Hospital Dr. Mickey Koh was quoted as saying that a single unit of cord blood didn't have enough stem cells for the transplant and hence they went for two combined units in order to achieve the requisite number of stem cells for the patient.
Hence, if you're wondering whether cord blood stem cells can be used for an adult, it depends on how many stem cells were collected in the first instance and if it isn't, at least you're halfway there with one unit. The odds of finding one matching unit is challenging enough, but two matching units like what Candy has here is almost a miracle*.
*Apart from just finding the right matching cord blood stem cell units, the medical care provided to ensure successful recovery is equally important and not to be taken for granted.
WHY CANDY HAD TO HAVE A STEM CELL TRANSPLANT FOR HER CONDITION
From Blood Journal:
Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL) has a poor prognosis when treated with conventional chemotherapy. We analyzed the outcome of 67 HLA-identical sibling bone marrow transplants (BMTs) for Ph1-positive ALL reported to the International Bone Marrow Transplant Registry (IBMTR). Twenty-one of 67 (31%) transplant recipients survived in continuous complete remission more than 2 years after transplant. Two-year actuarial probabilities (95% confidence interval) of leukemia-free survival were 38% (23% to 55%) for 33 patients transplanted in first remission, 41% (23% to 61%) for 22 patients transplanted after relapse, and 25% (9% to 53%) for 12 patients failing to achieve remission with conventional chemotherapy. These data indicate that transplants are effective treatment for Ph1- positive ALL.
Also for the record, there is little indication that propensity for ALL is passed on from parents to children.
Thursday, August 30, 2007
Monday, August 27, 2007
Stem Cell Cure Claims for Cerebral Palsy and Down's Syndrome? Definitely NOT StemLife
There were a few statements made by the Malaysian Minister of Health reported in Malaysia's local newspaper "the Star" today. I'm writing this entry for StemLife clients, staff, shareholders and supporters who may be wondering if it relates to our work.
The Health Minister was quoted saying that there are those who claim that stem cells can cure diseases such as cerebral palsy and Down's syndrome, and a doctor who charged RM 25,000 for a stem cell treatment for these two conditions*.
Firstly, I'd like to put on record that StemLife has never claimed that stem cells can cure either of these conditions and that the doctor who administered the "treatment" worth RM25,000 is NOT in any way associated with StemLife.
Secondly, I'd like to address a few points that the article failed to mention (perfectly understandable as the journalist was reporting statements, not providing any analysis). The assumption that people only invest in something when there is a guarantee is largely incorrect, especially when it comes to one's health. One thing that can be certain is that in the medical profession, there is never a guarantee for a cure for any disease, whether the procedure concerns stem cells or not.
Further, the article and statements address the false hopes about what stem cells can do but fails to mention anything about the areas where stem cells have been used successfully in medical applications in Malaysia. This does not provide the Malaysian public with a pragmatic assessment of what facilities and procedures are available or possible in the appropriate medical context.
Thirdly, cord blood stem cell banking has been available in Malaysia over the last five and a half years -both privately and publicly- and the cost of storing stem cells has been declining, while the number of applications has increased significantly since it was first used in 1987. Therefore if one can afford the storage costs, then it is an option that can be considered.
Finally, in all fairness, no one should think of stem cells as a miracle cure for anything and everything. In all of human history, there has yet to be such a thing.
In case this topic is new to you, I'm including a few links below that I hope you will find useful. More stories can be found on this blog- try using the search box on the top left of this page or let me know if you have a particular question (we will refer to the medical specialists). We can't guarantee that we'll have an answer, but we'll be happy to share any information that we have on stem cells or its current applications.
Cord Blood Transplants from the National Marrow Donor Program, USA
Cord Blood Transplant Case as reported on CNN
Cord Blood Stem Cells as a Source for Adult Cancer Patients from the American Cancer Society
Cord Blood Registry (CBR)- one of USA's Largest and Oldest Cord Blood Stem Cell Banks Application Publication (click on the thumbnail on the right)
Cord Blood Stem Cell Transplant for Immune Diseases (from the British Medical Journal)
Statistics of Autologous Cord Blood Storage and Use by Dr. Frances Verter and Dr. Nietfeld (note that this is a .ppt file)
* I found this article published which might be one of the organizations that the Minister might be referring to.
The Health Minister was quoted saying that there are those who claim that stem cells can cure diseases such as cerebral palsy and Down's syndrome, and a doctor who charged RM 25,000 for a stem cell treatment for these two conditions*.
