Multiple Route AUTOLOGOUS Bone Marrow Stem Cell Injections Show Promise To Treat Spinal Cord Injury

Just published a few days ago in the current issue of Cell Transplantation (Vol. 17 No.12), researchers from DaVinci Biosciences, Costa Mesa, California, in collaboration with Hospital Luis Vernaza in Ecuador, have determined that injecting a patient's own bone marrow-derived stem cells (own-autologous BMCs) directly into the spinal column using multiple routes can be an effective treatment for spinal cord injury (SCI) that returns some quality of life for SCI patients without serious adverse events.

The researchers reported on eight patients with SCI (four acute and four chronic) to whom they administered BMCs directly into the spinal column, spinal canal and intravenously for each patient and followed for two years using MRI imaging to assess morphological changes in the spinal cord.

"Our objective in this study was to demonstrate that multiple route administration of BMCs for SCI is safe and feasible," said corresponding author Dr. Francisco Silva. "To date, we have administered BMCs into 52 patients with SCI and have had no tumor formations, no cases of infection or increased pain, and few instances of minor adverse events. We also found that patient quality of life improved.

According to Dr. Silva, presently there is no cure or effective treatment for spinal cord injury, a disorder affecting millions globally. Tissue loss from the primary injury and the complexity of cell types required for functional recovery lead the list of considerations. Once more, to be considered successful, any treatment should ultimately help to improve patient quality of life and demonstrate functional improvements.

"Autologous stem cell transplantation of BMCs can promote the growth of blood vessels and, therefore, represent an alternative therapy," said Dr. Silva. Following primary trauma to the adult spinal cord there is evidence of hemorrhage and blood flow is attenuated, he explained. The disruption of blood flow leads to spinal cord infarction, the disruption of the blood-spinal cord injury barrier, swelling and the release of molecules influencing spinal cord perfusion and ischemia, a restriction in blood supply.

"BMCs are well known for their ability to grow blood vessels," explained Dr. Silva. "This angiogenesis is necessary for wound healing and establishing a growth permissive environment. We hypothesized that improved blood flow and oxygen supply could contribute to functional improvements for SCI transplanted with autologous BMCs.

In eight patients who received BMC transplants through various routes and followed for two years, the scientists reported several functional improvements, perhaps the most important of which was improved bladder control.

Finally, the researchers noted that one of their cases suffered a gunshot wound and that their study marked the first time a gunshot wound victim had received BMC transplants through multiple routes."It is important to note," concluded Dr. Silva," that all of our patients with acute injuries improved significantly with no signs of deterioration or impediment of presumed spontaneous recovery.

According to Dr. Svitlana Garbuzova-Davis, a spinal cord researcher at the University of South Florida, the study highlights the value of using several different simultaneous routes for the administration of stem cells, as well as the benefit of the cells themselves."While it would be interesting to know the respective contribution of each route of administration, this study does appear to support the need to move to carry out double blind clinical trials of BMCs in SCI, especially if a non-invasive route could be used.


Reference:

1. Geffner, L. F.; Santacruz, P.; Izurieta, M.; Flor, L.; Maldonado, B.; Auad, A. H.; Montenegro, X.; Gonzalez, R.; Silva, F. Administration of Autologous Bone Marrow Stem Cells Into Spinal Cord Injury Patients Via Multiple Routes Is Safe and Improves Their Quality of Life: Comprehensive Case Studies. Cell Transplantation, 2008; 17 (12): 1277

STROKE and Your OWN STEM CELLS

"Every five minutes someone in the UK has a stroke and it is vital that we do all we can to help those affected by stroke."

Wise words from a team of wise scientists in the UK that pushed effective stem cell treatment for strokes a significant step forward as they revealed in their work is published in the Journal Biomaterials how they have replaced stroke-damaged brain tissue in rats.

The team of scientists is funded by the Biotechnology and Biological Sciences Research Council (BBSRC) and led by Dr Mike Modo of the Institute of Psychiatry, King's College London. The work, carried out at the Institute of Psychiatry and University of Nottingham, shows that by inserting tiny scaffolding with stem cells attached, it is possible to fill a hole left by stroke damage with brand new brain tissue within 7 days. Previous experiments where stem cells have been injected into the void left by stroke damage have had some success in improving outcomes in rats.

The problem is that in the damaged area there is no structural support for the stem cells and so they tend to migrate into the surrounding healthy tissues rather than filling up the hole left by the stroke.

Dr Modo said: "We would expect to see a much better improvement in the outcome after a stroke if we can fully replace the lost brain tissue, and that is what we have been able to do with our technique."

Using individual particles of a biodegradable polymer called PLGA that have been loaded with neural stem cells, the team of scientists have filled stroke cavities with stem cells on a ready-made support structure.

Dr Modo continued: "This works really well because the stem cell-loaded PLGA particles can be injected through a very fine needle and then adopt the precise shape of the cavity. In this process the cells fill the cavity and can make connections with other cells, which helps to establish the tissue. (picture)

"Over a few days we can see cells migrating along the scaffold particles and forming a primitive brain tissue that interacts with the host brain. Gradually the particles biodegrade leaving more gaps and conduits for tissue, fibres and blood vessels to move into."

The research published today uses an MRI scanner to pinpoint precisely the right place to inject the scaffold-cell structure. MRI is also used to monitor the development of the new brain tissue over time.

The next stage of the research will be to include a factor called VEGF with the particles. VEGF will encourage blood vessels to enter the new tissue.
Professor Douglas Kell, BBSRC Chief Executive said: "Stroke is a leading cause of disability in industrialised countries. It is reassuring to know that the technology for treating stroke by repairing brain damage is getting ever closer to translation into the clinic.

This crucial groundwork by Dr Modo and his colleagues will surely be a solid foundation of basic research for much better treatments in the future. Joe Korner, Director of Communications at The Stroke Association commented: "This research is another step towards using stem cell therapy in treating and reversing the brain damage caused by stroke. It is exciting because researchers have shown they are able to overcome some of the many challenges in translating the potential of using stem cells into reality."

The potential to reverse the disabling effects of stroke seems to have been proved. However the development of stem cell therapy for stroke survivors is still in the early stages and much more research will be needed before it can be tested in humans or used in practice.

Cord Blood Banking in the Middle East

If there's one building that I never get tired of looking at in KL, it has definitely got to be the Petronas Twin Towers. If the number of tourists in the park just beneath it is any indication, it confirms that I am certainly not the only one. Since the sunshine brings such perfect days and stormy nights, even the movie producers are out in full force, taking full advantage of the predictability of cloudless skies.

These towers were once the tallest in the world (est 1998), but it has now been beaten by the Taipei 101 (2004) and I read that the completion of Dubai's Burj Dubai which is a huge structural icon in the making, will rank number one as of next year if the project finishes on schedule (estimated completion Dec 2009).

I know you must be wondering where I'm going with this but please indulge me a little longer.

As someone who has yet to visit the middle east nations, I can only imagine what their cities and populations are like. Dubai has a population of just over a million people, so I'm wondering what all the space in the Burj will be used for, but I suppose that they are planning to attract migrants to the city and plan to expand the city's population to three times of what it is today in the next one or two decades.

The population in other Arab Emirates is also fairly small. Doha, the capital of Qatar which lies westerly of Dubai across the sparkling Persian Gulf competes with Dubai in terms of infrastructure and is likewise in the process of establishing itself for other activities apart from finance. Doha laid claim to a fantastic sports center built to groom and train athletes for modern Olympics and apparently also has some architecturally tasteful and stylish designer buildings which serve as office and varsities.

Qatar is wealthy due to their oil and gas deposits which provide the financial bedrock for the economy and with a small population of less than a million, the GDP is thus very high.

It is in Doha which Richard Branson and his partner Excalibur (PE fund) have decided to relocate and re-launch the Virgin Cord Blood Bank with the new name of Virgin Health Bank QSTP (where QSTP is an abbreviation for Qatar Science and Technology Park).


WHY DOHA?

According to the press article, the Virgin Team did consider other major cities in the UAE but decided on Doha due to the Qatari commitment from the government and its Queen:

BACKED BY THE GOVERNMENT
"Branson said today that the bank chose Qatar because “the government of Qatar and the queen in particular understood the importance of this and wanted it.” Evans said that the presence of facilities such as the Weill Cornell Medical College campus and the future Sidra Medical & Research Center (now under construction) in Qatar were also part of the country’s draw."

