This blog isn't about embryonic stem cells but I thought this bioethics opinion was interesting from the perspective of how adult stem cells are making progress whereas embryonic stem cells still have to defend themselves against criticism and that proving its application and safety will be an uphill battle.
Read:
http://www.investors.com/NewsAndAnalysis/Article.aspx?id=482427
Showing posts with label ethics. Show all posts
Showing posts with label ethics. Show all posts
Saturday, July 18, 2009
Wednesday, June 24, 2009
Legal Rights of Parents for Cord Blood Collection
There was once a time, when we had just initiated StemLife, that I was personally visiting obstetricians to let them know about our service. It was feet-killing work for the initial years, long hours in formal attire and smart shoes, sitting in many a doctor's waiting room for hours before the patients would clear out and the obstetricians could spare a few precious moments to hear us out.
Inevitably, one of the questions that would come up among the more astute clinicians would be regarding the legal implications of collecting umbilical cord blood (perhaps they have experienced litigious clientele themselves before). They would ask what the implications are should the collection not be successful or if there was an emergency and the cord blood could not be collected due to some unpredicted situation. StemLife has a very specific form and clause for this, nothing is absolutely guaranteed and we explain very carefully to parents that in the event of an emergency, the life of mum and babe comes first.
In the same vein, I thought that this article was interesting in that Professor Colin McGuckin has brought up another scenario in which parents would have possible legal recourse with doctors.
That cord blood stem cells have been harnessed for regenerative medical purposes cannot be denied. From trials being conducted on Type 1 diabetes in Florida to Cerebral Palsy at Duke, parents of these afflicted children were not able to foresee the fate of their child nor to take any measured steps to prevent the problem from happening. Doctors also have no way of guaranteeing the safety and wellness of mother and baby. Although advanced equipment and well trained staff can help in mitigating risk factors, everyone appreciates that there are no absolutes in life.
Parents world over who have healthy children, born without any genetic condition and fault may or may not appreciate what parents who have a lifetime of sleepness nights ahead go through without a shred of hope or any help from clinicians who refer to text books and tell parents that there is no cure.
I do appreciate that not every parent can or will want to bank their cord blood stem cells for a variety of reasons but it would seem to me that it would be a good idea for clinicians to cover themselves by at least letting the patients know that the service exists and a stamp on their folders to indicate that they've been told so as to pre-empt that unforseeable case in the future.
Inevitably, one of the questions that would come up among the more astute clinicians would be regarding the legal implications of collecting umbilical cord blood (perhaps they have experienced litigious clientele themselves before). They would ask what the implications are should the collection not be successful or if there was an emergency and the cord blood could not be collected due to some unpredicted situation. StemLife has a very specific form and clause for this, nothing is absolutely guaranteed and we explain very carefully to parents that in the event of an emergency, the life of mum and babe comes first.
In the same vein, I thought that this article was interesting in that Professor Colin McGuckin has brought up another scenario in which parents would have possible legal recourse with doctors.
That cord blood stem cells have been harnessed for regenerative medical purposes cannot be denied. From trials being conducted on Type 1 diabetes in Florida to Cerebral Palsy at Duke, parents of these afflicted children were not able to foresee the fate of their child nor to take any measured steps to prevent the problem from happening. Doctors also have no way of guaranteeing the safety and wellness of mother and baby. Although advanced equipment and well trained staff can help in mitigating risk factors, everyone appreciates that there are no absolutes in life.
Parents world over who have healthy children, born without any genetic condition and fault may or may not appreciate what parents who have a lifetime of sleepness nights ahead go through without a shred of hope or any help from clinicians who refer to text books and tell parents that there is no cure.
I do appreciate that not every parent can or will want to bank their cord blood stem cells for a variety of reasons but it would seem to me that it would be a good idea for clinicians to cover themselves by at least letting the patients know that the service exists and a stamp on their folders to indicate that they've been told so as to pre-empt that unforseeable case in the future.
Wednesday, March 04, 2009
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.
====
Monday, November 03, 2008
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?