Firstly, I'd like to put on record that StemLife has never claimed that stem cells can cure either of these conditions and that the doctor who administered the "treatment" worth RM25,000 is NOT in any way associated with StemLife.
Secondly, I'd like to address a few points that the article failed to mention (perfectly understandable as the journalist was reporting statements, not providing any analysis). The assumption that people only invest in something when there is a guarantee is largely incorrect, especially when it comes to one's health. One thing that can be certain is that in the medical profession, there is never a guarantee for a cure for any disease, whether the procedure concerns stem cells or not.
Further, the article and statements address the false hopes about what stem cells can do but fails to mention anything about the areas where stem cells have been used successfully in medical applications in Malaysia. This does not provide the Malaysian public with a pragmatic assessment of what facilities and procedures are available or possible in the appropriate medical context.
Thirdly, cord blood stem cell banking has been available in Malaysia over the last five and a half years -both privately and publicly- and the cost of storing stem cells has been declining, while the number of applications has increased significantly since it was first used in 1987. Therefore if one can afford the storage costs, then it is an option that can be considered.
Finally, in all fairness, no one should think of stem cells as a miracle cure for anything and everything. In all of human history, there has yet to be such a thing.
In case this topic is new to you, I'm including a few links below that I hope you will find useful. More stories can be found on this blog- try using the search box on the top left of this page or let me know if you have a particular question (we will refer to the medical specialists). We can't guarantee that we'll have an answer, but we'll be happy to share any information that we have on stem cells or its current applications.
Cord Blood Transplants from the National Marrow Donor Program, USA
Cord Blood Transplant Case as reported on CNN
Cord Blood Stem Cells as a Source for Adult Cancer Patients from the American Cancer Society
Cord Blood Registry (CBR)- one of USA's Largest and Oldest Cord Blood Stem Cell Banks Application Publication (click on the thumbnail on the right)
Cord Blood Stem Cell Transplant for Immune Diseases (from the British Medical Journal)
Statistics of Autologous Cord Blood Storage and Use by Dr. Frances Verter and Dr. Nietfeld (note that this is a .ppt file)
* I found this article published which might be one of the organizations that the Minister might be referring to.
Wednesday, August 15, 2007
First Ever Beijing Stem Cell Donor for Taiwanese Recipient
Despite any political maneuvering between China and Taiwan, it is articles like these (1, 2) that bring our minds back to the basics- which is that geopolitics aside, our genetic heritage links us and binds us eventually to a common fate.
Additionally, stem cell resources will always reside with the size and diversity of the population, hence China with more than 1.3 billion is a stem cell treasure trove for chinese people all over the world if we are able to thoroughly profile and screen the stem cells.
The article which I noted a while ago (sorry, it's a late comment, but I thought it worthwhile) reports the first time that stem cells were matched from a patients in Taiwan to donors in Beijing*. The two profiled donors were Ms. Hang from Jiangsu province and Ms. Xiaoyan from Hunan province. (click here if you'd like to know where the provinces are in relation to Beijing)
They were brought to Beijing and their stem cells were mobilized from their bone marrow to the bloodstream (you can read more on mobilization and collection here) and their stem cells collected via apheresis. Their stem cells were subsequently transported to Taiwan for the transplantation.
The second article provides a little more detail on the donors and their perceptions of stem cell harvesting and donation.
Ms. Hang who is a youthful 36 year-old is a registered blood donor who has donated blood several times in her life. Apparently, a marrow bank was established in her home province in 2003 but few people registered as donors. Ms. Hang signed up as a donor in the registry not only because her employer, Amway urged all employees to do so, but also because she saw it as "an opportunity to help others... why not do it?"
Amway's staff registration yielded 1,500 new potential donors and they report that 4 of them have already been called on as donors.
Ms. Hang's father is a doctor and said that the process of mobilizing and collecting stem cells was harmless and supported her decision to donate. The recipient was a 16 year-old girl and I hope that they collected as many stem cells as they could and that the patient has recovered.
*Taiwan has exported stem cells obtained from donor's cord blood, bone marrow and peripheral blood to patients all over the world. Cord blood stem cells obtained from a private company that facilitates the storage facility for databasing and sale, Stemcyte incur a charge of between RM 100,000 to RM 150,000 per unit (they have released in excess of 250 cord blood stem cell units). Some patients have also withdrawn 2 cord blood stem cell units to use in a double transplant when one unit is insufficient.