The Qatar Science Center (featured on the right)


HOW MUCH?

At the press conference held on Tuesday, the investment in starting a cord blood bank was announced to require 9 million British Pounds (46 million RM) while stating that 10 million USD had already been spent.

As for the charge for Virgin's services which encompass a private-public model, nothing is confirmed but it is supposed that the Qatari government will initiate the project by footing the bill. Given a birth rate of approx. 16 births per 1000 people, all of Qatar would have a birth rate of 16,000 per year. Not too much to handle if most deliveries are managed by a few hospitals.

The shareholders have declared that all profits from the service will be channeled back into health care charities, and to be fair to the corporates, probably less operational and running costs.


NEW GOALS

"The company’s goal is to create a comprehensive source of stem cells that could be of particular use for treating people of Middle Eastern descent, whose tissue types are often underrepresented in the public tissue banks such as those in the U.S. and elsewhere. “This cord blood bank could end up being bigger than the U.K.’s bank quite quickly,” Branson noted at a press conference today marking the company’s inaugural board meeting in Qatar."

I wrote about Virgin's plan previously and if you need a helpful reminder of what it was, click here.


Cultural Mind-Shift

One of the acknowledged challenges of the service would be to convince the Qataris to participate and engage the cord blood service. I was very impressed to know that the Qatari Islamic religious leaders are forward thinking and have already issued a fatwa (muslim sharia law) approving the collection of cord blood and encouraging its use. Dr. Yousuf Qaradawi a prominent Islamic scholar has endorsed its use.

Here in Malaysia, it would be great if the Islamic leaders would take up the issue and do the same in responding to the concept of cord blood banking.

We're being SPAMMED by StemTech

I'm not sure how we've managed to make it onto StemTech's spambot list of blogsites, but we've just been patiently deleting them as they come in.

Today, I changed my mind and instead of just going ahead to hit delete, I've decided to dedicate an entire post entry to them due to the fact that they have been actively making their rounds in Malaysia.

One bottle of algae based supplements sells for RM 200+ per bottle (I'm told by those who have bought it) and is supposed to raise your own body's endogenous stem cells by an amount significant enough to increase one's sense of well-being.

My colleague Prof. Aw - who by the way is a recent convert to supplementation- was contacted by one of the StemTech agents/ distributors before. He asked them to send him journal papers (which they claimed they had) and on a second encounter, asked them to do a proof of concept trial by checking on the amount of stem cells raised after taking the supplements for a month.

NO REPLY was forthcoming.

I was even more surprised when I discovered that the french neurologist scientist who is the founder of the organization was invited to present at one of the major hospital's inaugural lecture series here. Due to the heavy downpour, none of us were able to attend but we were most curious as to whether they had received some sort of approval from our government, or whether the major hospital chain was endorsing their product.

I've asked some of the people who are taking this supplement to subject themselves to a simple trial which we'll conduct to see if what they've claimed is true. If I'm able to convince them, I'll be sharing the results with you.

If you're from StemTech and you're reading this, you might like to sponsor the trial if the confidence you have in your product is high.

If not, please stop misleading the public and don't use the term stem cells - call it what it probably is- a vitamin supplement.

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Stem Cell Enhancers: The NEW Science

Standing singly, away from all the controversy, some of the scientific community is giving rise to the world's very first patented, organic stem cell enhancer. With only a single dose of this modern day amazement your body can begin the renewal process. In fact, within just one hour after taking this wonder supplement,three to 4 million, yes MILLION stem cells are added to your bloodstream and go to work.

StemEnhance is a revolutionary breakthrough, all natural product that supports adult stem cell physiology. It's the first patented product on the market in the latest phytoceutical category called "Stem Cell Enhancers".http://www.phyl247.com or http://www.phyl247.biz phyl247 970-985-4076
As we age, the number and quality of stem cells that circulate in our body gradually decrease, leaving our body more susceptible to injury and other age-related health challenges. StemTech Health Science's Stem Enhance is the alternative to the controversial stem cells we hear about in the news. Patented Product StemEnhance supports the natural release of stem cells to promote optimal healing and stem cell physiology.

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Note to StemTech: Please stop spamming us.

Menstrual Stem Cell Banking by LifeCell India

Note to Indian Women: If you're having your period this week, you're probably an immediate target for LifeCell India.

One of the latest news articles to come out of Chennai this week is LifeCell India's announcement that they will be offering menstrual blood cell banking at their facility, adding to the cord blood business.

Personally, I think that most asian women would find this quite disgusting (and disturbing!) given that there are far more hygenic sources. What do you think?

The new service which commences on the 8th of March (Sunday) and apparently designated "Women's day" will be the launch, though I wonder how exactly one would launch a service like this.

LifeCell India signed on to license the technology from Cryo-cell which sent letters to all cord blood stem cell banks around the world (or at least they were courteous to send one my way) inviting any interested parties to license the technology which they were probably going to charge six to seven figures for.

Ironically, with the difficulties of obtaining parents to bank cord blood stem cells, LifeCell India seems unperturbed by the fact that menstrual cells are not even a proven source of stem cells and that culturally, there would be no objections.

"The limited availability of bone marrow led to the discovery of cord blood stem cells. Now it is proved that the success rate of menstrual blood stem cells is about 100 times higher than the 0.2 to 0.3% of stem cells derived from human bone marrow," said Mayur Abhaya, executive director, Lifecell International.

I'm a little skeptical about these statements, though to be fair I haven't read any scientific literature describing menstrual blood contents. But why would the body waste precious stem cells in menstrual blood? One can understand baby's cord blood, as that is blood that circulates through the placenta and the baby's developing blood system, but cells that are meant to be shed are probably already hormonally directed down a self-destruct pathway.

"These stem cells are unique because they multiply rapidly and can differentiate into many other types of cells such as neural, cardiac, bone, fat, cartilage etc," said Dr Ajit Kumar, chief scientific officer, LifeCell International. They can be used to treat everything from heart disease to diabetes to neurological disorders.

Assuming that stem cells can truly treat everything, they would still have to prove that menstrual stem cells can be manipulated to the same extent.

LifeCell will introduce special collection kits for women who wish to bank their stem cells. The kit has a silicon cup that can collect up to 30 ml of menstrual blood. "It is like a sanitary napkin or tampon, and can last up to eight hours," explained Abhaya.

Kind of messy isn't it?

If you'd like to know what questions to ask and what kind of assurances you're getting for your money, you might want to check out this posting that we reviewed a while ago.

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Singapore advertises Cord Blood Stem Cell Banking (Part 2)

A Cordlife ad was timed right after the appearance of the Singapore Cord Blood Bank's news article - and that wasn't a coincidence.



In fact this latest ad was a masterful stroke of PR execution, citing rates of stem cell usage from the SCBB's own article and adding on the other applications worldwide. It highlights what families ought to store their own babies stem cells for their own use and advocates that private cord blood banking ensures 100% accessibility to your own banked cells.


If you can't see the facts and figures in the picture above here's the wording on the left:

Incidence rate of stem cell treatable diseases:

6 people are diagnosed with blood related diseases in Singapore every day
2 of the top 10 cancers afflicting Singaporeans are Lymphoma and Leukemia
1 in 500 babies are diagnosed with Cerebral Palsy
2 children are diagnosed with Type 1 diabetes in Singapore every month
80 diseases are now treatable using cord blood stem cells and possibly more in the future.

Chances of using stem cells:

1 in 217 chance that a person may need cord blood stem cells for treatment in their lifetime
80 cord blood units were released for transplants and therapeutic applications by Cordlife.

Higher chance of finding a match within the patient's family:

70% of cord blood transplants by Cord Blood Registry were from siblings. 30% was for self use.
75% chance of a sibling match
25% chance of a 100% match between siblings. A perfect match is required for bone marrow transplants but not in cord blood transplants.
$26,000 is the minimum cost of buying back a donated cord blood unit if it is still in storage.

Availability of stem cells:
50% of all donations to a public cord blood bank are normally discarded for various reasons
100% - your accessibility to your privately stored cord blood stem cells.