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?
Thursday, July 24, 2008
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
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
Monday, July 21, 2008
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.
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.
Sunday, May 18, 2008
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.
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.
Tuesday, February 06, 2007
Stem Cell News Updates- Hearts & Virgin & Astronauts...
I came back into the office this morning sporting a new flu bug and trying not to speak to anyone for fear that it might spread. Two bottles of anti-tussive Robitussin (manufactured locally by pharmaceutical manufacturer Pharmaniaga) and a whole tube of fizzy Redoxon later, the fever has fortunately been reduced to phlegmy obstruction in my eustachian tubes, nose and throat.
I have full confidence that my stem cells are kicking into overdrive to produce the necessary lymphocytes and leukocytes to do battle, as evidenced by the phlegm (cellular war debris and aftermath). :)
BATTLE AGAINST BREATHLESSNESS & PAIN
Anyway, I had a quick look at the recent news in the stem cell arena and saw another update on the Gary Schaer trial at Rush Medical Center's Cardiac Catheterization Lab using CD34+ cells for heart disease, where the objective is to "stimulate the growth of new blood vessels to bring more blood and oxygen to the heart muscle, so that these patients will have a better quality of life and less chest pain". One of the reasons why I highlight this clinical application is because one of the big brand names, Baxter, is helping to bring together two specialties- cardiology and hematology. No longer are CD34+ a code language for hematologists to use alone, but these cells have been perhaps overlooked or underestimated in their capacity to regenerate. Their results have been like ours, which is good news to reinforce our work- the treatment is well tolerated and patients report having less chest pain and improved exercise capacity.
Many doctors I speak with are afraid of cross specialties, largely because to properly understand it requires an extensive undertaking in time to read up on one's own, or to have to fork out a decent amount of time (+ money) to receive further training in the area. I understand the reluctance and agree somewhat that these are special interest areas and think that it should probably be left up to those who are keenly interested or have been specifically trained so that it can administered safely and ethically.
Having said that, I also believe that it is possible that doctors who are interested in this subject area but neither have the time nor money to pursue it as a specific interest area, are able to garner the expertise through collaborating with a specialist organization like StemLife. Unlike other companies who found the business attractive and believed they could replicate our work after reading our prospectus, it does take more than cash to ensure committment, energy and drive to fuel passion and continuous knowledge assimilation.
MONEY MAKES THE WORLD GO ROUND?
Whilst we're on the topic of spending wads of cash, I also read about Sir Richard Branson's very PR-driven announcement of initiating a cord blood stem cell bank in the UK. From the BBC news site:
Virgin says its service is unique because it will offer a charitable element, allowing the NHS to use some of stem cells the company stores. Sir Richard explained: "We will take an individual's cord blood and we will divide it in two. "So, part of it will go into a national blood centre that anybody can get access to. And the other half will be put aside for the child." He said this should help particularly high risk ethnic groups who are prone to conditions that can be treated with stem cells but who may have difficulty finding well-matched cord blood.
I found this to be interesting on the ownership and ethical prospect. The idea is marvellous, semi-altruistic (except for the fact that parents still have to pay a fee) but leaves behind quite a number of questions in my mind which I wonder how they will resolve. Here's a few ones that spring immediately to mind:
Parents have to pay 1500 British Pounds or (RM 10,500) to store their stem cells in Virgin's bank.
1. So if it is divided in 2, who owns which half and does the parent have the first right of refusal if someone needs it but they wish not to donate?
2. How will they ensure that the cord blood collected will be sufficient to be divided in half? (volumes are highly variable)
3. Does the NHS have to pay Virgin for the use of the stem cells?
4. With this new company, will the NHS now permit Virgin to collect the cord blood in their trust hospitals or will be specific ones only? (see previous blogs)
5. If the unit is half used and the donor now needs it, can they get a replacement for free?
According to the Virgin press release on this topic, Professor Colin McGuckin and his Newcastle team are involved with Sir Richard on this project and are his advisors. If the cord blood stem cells can also be used for research, it would guarantee their facility an endless supply of cells to work with for stem cell expansion or treatment. I'm not against entrpreneurs wishing to start up stem cell banks, but I do think that if new models are being thought up, I'm keen to know how they are being thought through.