Malaysian patients have accessed this facility many times and have been able to find successful matches which has allowed life-changing stem cell transplantation to proceed.
Credit also goes to the Tzu Chi Taiwan Marrow Donor Registry, the third largest of its kind in the world, which has made over a hundred matches for mainland patients and patients in South East Asia.
Additionally, stem cell resources will always reside with the size and diversity of the population, hence China with more than 1.3 billion is a stem cell treasure trove for chinese people all over the world if we are able to thoroughly profile and screen the stem cells.
The article which I noted a while ago (sorry, it's a late comment, but I thought it worthwhile) reports the first time that stem cells were matched from a patients in Taiwan to donors in Beijing*. The two profiled donors were Ms. Hang from Jiangsu province and Ms. Xiaoyan from Hunan province. (click here if you'd like to know where the provinces are in relation to Beijing)
They were brought to Beijing and their stem cells were mobilized from their bone marrow to the bloodstream (you can read more on mobilization and collection here) and their stem cells collected via apheresis. Their stem cells were subsequently transported to Taiwan for the transplantation.
The second article provides a little more detail on the donors and their perceptions of stem cell harvesting and donation.
Ms. Hang who is a youthful 36 year-old is a registered blood donor who has donated blood several times in her life. Apparently, a marrow bank was established in her home province in 2003 but few people registered as donors. Ms. Hang signed up as a donor in the registry not only because her employer, Amway urged all employees to do so, but also because she saw it as "an opportunity to help others... why not do it?"
Amway's staff registration yielded 1,500 new potential donors and they report that 4 of them have already been called on as donors.
Ms. Hang's father is a doctor and said that the process of mobilizing and collecting stem cells was harmless and supported her decision to donate. The recipient was a 16 year-old girl and I hope that they collected as many stem cells as they could and that the patient has recovered.
*Taiwan has exported stem cells obtained from donor's cord blood, bone marrow and peripheral blood to patients all over the world. Cord blood stem cells obtained from a private company that facilitates the storage facility for databasing and sale, Stemcyte incur a charge of between RM 100,000 to RM 150,000 per unit (they have released in excess of 250 cord blood stem cell units). Some patients have also withdrawn 2 cord blood stem cell units to use in a double transplant when one unit is insufficient.
Malaysian patients have accessed this facility many times and have been able to find successful matches which has allowed life-changing stem cell transplantation to proceed.
Credit also goes to the Tzu Chi Taiwan Marrow Donor Registry, the third largest of its kind in the world, which has made over a hundred matches for mainland patients and patients in South East Asia.
Wednesday, August 08, 2007
A Lifetime of Ailments and Probable Strokes removed by Stem Cell Transplantation
More often than not, when we think of people who suffer from strokes, older people- someone's uncle, father or grandmother- comes to mind. Did you know that some 2 year-olds have strokes too?
This article reports the work of doctors at a Children's medical center who performed a stem cell transplant in 2005 on 2 year-old Shylynn Turner, whose previous two strokes had already hobbled her right leg and limited the ability of her right hand.
YOUNGER SISTER'S STEM CELLS
Now a bright looking 4 year old (her photo is in the article), Shylynn received her younger sister's stem cells for the treatment of her condition- sickle cell anemia*. Her transplant was performed last year and after clearing the one-year anniversary of her transplant, her pediatric hematologist and oncologist Dr. Mukund Dole pronounced her "cured of her sickle cell disease".
The credit for this work is attributed to the supervising doctor and his transplant team at Dayton Children's hoapital.
"She is cured of her sickle cell disease," said Dr. Mukund Dole, a pediatric hematologist and oncologist at Dayton Children's.
NOT EVERY TRANSPLANT IS A SUCCESS
Shylynn's doctor can say that with confidence now that Shylynn has passed the one-year anniversary of the transplant, Children's first success at the rare, complicated and potentially fatal procedure. A previous attempt at the same hospital for another patient to transplant a patient for the same condition failed.
WHAT IS SICKLE CELL ANEMIA?
Shylynn's doctor defines this condition* as follows:
Sickle cells are abnormally shaped red blood cells that can get stuck in blood vessels and block blood flow, which can cause pain, strokes, organ damage and infections. The only way to rid the body of the cells is through a stem cell transplant.
The idea is that normal blood cells (red cells, white cells and platelets) and immune cells (lymphocytes) will arise from the donated stem cells, which can come from bone marrow, peripheral blood and umbilical cord blood.
But the chance of a donor sibling who is a perfect tissue match is only about 25 percent, Dole said, which is why the procedure is so rare.