All true of course, and I've always wondered this: Singapore's birth rate is at thirty to forty thousand per year and it's conceivable that there may be a time when every Singaporean has his or her cord blood stem cells banked in the future. Given Singapore's small population, its probably the best place imagining that this could happen, a very accessible and heterogenous database which could be leveraged for treatment and if consented, research for autologous regenerative purposes.


Now that would be really cool.


** Unfortunately the online version of this article isn't the full version that was published in print.


Malaysian Medical Advertising Regulations prohibits any form of advertising using terms ranging from "treatment" to "Thalassemia" so it is virtually impossible for us to advertise as our neighbors did (all brochures and the stem cell organization are required to be separately licensed by the Ministry of Health, so make sure the stem cell bank you're talking to has all the documented approvals and are operating within legal guidelines).

However, since all of it was factual and cited from peer-reviewed journals and both local and international news articles, its good to share these statistics with our patient base here too.


More information on StemLife's stem cell banking services can be found at www.StemLife.com

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Cord Blood Stem Cells to treat Breast Cancer?

In a groundbreaking study (click on title for abstract), just published and not yet picked up by the media, researchers from the Departments of Anatomy and Physiology and Diagnostic Medicine/Pathobiology at the College of Veterinary Medicine in Kansas State University in Kansas, reported in the February edition of the journal "Cancer Research" that "Rat Umbilical Cord Stem Cells Completely Abolish Rat Mammary Carcinomas with No Evidence of Metastasis or Recurrence 100 Days Post-Tumor Cell Inoculation."

What they did was that they transplanted Fisher 344 rat-derived mammary adenocarcinoma cells (Mat B III-breast cancer) orthotopically (meaning into the breast of the female rats) into syngeneic (related) F344 rats with an intact immune system. Then they injected rat umbilical cord matrix stem (rUCMS) cells derived from Wharton's jelly, intratumoral (i.t. meaning into the tumor) or i.v. (into the veins of the animals) 4 days later.

Then they compared the tumor attenuation effect (meaning how the tumor was suppressed-fought / extinguished) at day 14 after the injection in the tumor or in the veins in cord blood stem cell-transplanted rats compared with sham-transplanted rats (meaning animals that received an injection but no stem cells). What they saw was amazing!

Unmodified rUCMS cord blood stem cell-transplanted rats showed complete regression of tumors to undetectable levels by 34 to 38 days with no evidence of metastasis or recurrence 100 days post-tumor cell inoculation (injection in the tumor). They concluded that their findings suggest that "unmodified human UCMS cells (cord blood stem cells from the Wharton's jelly of the umbilical cord) could be used for targeted cytotherapy for breast cancer".

Well, this is REALLY something to look out for, isn't it?! [Cancer Res 2009; 69(5): 1815-20]

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And... the blog is back!

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Apologies to all blog readers, it appears that our blog on Google is experiencing a display glitch. We are trying to contact Google now to establish what the problem is.. Please bear with us!

Singapore Advertises Cord Blood Stem Cell Banking (Part 1)

Last week in the Singapore Straits Times, there were two snippets about cord blood stem cell banking. The first one was a news piece on the Singapore public cord blood bank (entitled Cord Blood Bank has saved 21 lives**) which was campaigning for an increase in units (arguably an ad in itself). The other snippet was an ad by a local private Singapore Cord Blood Bank Cordlife. The ad appeared 2 days after the news article and I don't think its a coincidence to keep the conversation and interest in Singaporean's minds.

The first article from the Singapore Cord Blood Bank at a press conference reveals quite a lot about what its like to be an operator of a public bank:

How many cord blood stem cell units have been released and where have they gone?

"In the 3 years it has been open, the Singapore Cord Blood Bank has saved 21 lives - here and overseas... a 22nd donation was winging its way over to France"

"Of the 21 recipients, 12 were patients here while the other nine were ethnic Asians in Europe and Malaysia."

Comment: 21 cord blood units utilized in transplantation is very respectable for a small bank. Financially, at a purchase price of SGD 26,000 per unit in Singapore, the SCBB would have generated SGD 312,000 in revenue for the 12 Singaporean patients and another approximately SGD 320,000 from the 9 overseas patients (assumption is that these patients came through the NMDP network and paid the standard price). That would bring the SCBB's total revenue to SGD 632,000 or slightly more than this.


How many Singaporeans have donated cord blood and how many of those have been successfully banked?

"The repository has been able to bank about half of the 9,000 donations so far. Donations sometimes do not yield enough stem cells to be viable*."

Comment: The yield of 50% is very much in line with what I've heard from other public cord blood banks. However the article doesn't explain that units are discarded due to bacterial / viral contamination (let's not forget that vaginal flora and fauna can be quite substantial) and that the cord blood bank sets its own guidelines as to the volume and/ or cell count required at the beginning before they proceed to process the unit.

As a guide, at the time of receipt of the cord blood unit, most public cord blood banks insist on a minimum volume of 100 mls or total cell counts exceeding 1 billion. The rationale for this is that the cord blood unit needs to be at a level high enough to treat an adult (including caucasian weight & bigger sized asians), otherwise its not worth keeping (bearing in mind that this inventory can and most certainly will take years to clear). *Thus the term "viable" in the article refers to the unit's chances of being used.

Targets for the Singapore Cord Blood Bank?

"An earlier target of banking 10,000 samples by next year has been extended to 2013 said Mr. Sobak (SCBB's CEO and COO of SingHealth), since its been harder to get good-quality donations."

Comment: 10,000 units in the tank is an ambitious target but let's consider the following points:

1) The SCBB is based in the KK Women's and Children's Hospital, which alone delivers the vast majority of Singaporean babies has handled almost 40,000 babies at its peak, but more likely in the range of fifteen to twenty thousand now.

If the SCBB were able to collect all of the cord blood units from all the babies delivered there per year, without approaching any other hospitals (and discounting the 50%) the SCBB would have had about twenty thousand or so units by now. But, that would mean that they would have been working at a pace of 20 units per day seven days a week, all year round for 3 years. Hence the limitation of time, processing space and cost all plays a part in the operational capacity. [4 years more for 5000 units]

2) Cordlife, the first local Singaporean private cord blood bank started in 2001 only recently achieved 13,000 units in 2008 (announced in an ad) and claim only a 1% contamination rate, which means that they store almost every unit they receive. So repositories take a long time to build. [7 years for 13,000 units]

3) StemLife achieved 10,000 units in 2006, about 4 years after operational commencement (I assure you, not without toil).


Another target mentioned by the CEO was 30 transplants for the financial year 2009. I find this to be an interesting target, as I suspect it greatly depend on whether the requests just happen to match the units in the tank? Or perhaps it is now possible to analyze the recipient population and to try to identify the relevant donors to collect the cord blood from.

Anyway, getting back to the financial year for SCBB, I suppose the financial target would be in excess of SGD 1 million in revenue - if they manage to sell the inventory overseas. It is a business after all.


What are the likelihoods of use?

"At least six people are diagnosed daily in Singapore with different types of blood-related diseases said the bank's medical director William Hwang."

"Many of these patients will require a blood stem cell transplant to survive"

"With these samples and those fom banks worldwide, the odds of local patients finding a match is about 10-20%"


OK, quick back of the envelope calculation here. 6 people diagnosed daily in Singapore with a blood related disorder, ie 2000+ people. Let's say 50% will require a transplant at some stage, so let's bring the figure to about 1000 people needing a transplant.

And since only 10-20% will be able to find a match from all available units locally and internationally, ie 100-200 people will get their stem cell treatment... and the rest will have to wait.

The Suze Ormon Show on Cord Blood Stem Cell Banking

I was watching late night TV last year and happened to stumble across the Suze Ormon Show which I had never seen before. Her program entitled "Can I afford it?" discusses the value and worth of any particular item a person, couple or family would like to purchase in the USA.

In this episode, there was a lady who rang up to ask her opinion on cord blood stem cell banking and I thought it would be good to share with StemLife parents. She's quite keen on the subject but I don't think it was sponsored (no brands in sight). Anyway, if you missed it here it is and Suze Ormon is usually on CNBC late in the evening.