Okay, this is turning out to be a rather long blog entry so bear with me for the last bit which I feel brings everything round and round and round.
STEM CELLS & SPACE TRAVEL: CORD BLOOD INTO A NEW DIMENSION
It turns out that this article mentioned that Prof. Colin McGuckin (yes, him again) has been awarded a USD 1 million grant to determine the potential of growing new body tissues to replace tissue damaged or turned cancerous by space radiation, using his zero-gravity simulator. He plans to put adult stem cells derived from astronaut's blood in a zero-gravity bio-reactor and using a cocktail of stimuli (ie cytokines), instruct the cells to grow into liver or muscle or any other tissue. The aim being to provide NASA with the means for a replacement body part for every astronaut on their travel to another planet (maybe Mars in 2030 or Uranus in 2090?).
This is exciting because it negates the effect of time on the wear and tear of the body. If you are a Star trek fan (and I'm talking The Next Generation here), you'll remember that cool wand that Dr. Beverly Crusher uses whenever one of the crew is injured to stimulate healing in a total of 5 seconds. Must be a stem cell activation factor.
And there weren't too many lives that she couldn't save :)
I have full confidence that my stem cells are kicking into overdrive to produce the necessary lymphocytes and leukocytes to do battle, as evidenced by the phlegm (cellular war debris and aftermath). :)
BATTLE AGAINST BREATHLESSNESS & PAIN
Anyway, I had a quick look at the recent news in the stem cell arena and saw another update on the Gary Schaer trial at Rush Medical Center's Cardiac Catheterization Lab using CD34+ cells for heart disease, where the objective is to "stimulate the growth of new blood vessels to bring more blood and oxygen to the heart muscle, so that these patients will have a better quality of life and less chest pain". One of the reasons why I highlight this clinical application is because one of the big brand names, Baxter, is helping to bring together two specialties- cardiology and hematology. No longer are CD34+ a code language for hematologists to use alone, but these cells have been perhaps overlooked or underestimated in their capacity to regenerate. Their results have been like ours, which is good news to reinforce our work- the treatment is well tolerated and patients report having less chest pain and improved exercise capacity.
Many doctors I speak with are afraid of cross specialties, largely because to properly understand it requires an extensive undertaking in time to read up on one's own, or to have to fork out a decent amount of time (+ money) to receive further training in the area. I understand the reluctance and agree somewhat that these are special interest areas and think that it should probably be left up to those who are keenly interested or have been specifically trained so that it can administered safely and ethically.
Having said that, I also believe that it is possible that doctors who are interested in this subject area but neither have the time nor money to pursue it as a specific interest area, are able to garner the expertise through collaborating with a specialist organization like StemLife. Unlike other companies who found the business attractive and believed they could replicate our work after reading our prospectus, it does take more than cash to ensure committment, energy and drive to fuel passion and continuous knowledge assimilation.
MONEY MAKES THE WORLD GO ROUND?
Whilst we're on the topic of spending wads of cash, I also read about Sir Richard Branson's very PR-driven announcement of initiating a cord blood stem cell bank in the UK. From the BBC news site:
Virgin says its service is unique because it will offer a charitable element, allowing the NHS to use some of stem cells the company stores. Sir Richard explained: "We will take an individual's cord blood and we will divide it in two. "So, part of it will go into a national blood centre that anybody can get access to. And the other half will be put aside for the child." He said this should help particularly high risk ethnic groups who are prone to conditions that can be treated with stem cells but who may have difficulty finding well-matched cord blood.
I found this to be interesting on the ownership and ethical prospect. The idea is marvellous, semi-altruistic (except for the fact that parents still have to pay a fee) but leaves behind quite a number of questions in my mind which I wonder how they will resolve. Here's a few ones that spring immediately to mind:
Parents have to pay 1500 British Pounds or (RM 10,500) to store their stem cells in Virgin's bank.