It's also risky because the patient first must undergo intensive chemotherapy to wipe out the abnormal blood cells and bone marrow, which devastates the patient's immune system.
Worldwide several hundred patients have undergone the procedure with a success rate of 85 percent.
A NEW LIFE?
"I am happy, I feel very blessed and Shylynn's very happy since they took her off her restrictions," Amber Turner said. "She gets to go out and play with other kids now. She's really been enjoying it."
**Sickle cell anemia is not prevalent in Malaysia but a parallel genetic condition of the blood that is prevalent is Thalassemia major. However, unlike the possible evolutionary advantages that sickled cells confer, I am not sure about Thalassemia. If anyone has any ideas or clues, please feel free to post your comment.
THE SICKLE CELL'S POSSIBLE EVOLUTIONARY ADVANTAGE
In 1949, British geneticist Anthony Allison found that the frequency of sickle cell carriers in tropical Africa was higher in regions where malaria raged all year long. Blood tests from children hospitalized with malaria found that nearly all were homozygous for the wild type of sickle cell allele. The few sickle cell carriers among them had the mildest cases of malaria. Was the presence of malaria somehow selecting for the sickle cell allele by felling people who did not inherit it? The fact that sickle cell disease is far less common in the United States, where malaria is rare, supports the idea that sickle cell heterozygosity provides a protective effect.
This article reports the work of doctors at a Children's medical center who performed a stem cell transplant in 2005 on 2 year-old Shylynn Turner, whose previous two strokes had already hobbled her right leg and limited the ability of her right hand.
YOUNGER SISTER'S STEM CELLS
Now a bright looking 4 year old (her photo is in the article), Shylynn received her younger sister's stem cells for the treatment of her condition- sickle cell anemia*. Her transplant was performed last year and after clearing the one-year anniversary of her transplant, her pediatric hematologist and oncologist Dr. Mukund Dole pronounced her "cured of her sickle cell disease".
The credit for this work is attributed to the supervising doctor and his transplant team at Dayton Children's hoapital.
"She is cured of her sickle cell disease," said Dr. Mukund Dole, a pediatric hematologist and oncologist at Dayton Children's.
NOT EVERY TRANSPLANT IS A SUCCESS
Shylynn's doctor can say that with confidence now that Shylynn has passed the one-year anniversary of the transplant, Children's first success at the rare, complicated and potentially fatal procedure. A previous attempt at the same hospital for another patient to transplant a patient for the same condition failed.
WHAT IS SICKLE CELL ANEMIA?
Shylynn's doctor defines this condition* as follows:
Sickle cells are abnormally shaped red blood cells that can get stuck in blood vessels and block blood flow, which can cause pain, strokes, organ damage and infections. The only way to rid the body of the cells is through a stem cell transplant.
The idea is that normal blood cells (red cells, white cells and platelets) and immune cells (lymphocytes) will arise from the donated stem cells, which can come from bone marrow, peripheral blood and umbilical cord blood.
But the chance of a donor sibling who is a perfect tissue match is only about 25 percent, Dole said, which is why the procedure is so rare.
It's also risky because the patient first must undergo intensive chemotherapy to wipe out the abnormal blood cells and bone marrow, which devastates the patient's immune system.
Worldwide several hundred patients have undergone the procedure with a success rate of 85 percent.
A NEW LIFE?
"I am happy, I feel very blessed and Shylynn's very happy since they took her off her restrictions," Amber Turner said. "She gets to go out and play with other kids now. She's really been enjoying it."
**Sickle cell anemia is not prevalent in Malaysia but a parallel genetic condition of the blood that is prevalent is Thalassemia major. However, unlike the possible evolutionary advantages that sickled cells confer, I am not sure about Thalassemia. If anyone has any ideas or clues, please feel free to post your comment.
THE SICKLE CELL'S POSSIBLE EVOLUTIONARY ADVANTAGE
In 1949, British geneticist Anthony Allison found that the frequency of sickle cell carriers in tropical Africa was higher in regions where malaria raged all year long. Blood tests from children hospitalized with malaria found that nearly all were homozygous for the wild type of sickle cell allele. The few sickle cell carriers among them had the mildest cases of malaria. Was the presence of malaria somehow selecting for the sickle cell allele by felling people who did not inherit it? The fact that sickle cell disease is far less common in the United States, where malaria is rare, supports the idea that sickle cell heterozygosity provides a protective effect.
Subscribe to:
Posts (Atom)
Posts