Risks involved in receiving treatment with donated fetal neural stem cells: Donor-Derived Brain Tumor Following Neural Stem Cell Transplantation

I find that the PloS Editor's summary in the article itself is an excellent popularized explanation of what the study means so I present it as is (except some added parentheses).

Editor's Summary

Most of the cells in the human body are highly specialized (‘‘differentiated’’). The brain and the spinal cord, for example, contain two main cell types—neurons, which transmit electrical signals to and from the brain, and glial cells, which support and protect the neurons. If these essential neural cells become damaged or diseased, the body cannot replace them. Scientists think, however, that it might be possible to use ‘‘neural stem cell’’ transplants to replace the neural cells that are lost in neurodegenerative diseases (for example, Parkinson’s disease) or damaged by strokes or trauma. Stem cells are undifferentiated cells that replicate indefinitely and that have the potential to develop into many different specialized cells. Pluripotent stem cells (which are able to develop into any kind of specialized cell) can be isolated from early human embryos; ‘‘multipotent’’ stem cells (which develop into only a few cell types) can be isolated from many differentiated tissues, including the brain. Human fetuses (unborn offspring from the end of the 8th week after conception) are thought to be a particularly good source of neural stem cells because many new neural cells are made in fetal brains.

Although stem cell transplantation might provide treatments for many debilitating diseases, some concerns have been raised over its safety (added: especially when unmatched embryonic or fetal stem cells are being used after donation). In particular, some experts fear that tumors might sometimes develop from (added: donated) transplanted stem cells. Tumor cells actually behave very much like stem cells—they divide indefinitely and they tend to be undifferentiated. It is very important, therefore, that every patient who receives a (added: donated, that is a non-self) human stem cell transplant is carefully followed up to see whether any tumors develop as a result. In this study, the researchers describe a case in which multiple, slow-growing, donor-derived brain tumors formed in a patient after the transplantation of (added: donated) human fetal neural stem cells.


What Did the Researchers Do and Find?

Beginning in 2001, (added: donated) fetal neural stem cells were injected several times into the brain and the fluid surrounding it of a boy with ataxia telangiectasia at a Moscow hospital. Ataxia telangiectasia*, a rare disorder characterized by degeneration of the brain region that controls movement and speech, occurs when both copies of the ATM gene (human cells contain two copies of most genes) contain a genetic change that stops the production of functional ATM protein. In 2005, the boy had a magnetic resonance imaging scan at the Sheba Medical Center (Israel) because of recurrent headaches. The scan revealed abnormal growths in his brain and spinal cord. In September 2006, when the boy was 14, the spinal cord growth was surgically removed. This growth has never reappeared but the mass in the boy’s brain has continued to grow slowly. The material removed from the boy’s spinal cord contained both neurons and glial cells, the researchers
report, and resembled a glioneuronal tumor. In addition, it contained both XX (female) and XY (male) cells and the tumor cells had two normal copies of the ATM gene (added: meaning it could not be derived from the recipient since the gene was normal). Finally, a technique called HLA typing showed that the tumor contained cells from at least two donors.


What Do These Findings Mean?

These findings indicate that the growth in the patient’s spinal cord was donor-cell derived and contained cells from two or more donors, at least one of whom was female. Although the growth in the patient’s brain has not been examined, the multiple masses seen in this patient probably arose independently from transplanted cells injected at different sites, suggest the researchers. Importantly, the slow growth of the tumors and the well-differentiated appearance of the cells removed from the patient suggest that the tumors are relatively benign. Donor-derived cells might have been able to establish tumors in this particular patient because people with ataxia telangiectasia often have an impaired immune system and the immune system normally helps to reject tumor cells. Nevertheless, this first example of a donor-derived brain tumor developing after fetal neural cell transplantation is worrying and suggests that further work should be done to assess the safety of this therapy.



This very important study highlights that we know as yet very little about embryonic and fetal stem cells and that their behavior when injected in human tissues is highly unpredictable. Treatments in humans are as yet not advisable but similar uncontrolled experiments are continuously occurring in uncontrolled centers and in desperate situations.

Everyone must be advised, patients and doctors equally that donor embryonic and/or fetal stem cells carry unknown risks. Embryonic and/or fetal stem cell treatment may in the future be a solution to many of today's untreatable diseases but must first be studied in well planned experiments, performed in specialized centers in animal models and must not be ill advised solutions in desperate human patients.


Important for readers to note the difference:

We also need to remember that this is about fetal stem cells obtained from unborn offsprings from the end of the 8th week after conception and not about current approved treatments as bone marrow transplantation using own or matched adult stem cells from cord blood, bone marrow or peripheral blood.



References

1. Amariglio N et al. Donor-Derived Brain Tumor Following Neural Stem Cell Transplantation in an Ataxia Telangiectasia Patient. PloS Medicine 2009; 6(2): e1000029



*More information on Ataxia Telangiectasia from the NIH Neurological Disorders Site

What is Ataxia Telangiectasia?

Ataxia-telangiectasia is a rare, childhood neurological disorder that causes degeneration in the part of the brain that controls motor movements and speech. Its most unusual symptom is an acute sensitivity to ionizing radiation, such as X-rays or gamma-rays. The first signs of the disease, which include delayed development of motor skills, poor balance, and slurred speech, usually occur during the first decade of life. Telangiectasias (tiny, red "spider" veins), which appear in the corners of the eyes or on the surface of the ears and cheeks, are characteristic of the disease, but are not always present and generally do not appear in the first years of life. About 20% of those with A-T develop cancer, most frequently acute lymphocytic leukemia or lymphoma. Many individuals with A-T have a weakened immune system, making them susceptible to recurrent respiratory infections. Other features of the disease may include mild diabetes mellitus, premature graying of the hair, difficulty swallowing, and delayed physical and sexual development. Children with A-T usually have normal or above normal intelligence.


Is there any treatment?

There is no cure for A-T and, currently, no way to slow the progression of the disease. Treatment is symptomatic and supportive. Physical and occupational therapy may help maintain flexibility. Speech therapy may also be needed. Gamma-globulin injections may be given to help supplement a weakened immune system. High-dose vitamin regimens may also be used.


What is the prognosis?

The prognosis for individuals with A-T is poor. Those with the disease usually die in their teens or early 20s.





Read a news account of this story.

The IMPORTANCE of YOUR FAMILY'S STEM CELLS

Haemopoietic stem cell transplantation for children in Australia and New Zealand, 1998–2006:a report on behalf of the Australasian Bone Marrow Transplant Recipient Registry and the Australian and New Zealand Children’s Haematology Oncology Group.

This above study is an important milestone epidemiological study in CHILDREN published in the Medical Journal of Australia in February 2009. It gives us invaluable information and insight on the source of stem cells used (from bone marrow, peripheral blood or cord blood), their origin (autologous: own; related allogeneic: matched siblings; unrelated allogeneic: matched strangers) and on the indications for which a bone marrow transplantation has been performed. Moreover, it studies the important aspect of Transplant Related Mortality (TRM). Few of us actually have insight in those issues and understanding them will aid in deciding whether to keep your own stem cells or not.

Let's have a look!

Over a period of 9 years (1998-2006) 1,259 BMTs were performed in children in Australia and New Zealand, of which 41% were autologous (used the child's own stem cells from bone marrow or peripheral blood) while 59% were allogeneic (someone else's stem cells). Of the latter 40% were from a matched sibling (23.6% of the total) and 60% from matched strangers. That brings the total number of children ultimately finding stem cells from themselves or within their immediate family up to 65% while the remaining 35% had to depend on matched strangers to donate or on donated cord blood. It means that at the end of the day when a child was ill and in need of stem cells for BMT, then those were found in 65% of the cases from the child or the immediate family. More important is that the stem cells used were bone marrow or peripheral blood stem cells and that means that in that perilous period of a family's and a child's life an extra burden in collecting stem cells from the bone marrow or peripheral blood is added on top of all stress that is already evident. One can also speculate how this additional psychological stress and wait may impact on disease progression. If those families had been informed about cord blood stem cells and had kept their children's cord blood stem cells then those little frozen bags would have been stored and waiting to be used at any given time! Furthermore, the importance of using your own or those of a matched immediate relative is reflected in the TRM; Transplant Related Mortality is 22-28% when one receives a matched stranger's stem cells and only 5-7% if one receives their own or a matched sibling's stem cells.

The other important issue is that the matched stranger stem cells come nowadays more from donated cord blood stem cells than bone marrow/peripheral blood. In the latest years more than half, almost 2/3, come from donated cord blood and subsequently since cord blood stem cells are immunologically naïve and cause 30% less rejections, more mismatched transplants have been performed. One can speculate if this is the reason for the difference in Transplant Related Mortality that is higher in mismatched stem cells from strangers. So, if one would not keep for own use one should definitely donate for public use!

In the words of the authors of the study “Autologous BMT has an important role in a range of childhood cancers, including neuroblastoma, medulloblastoma, Ewing sarcoma/PNET, Hodgkin lymphoma and non-Hodgkin lymphoma” while “allogeneic (matched siblings or strangers) transplantation is most frequently offered to children with high-risk and relapsed leukaemias, myelodysplastic syndromes, aplastic anaemia, congenital bone marrow failure syndromes, thalassaemia major, sickle cell anaemia and various inborn errors of metabolism”.

The results of this study are similar to a previous one published in the Biology of Blood and Marrow Transplantation in 2007, entitled “Haematopoietic Stem Cell Transplantation in Australia and New Zealand, 1992-2004”. In this study that encompasses all transplantations in Australia and New Zealand both in adults and children, the same trend is evident and even more pronounced. That is, when you need stem cells you find them in you or in your immediate family! In2004 alone, 68% of the patients used their own stem cells (889/1,313) while another 19% received stem cells from matched siblings and only 13% managed to find stem cells from matched strangers. That means that a total of 87% found the needed stem cells in themselves or within the immediate family! Importantly, Transplant Related Mortality was 8.1% for stem cells from strangers compared 1.1% for own stem cells! One can also in the adult cases speculate how the effect of the additional psychological stress of stem cell collection and/or wait to find stem cells from strangers may impact on disease progression. If those families had kept their own peripheral blood stem cells then those little frozen bags would then have been stored and waiting to be used at any given time!

Cord blood stem cells and peripheral blood stem cells have an immense importance be it for a family's own use or for complete strangers where anyone can offer the hope of life. Regardless the use or the intention, those stem cells must be kept for their purpose to be fulfilled! Do not let them go wasted!

References

1. Moore AS, Shaw PJ, Hallahan AR, Carter TL, Kilo T, Nivison-Smith I, O'Brien TA, 
Tapp H, Teague L, Wilson SR, Tiedemann K. Haemopoietic stem cell transplantation
for children in Australia and New Zealand, 1998-2006: a report on behalf of the
Australasian Bone Marrow Transplant Recipient Registry and the Australian and
New Zealand Children's Haematology Oncology Group. Med J Aust 2009; 190(3): 121-5  

2. Nivison-Smith I, Bradstock KF, Dodds AJ, Hawkins PA, Ma DD, Moore JJ,
Simpson JM, Szer J.Hematopoietic stem cell transplantation in Australia and New Zealand,
1992-2004. Biol Blood Marrow Transplant 2007; 13(8): 905-12 

Autologous PBSC bone marrow transplantation for MS

Fantastic NEWS for MS patients. New hope in the horizon with OWN Peripheral Blood Stem Cells the way StemLife companies around SE Asia have been collecting and storing for the past 9 years. This novel phase US II/III study (click on the title to see the study) confirms what European scientists have been investigating in the past few years with dr Fassas in Northern Greece as one of them. So this study provides one more proof that in Patients with MS, their OWN Stem Cells can be their chance to live a normal life again!

If you wish a comprehensive list on MS, a presentation in pdf form is available after emailing to info@thaistemlife.co.th

Sel Stem dan Statistik Transplantasi Darah Tali Pusat

Bolehkah Sel Stem Darah Tali Pusat Bayi Merawat Penyakit Thalassaemia Kakak/Abang?

Apakah Statistik Kegunaan Sel Stem Darah Tali Pusat?

Asalamualaikum,

Salam dan semoga Sihat Sejahtera.

Baru-baru ini Saya telah mendapat beberapa soalan mengenai kegunaan sel stem darah tali pusat bayi.

Untuk soalan pertama, pembaca perlu menjawab beberapa soalan. Adakah pesakit sedang berulang ke hospital untuk dirawat oleh pakar Thalassaemia? Jika tidak, mungkin keadaan mereka, setakat ini, belum memerlukan rawatan. Jika ya, pembaca perlu tekun menyoal dan menyaran pakar Thalassaemia supaya meneliti samada keadaan pesakit sudah menurun dan perlu dirawat dengan kaedah lain seperti sel stem?

Sel stem boleh didapati dari sum-sum tulang, tetapi tekniknya agak invasif. Cara yang lebih senang untuk mendapatkanya ialah dari darah tali pusat yang diambil semasa bayi dilahirkan. Kedua-dua sumber ini ada bezanya dari segi kematangan sel, kaedah penggunaan, risiko dan keberkesananya.

Sel stem darah tali pusat bayi, jika disimpan semasa bayi dilahirkan, memang besar potensinya untuk diggunakan. Tetapi, ada beberapa syarat yang perlu dipatuhi. Darah tali pusat mestilah mengandungi jumlah sel stem yang mencukupi, padanan HLA yang tinggi dan tidak berpenyakit.

Sel Stem dari bayi perlu sepadan (secara ujian darah HLA) dengan sel kakak atau abangnya. Jika separa sepadan atau sepadan sepenuhnya, memang ada potensi ianya digunakan untuk menolong merawat kakak atau abang. Sel stem juga perlu bebas dari Thalassaemia dan penyakit lain. Pakar Thalassaemia perlu memutuskan samada keadaan pesakit sudah kritikal dan memerlukan rawatan sel stem.

Proses pengambilan darah tali pusat perlu dilakukan semasa bayi dilahirkan. Sejurus selepas bayi dilahirkan, dan sebelum uri dilahirkan. Doktor di Hospital akan mengambil darah dari tali pusat. Prosesnya senang, seperti proses derma darah biasa. Ianya cepat dan tidak melukakan bayi atau ibu. Kami tidak mengambil tali pusat atau pun uri. Penggunaan sel stem darah tali pusat dalam perubatan boleh dilakukan tanpa keraguan kerana pihak JAKIM telah pun mengeluarkan Fatwa pada tahun 2002.

Kami akan membekukan dan menyimpan sel stem darah tali pusat ini untuk kegunaan bayi sendiri atau mungkin untuk kegunaan kakak atau abangnya dimasa hadapan.

Apabila Pakar Thalassaemia berpendapat rawatan susulan kakak/Abang memang diperlukan, dan sel stem dijangka boleh memberi kesan, pakar-pakar akan meminta supaya sel stem darah tali pusat yang disimpan dibawa ke hospital untuk digunakan.

Pesakit Thalassaemia juga mungkin boleh mendapatkan sel stem darah tali pusat dari pihak Bank Darah Kerajaan di Pusat Darah Negara, KL, http://www.pdn.moh.gov.my/.

Senangkah untuk mendapatkan sel stem ini?

Saya belum pernah melihat statistik di Malaysia yang boleh menolong untuk membuat anggaran tepat. Sel stem yang disimpan di PDN telah didermakan. Agak sukar untuk membuat anggaran samada sel stem, yang sepadan dengan pesakit, boleh didapati dengan senang di Bank Darah Kerajaan atau pun tidak.

Saya pernah membaca di akhbar New Straits Times, 14 Ogos 2006, yang melaporkan pada masa itu, terdapat 17 kanak-kanak yang memerlukan transplantasi sel stem tetapi terpaksa menunggu untuk mendapatkan sel stem dengan padanan yang sesuai. Wartawan juga melaporkan bahawa ada yang tidak dapat menunggu dan tidak dapat diselamatkan walaupun Pusat Darah Negara telah menyimpan lebih kurang 1,000 beg sel stem darah tali pusat.

Jumlah itu, dari segi statistik, terlalu rendah untuk membekalkan darah tali pusat bagi pesakit yang memerlukanya. Ada beberapa anggaran yang sering disebut di laman web-laman web bank darah tali pusat. Anggaran untuk mendapatkan sel stem, bukan dari keluarga sendiri, yang sepadan dengan pesakit adalah dalam lingkungan 1 dalam 20,000. Dengan statistik kebarangkalian padanan yang amat rendah ini, peluang 17 kanak-kanak itu kelihatan agak tipis. Alternatif lain perlu di usahakan. Sebab itulah, kita sering dapat membaca dalam akhbar-akhbar tempatan pesakit-pesakit merayu untuk mendapatkan dermaan sel stem. Sebab itulah juga mengapa ramai pelanggan kami menyimpan sel stem sendiri bagi kegunaan keluarga sendiri.

Pembaca juga boleh layari laman web Persatuan Transplantasi Malaysia http://www.mst.org.my/, dimana terdapat Senarai Transplantasi Kebangsaan. Laporan itu menunjukkan setakat tahun 2006, 1174 pesakit telah menggunakkan sel stem dimana 50 telah menggunakkan samada sel stem darah tali pusat sahaja ataupun dengan tambahan sel stem yang didapati dari sum-sum tulang.

Setakat ini Syarikat StemLife Berhad telah menyimpan sel stem darah tali pusat untuk lebih dari 23,000 pelanggan. Empat (4) pelanggan kami telah berjaya menggunakan sel stem darah tali pusat mereka samada untuk abang, kakak atau adik mereka dalam menolong merawat penyakit Leukaemia dan Thalassaemia. Satu (1) telah dirawat di Hospital Kuala Lumpur dan tiga (3) di Pusat Perubatan Universiti Malaya.

Pembaca juga disyorkan untuk melayari laman web http://www.parentsguidecordblood.com/ dan http://www.apcbbc.org/ untuk mendapatkan statistik simpanan/kegunaan di seluruh dunia dan di rantau Asia Pasifik. Laman web yang kedua ada membentangkan jumlah simpanan ahli-ahli persatuan iaitu bank-bank sel stem darah tali pusat terkemuka di rantau Asia Pasifik yang pada masa ini dipengerusikan oleh Pengarah Urusan StemLife Berhad.

Saya harap telah dapat menjawab beberapa soalan anda. Jika jawapan yang lebih terperinci diperlukan, sila hantarkan nombor anda kepada info@stemlife.com dan kami boleh menghubungi anda untuk memberi maklumat yang lebih mendalam lagi.

Sekian buat masa ini......Wslm..WBK.......................

Bank Sel Stem sudah lama wujud dalam bidang perubatan!

Assalamualaikum WBK,

Salam Sejahtera kepada rakan-rakan saya sekelian, ibu-bapa, bakal ibu-bapa, pengunjung/pembaca blog ini.

Kebelakangan ini Menteri Kesihatan Malaysia Y.B. Dato’ Liow Tiong Lai telah melawat premis kami di Wisma Perintis untuk melihat sendiri operasi pengambilan sel stem dewasa StemLife serta untuk memahami dengan lebih mendalam lagi status penggunaan sel stem dewasa dalam bidang kepakaran penyakit jantung, barah darah, dan kecederaan sendi serta mendapat penjelasan mengenai projek-projek penyelidikan yang giat dijalankan di seluruh dunia.

Beliau telah menekankan komitmen Kerajaan dalam mengunakkan teknologi sel stem dalam bidang perubatan di Malaysia. Pada pendapat saya, ini adalah kerana fakta-fakta adalah jelas sekali tentang potensi sel stem dalam menolong pakar-pakar perubatan menangani beberapa penyakit yang setakat ini amat sukar ditangani. Ini sekaligus meningkatkan kebolehan pakar-pakar Negara supaya tidak ketinggalan zaman.

Seperti yang disiarkan akhbar-akhbar tempatan, Kerajaan menyokong bidang penyelidikan sel stem. Kabinet telah membuat peruntukkan lebih RM32juta untuk mengembangkan dan mengukuhkan aktiviti perbankan sel stem. RM5.86juta untuk memulakan makmal transplantasi sel stem di Institut Penyelidikan Perubatan (IMR). RM18.87juta untuk mengembangkan kemudahan simpanan sel stem darah tali pusat di Pusat Darah Negara dan di Hospital Sultan Abdul Halim, Sungai Petani. Kerajaan juga telah memperuntukan RM5.57juta untuk mengukuhkan perkhidmatan transplantasi sel stem dan sum-sum tulang di Hospital Ampang. Ini diharapkan akan meningkatkan jumlah simpanan beg sel stem darah tali pusat dan mengukuhkan tahap kemudahan perbankan kerajaan. Kami berharap pihak Kerajaan akan menyediakan peruntukan yang lebih dimasa akan datang supaya fasiliti dan kemudahan tempatan dapat bertanding diarena antarabangsa.

Ramai mungkin telah membaca akhbar-akhbar tempatan dan luar negara yang sering menerbitkan kes-kes rayuan pesakit untuk mencari penderma sel stem dan juga dermaan kewangan yang diperlukan dalam masa yang suntuk dan keadaan tertekan. Mengapakah ini boleh berlaku jika stok simpanan sel stem bank darah dalam dan luar negara mencukupi? Besar kemungkinan memang stoknya tidak mencukupi dan juga agak sukar bagi seorang pesakit untuk mendapatkan sel stem yang sepadan dengan sistem darah pesakit itu sendiri. Anggaran kebarangkalian mendapatkan penderma sel stem adalah satu (1) dalam dua puluh ribu (20,000) dan kebawah. Ini bermakna, jika saya memerlukan sel stem, terpaksalah saya mempelawa 20,000 rakan untuk diuji dan mungkin hanya 1 akan sepadan dan boleh menderma. Kemungkinan mendapatkan penderma bukanlah rendah sangat, tetapi, ia mungkin akan mengambil masa yang agak lama jika tiada simpanan sendiri. Ini seakan ”Sindrom Waiting List”.

Sepertimana kita boleh lihat dalam industri perubatan Malaysia, inisiatif swasta boleh dan perlu diusahakan seiring dengan inisiatif Kerajaan. Ini jelas dilihat dimana terdapat kewujudan Hospital Kerajaan dan Hospital Swasta, Doktor Kerajaan dan juga ramai lagi Doktor Swasta. Sudah terbukti di seluruh dunia kewujudan Bank Sel Stem Kerajaan/NGO boleh wujud seiring Bank Sel Stem Swasta malah beberapa bank Kerajaan/NGO dan Bank Swasta di UK telah berjaya berganding bahu untuk menawarkan perkhidmatan menyeluruh supaya warganegara dapat memilih perkhidmatan yang memenuhi kehendak mereka.

Bank Sel Stem darah tali pusat telah mula beroperasi di dunia mulai awal tahun ’90an. Bank-bank di Singapura, Taiwan, Korea, Jepun, Hong Kong sudah beroperasi lebih 10 tahun. Setakat ini terdapat anggaran 150 bank-bank darah tali pusat Kerajaan, NGO dan Swasta di dunia. Anda boleh layari laman web www.parentsguidecordblood.com untuk mendapatkan senarai bank-bank swasta dan Kerajaan/NGO. Negara-negara yang tidak membenarkan operasi bank sel stem swasta hanya segelintir sahaja. Kebanyakkan negara-negara besar di dunia seperti Amerika Syarikat, Kanada, UK, Perancis, Jerman, Australia, New Zealand dan kebanyakkan Negara Asia membenarkan malah menyediakan polisi, akta-akta, garispanduan dan piawaian supaya bank-bank in dapat berkembang serta menyumbang kepada Ekonomi Negara sambil meningkatkan tahap penyelidikan sel stem di negara masing-masing.

Dalam Tanahair pula, apa status nya? Bank sel stem StemLife telah beroperasi semenjak tahun 2001. Kami telah dijemput oleh ’Multimedia Development Coorporation’(MDC) untuk membuka makmal simpanan kami di Cyberjaya dan diberi status MSC. Makmal kami mula beroperasi di Cyberjaya di bangunan MDC iaitu ’Center for Health Innovation & Medical Enterprises’ (CHIME) yang dirasmikan oleh YB Tun Perdana Menteri pada tahun 2002. Bank sel stem Kerajaan di Pusat Darah Negara juga telah dibuka disekitar tahun-tahun yang berdekatan. Kali pertama Sel Stem dewasa/sum-sum tulang telah digunakkan dalam perubatan di hospital Tanahair adalah pada tahun 1987. Sel Stem darah tali pusat pula mula digunakkan di hospital tempatan pada tahun 1997. Setakat tahun 2006, Registry Transplantasi Kebangsaan telah mencatatkan 1,174 kes kegunaan sel stem yang dilaporkan oleh hospital-hospital tempatan Kerajaan dan swasta.

Pada tahun 2006, StemLife telah berjaya disenaraikan di bursa saham BSKL dibawah MESDAQ dan disenaraikan sebagai Stok Syariah. Pada tahun itu juga Jawatankuasa Etika Penyelidikan dibawah naungan KKM dan MOSTI telah mengeluarkan ’Garispanduan Penyelidikan Sel Stem’. Garispanduan ini juga menyatakan hasrat Kerajaan untuk menyokong dan mengembangkan penyelidikan sel stem dalam Negara.

Setelah terbukti kejayaan StemLife, beberapa lagi bank swasta sel stem telah mula beroperasi termasuk pembekal sel stem haiwan. Ramai yang mula membuat kenyataan dalam akhbar-akhbar tempatan mengenai keberkesanan produk mereka. Dalam usaha untuk menjaga kepentingan pengguna/pesakit, pada bulan Mac tahun 2008, Kementerian Kesihatan Malaysia telah mula mengeluarkan lesen dibawah Akta PHFS 1998 lalu menghadkan operasi kepada 4 bank sel stem darah tali pusat sahaja. Bersamaan dengan itu juga, KKM telah menerbitkan ’Piawaian Kebangsaan - Bank Darah Tali Pusat dan Transplantasi’.

Laporan juga menyatakan bahawa pihak KKM sedang dalam proses menyediakan ’Garispanduan Penyelidikan dan Terapi Sel Stem’ serta ’Piawaian Kebangsaan - Terapi Sel Stem’.

Pada masa akan datang, kami berpendapat Terapi Sel Stem akan menjadi salah satu dari Tiga teras perubatan setanding dengan bidang famasi dan bidang pembedahan. Sejarah perkembangan Kedua-dua bidang ini telah berkurun/berabad lamanya. Sesuatu ubat/prosedur pembedahan selalunya mengambil masa 10 tahun keatas untuk diselidik dan disahkan/diluluskan kegunaan dan keberkesananya. Sejarah bidang Sel Stem Dewasa/Sum-sum Tulang sudah dekat 50 tahun manakala Sel Stem Darah Tali Pusat dekat 20 tahun. Ini adalah jankamasa yang amat singkat kalau dibandingkan dengan bidang famasi. Tetapi, keberkesananya telah diiktiraf di seluruh dunia. Sekurang-kurangya 100,000 pesakit setahun menggunakkan sel stem di seluruh dunia.

Adakah statistik ini memberangsangkan? Sudah tentu. Bagi saya, jika saya berhadapan dengan statistik sedih penyakit kanser darah seperti Lukimia, sudah tentu saya akan berusaha dan merayu supaya pakar-pakar tempatan mencuba teknologi sel stem terkini yang diamalkan di luar negara dan bukan hanya mengesyorkan teknologi yang sudah lama diamalkan. Sampai bila hendak ketinggalan 20 tahun?

Irish Medicine Board Consults Professor Colin McGuckin on Cord Blood Stem Cells

NEWSFLASH: UMBILICAL CORD STEM CELL BAN MAY BE LIFTED

Since Prof. Colin visited us in April this year and shared with us the difficulty of convincing medical experts that cord blood stem cells provide a real alternative to bone marrow and are able to produce various cell lineages, I was most delighted to see that Irish Authorities are finally acknowledging that cord blood stem cells are useful and can be banked for their citizen's use (see previous entry on Cavan General Hospital).

Ireland has pretty high incidences of cancer, inline with the rest of the world, although the treatment of it may be restricted due to the available medical facilities and services offered to the patients. Ireland has one of the worst cancer survival incidences in Europe.

If you're wondering if cord blood stem cells really can be used in cancer treatment in adults, have a look at this article citing one of the world's most famous transplanters, Prof. Mary Laughlin who is the haematologist and oncologist at Case Comprehensive Cancer Center and University Hospitals of Cleveland Ireland Cancer Center.

Just in case the article is taken offline, the article is below:

=====================================================
By Fiachra O'Cionnaith

Friday July 18 2008

Official policy banning the retrieval of cord blood stem cells at Dublin's three main maternity hospitals could be set to come to an end under new Department of Health plans.

Since August 2005, official policy at the Rotunda, the Coombe and the National Maternity Hospital has meant that requests from new mothers for medics to retrieve stem cells from the umbilical cord have fallen on deaf ears.

But after confirmation from the Department of Health that it has met with international experts over the possibility of creating a public cord blood stem cell bank for medical and research purposes, the official policy ban may now be overruled.

Since the cord blood stem cell retrieval technology became a reality, a wide-ranging international debate has raged over the use of stem cells obtained in this way.

Those in favour of the medical technique say that cord blood stem cells significantly improve the chances of using the stem cells in question to help treat future medical conditions in the newborn baby or their relatives.

Ethical

But opponents have countered by pointing to ethical concerns over the use of cord blood stem cells and have added that there is not yet enough long-term research to support the claims made about the technique.

As a result of the increased profile of the cord blood stem cell retrieval -- which has been used in over 10,000 births, mainly in the US -- a rising number of Irish mothers have asked for the procedure when giving birth.

Until recently, they have been told the matter was against hospital policy at Dublin's three maternity hospitals, with a formal policy clarification signed by the Masters of the Rotunda, the Coombe, and the National Maternity Hospital in August 2005 noting: "There is insufficient scientific research to support the procedure of taking cord blood for stem cell retrieval. The three maternity hospitals do not support requests to take core blood for stem cell retrieval."

However, speaking to the Herald today, the head of the Irish Patients Association Stephen McMahon said that the Department of Health is now considering plans to potentially bring the policy to an end.

The Department of Health has confirmed that after consulting international experts on the matter it is now considering establishing a public bank for the storage of cord blood stem cells for medicinal and research purposes.

It is continuing to hold meetings with "relevant" interest groups on the matter.

Last week the Department, the HSE, the Irish Blood Transfusion Service and the Irish Medicines Board met with international expert Professor Colin McGuckin of the Institute of Human Genetics at the UK's Newcastle University to hear the benefits of freezing cord blood cells for future use.

The international expert said that the only major hurdle to the plans was the current financial restrictions in the health service.

- Fiachra O'Cionnaith

Stem Cell Snake Oil? When a rotten apple spoils the whole barrel

There's no need to tell me that this blog site seems to be gathering a rather thick layer of dust since we last posted in April. It certainly isn't for the lack of interest but simply the lack of time and sleep!

Well, there's been lots happening in the stem cell world and if you've been keeping up with the news (and if you've been doing that, you definitely have had more time than I have) you'll have seen the many various promotions by new companies, the new technological adoptions and the wide-scale criticism of certain organizations who offer purported stem cell treatments without credible medical data or volunteer themselves for western methods of accreditation and inspection.

There has been most unfortunate reports the media, highlighting the cases of families being "conned" into stem cell treatments and spending hard-earned or hard-raised cash flying to exotic countries for injections. The media certainly portray these families as having no money and no idea as to what they are getting into and are therefore considered "victims" of scams.

It does seem to me that some of these criticisms of the various centers, while valid, give too much credit and sympathy to the patient. Patients who are willing to spend that amount of money should certainly conduct their own research first and opt to try something experimental, knowing that the outcome at best may be to return home safely after a vacation from their usual drudgery and hopefully no worse than what conventional drugs or palliative treatment can offer.

Some of these centers have claims of miraculous cures and patients who have shown remarkable improvements in their conditions. What I'm wondering is whether these centers have been invited to the table to present their work and explain why they think a particular treatment worked in some patients and not in others.

The stem cell world is still new and many issues surrounding the understanding of how stem cells migrate and assist in tissue regeneration have yet to be elucidated.

In any case, the jury is still out and therefore it all depends on whether you believe in "innocent until proven guilty" or "guilty until proven innocent". Criticism is always easier when you haven't got a sick child or a parent with an incurable disease. Desperation itself is a powerful motivating factor to try anything or to try nothing, and is the individual's or family's decision.

One of the biggest problems that a patient faces is access to information and doctors who are really willing to discuss the issues knowledgeably and openly. Doctors could also inform the patients that there are no guarantees in any medical treatment and in the cases of the currently "incurable", inform the parents of the basis of the disease and why stem cells may or may not be able to help.

A short list of questions that might be useful for potential patient to ask are:

1) Are these treatments performed in licensed hospitals?
2) Who are the doctors performing the treatments?
3) How are the stem cells applied?
4) What is the source of the stem cells?
5) Can I see your laboratory facility? (sterility controls, infectious disease etc)
6) Can my medical doctor speak with your medical director?
7) What is the track record of your patients? (success vs. failures, how many still alive?)
8) What other therapies/ treatments do I have to undergo?
9) Adequate back-up facilities for complications?

There are no right or wrong answers but its good to understand the main motives of the providing organization to know whether it is purely for profit and the injections may only be saline.

Sel Stem Darah Tali Pusat Bayi - diiktiraf di seluruh Dunia!

Sel Stem Darah Tali Pusat Bayi - diiktiraf di seluruh Dunia!

Assalamualaikum WBK,

Salam Sejahtera kepada rakan-rakan saya sekelian, ibu-bapa, bakal ibu-bapa, pengunjung/pembaca blog ini.

Beberapa hari kebelakangan ini kami telah mengambil bahagian dalam program-program ceramah topik Sel Stem Darah Tali Pusat dan kegunaanya dalam menangani masaalah Leukemia dan Talasemia di beberapa lokasi yang telah dianjurkan oleh beberapa organisasi berwawasan sempena Hari Ibu yang diraikan beramai-ramai bulan ini.

Organisasi termasuk Bank Negara, Pusat Perubatan MUIP dan Sekolah Sri Ayesha. Ketiga-tiga telah mengundang kami sebagai Pakar Sel Stem kerana ingin mendapatkan penjelasan yang terkini. Para hadirin ketiga-tiga program ingin penjelasan mengenai pengiktirafan dan status perkhidmatan Sel Stem darah Tali Pusat. Bersama-sama kami di Bank Negara adalah Ratu Jazz Sheila Majid yang telah turut serta di majlis ini kerana beliau juga telah menyimpan Sel Stem Darah Tali Pusat anaknya Khalifah tahun lepas dan ingin mengumumkan kepada peminat beliau mengapa beliau telah memilih untuk menyimpan sel stem darah tali pusat anaknya.

Sudah tentu ramai di antara anda telahpun membaca dalam akhbar-akhbar tempatan tentang penggunaan Sel Stem Binatang untuk mengubati penyakit-penyakit yang sering dihidap zaman ini. Saya berpendapat jika adanya Sel Stem sendiri ataupun yang diderma oleh saudara lain, kita tidak perlu menggunakkan Sel Stem Binatang. Sudah tentu ia tidak menjadi pilihan saya. Kita sering mendengar tentang penyakit ’Bird Flu’, ’Jangkitan Nipah Virus’, ’JE’, dan ’Mad Cow Disease’ yang mungkin menjangkiti manusia dan ada yang telah membunuh ramai - adakah mungkin selamat penggunaan sel stem binatang? Saya masih was-was dan menasihati semua supaya berwaspada. Jika betul ada kajian yang membuktikan keselamatan, kesahihan, dan keberkesanan sel stem binatang digguna bagi manusia dan jika betul ia diiktiraf negara Eropah seperti UK, di USA atau di Australia barulah saya akan menimbangkan penggunaanya. Ini juga jika sudah betul kesesakan dan betul tiada pilihan lain dan juga jika tidak melanggar hukum syarak. Teknologi terkini amat canggih dan mampu memberikan pelbagai pilihan semulajadi seperti sel stem sendiri, buat masa ini dan juga di masa hadapan.


Sel Stem darah tali pusat dan sum-sum tulang yang diderma oleh sahabat kita atau disimpan masa bayi dilahirkan yang sering diggunakan oleh pakar-pakar perubatan telah pun mendapat perhatian dan penerimaan oleh pihak Majlis Kebangsaan Bagi Hal Ehwal Agama Islam.

Penggunaan Sel Stem Darah Tali Pusat juga telah diterima oleh Kementerian Kesihatan Malaysia. Semenjak tahun 2002 lagi kerajaan telahpun mengiktiraf kepentingan sel stem darah tali pusat apabila Pusat Darah Negara telah memulakan perkhidmatan bank sel stem darah tali pusatnya di Pusat Darah Negara di Jalan Tun Razak Kuala Lumpur. PDN telah berganding bahu dengan Hospital Besar Kuala Lumpur dimana ibu-ibu yang bersalin di Hospital Besar KL boleh menderma darah tali pusat mereka kepada PDN.


Pada lewat tahun 2007, Menteri Kesihatan pada masa itu telah pun mengumumkan untuk meningkatkan lagi mutu perkhidmatan dan menambahkan saiz simpanan Sel Stem Darah Tali Pusat Kerajaan di Pusat Darah Negara dan juga membina bank sel stem darah tali pusat di Sg Petani, kedah. Menteri Kesihatan juga telah berjanji untuk meningkatkan perkhidmatan transplantasi sel stem di hospital-hospital Kerajaan tertentu. Pihak KKM juga telah mengiktiraf kewujudan Bank Sel Stem Darah Tali Pusat Swasta apabila telah melesenkan perkhidmatan StemLife Berhad di bawah Akta Perkhidmatan dan Fasiliti Perubatan Swasta 1998.

Terapi sel stem, transplantasi sel stem ataupun pemindahan sel stem telah mula diamalkan di Malaysia lebih dari 15 tahun yang lepas. Pusat perubatan Universiti-Universiti tempatan dan Hospital Kerajaan seperti Hospital Besar Kuala Lumpur sudah lama dan sering mengamalkan prosedur ini. Ianya masih belum kerap dilakukan atau diumumkan pihak media kerana masih ramai gagal mendapat bekalan sel stem.

Perangkaan dari NDMP-USA(Program Pendermaan Sum-Sum Tulang Nasional–USA) bagi tahun 2007 adalah lebih 6,000 pesakit mencari sel stem di bank-bank darah kerajaan USA setiap hari tetapi hanya 648 berjaya mendapatkan sel stem untuk menyelamatkan nyawa mereka. Setiap tahun sekurang-kurangnya 40,000 hingga 50,000 pesakit diseluruh dunia berjaya mendapatkan perkhidmatan pemindahan sel stem bagi penyakit-penyakit barah darah seperti Leukemia dan kepincangan sistem darah seperti Talasemia.

Kini, beberapa Kerajaan Negeri di Negeri-Negeri di bawah Negara USA telah pun menyarankan supaya doktor-doktor menasihati ibu-ibu tentang keggunaan sel stem darah tali pusat dan peluang sekali seumur hidup mereka. Peluang ibu-ibu untuk membuat pilihan samada menderma kepada bank darah Kerajaan untuk keggunaan umum atupun menyimpan di bank darah swasta untuk keggunaan keluarga sendiri.

20 tahun lepas, sel stem darah tali pusat hanya diggunakkan untuk menyelamatkan pesakit-pesakit bagi Satu penyakit. 10 tahun lepas, bilangan penyakit telah meningkat ke lebih kurang 10 penyakit. Kini, anggaran oleh Prof. Dr. Colin McGuckin dari Newcastle University adalah 85 penyakit dan jumlah penyakit akan makin meningkat.

Jadi, terapi sel stem darah tali pusat bayi bukanlah suatu prosedur amalan alternatif tetapi adalah prosedur biasa diamalkan dan diiktiraf pakar-pakar dan kerajaan-kerajaan di seluruh dunia.

Sekian buat masa ini......Wslm..WBK.

Launch of NOVUSSANGUIS

Today marks the launch of a new international research consortium called Novussanguis for cord blood and adult stem cells. Its founding members, Professor Colin McGuckin and the Jerome LeJeune Foundation plan to bring together key researchers to discuss and collaborate on the development of stem cells for clinical application.


The launch is held in Paris today and I'll provide some insights about it later on. Here's a snapshot of the launch program.