1. So if it is divided in 2, who owns which half and does the parent have the first right of refusal if someone needs it but they wish not to donate?
2. How will they ensure that the cord blood collected will be sufficient to be divided in half? (volumes are highly variable)
3. Does the NHS have to pay Virgin for the use of the stem cells?
4. With this new company, will the NHS now permit Virgin to collect the cord blood in their trust hospitals or will be specific ones only? (see previous blogs)
5. If the unit is half used and the donor now needs it, can they get a replacement for free?
According to the Virgin press release on this topic, Professor Colin McGuckin and his Newcastle team are involved with Sir Richard on this project and are his advisors. If the cord blood stem cells can also be used for research, it would guarantee their facility an endless supply of cells to work with for stem cell expansion or treatment. I'm not against entrpreneurs wishing to start up stem cell banks, but I do think that if new models are being thought up, I'm keen to know how they are being thought through.
Okay, this is turning out to be a rather long blog entry so bear with me for the last bit which I feel brings everything round and round and round.
STEM CELLS & SPACE TRAVEL: CORD BLOOD INTO A NEW DIMENSION
It turns out that this article mentioned that Prof. Colin McGuckin (yes, him again) has been awarded a USD 1 million grant to determine the potential of growing new body tissues to replace tissue damaged or turned cancerous by space radiation, using his zero-gravity simulator. He plans to put adult stem cells derived from astronaut's blood in a zero-gravity bio-reactor and using a cocktail of stimuli (ie cytokines), instruct the cells to grow into liver or muscle or any other tissue. The aim being to provide NASA with the means for a replacement body part for every astronaut on their travel to another planet (maybe Mars in 2030 or Uranus in 2090?).
This is exciting because it negates the effect of time on the wear and tear of the body. If you are a Star trek fan (and I'm talking The Next Generation here), you'll remember that cool wand that Dr. Beverly Crusher uses whenever one of the crew is injured to stimulate healing in a total of 5 seconds. Must be a stem cell activation factor.
And there weren't too many lives that she couldn't save :)
Friday, November 24, 2006
Concerns over Indian Cord Blood Bank Life Cell
I saw this blog entry which was pretty interesting. Essentially, the author describes the controversies of running a cord blood bank, even a "public-access" one, which create perceptions of charity or public responsibility, but may have its own consequences of ethics and points of controversy*.
I'll provide you with the start of the article and maybe you'll find it interesting enough to read the whole entry (which isn't long) and think through its perspectives... The first 3 lines were very provoking.
Cord blood banks are a lot like real ones. The more people participate, the better the value for everyone.
It's free to make a deposit, but withdrawals come with all kinds of fees.
US banks are pretty well regulated. The rest of the world has its colorful outliers.
People fear that India, which is coming into the cord banking world now with LifeCell, may not be too stringent on who gets to buy their blood -- and people may be dying to donate. Wired has the story:
Most experts agree that public cord-blood banking is a good idea. Stem cells from both cord blood and bone marrow treat many blood diseases, but cord blood is easier to obtain. Cord blood is also less likely to be rejected than bone marrow, which requires an exact match, usually from a family member. Similar to a blood bank, a cord-blood bank relies on donations to cover a broad range of immune types. The more donors, the more likely patients in need will find a match.
But in India, where female infanticide and body-organ sales are not uncommon, watchdog groups worry that a massive cord-blood bank like LifeCell's could create a dangerous demand for umbilical cords.
I believe that if good quality stem cell banking can be made available for a reasonable price, expectant parents would have no qualms about making the decision to store their babies's stem cells. Whilst greater popularity amongst investors should be a good thing, one of the challenges facing cord blood banks in many countries today is posed by ruthless competition, where price slashing may lead to a consequential cutting corners in a service which confuses the public and gives the entire industry a bad name.
At StemLife, we believe in providing value added services to our clients at an affordable cost and going the extra mile to make sure that the stem cell banking service is available to anyone who enquires. Our committment to our clients is that we care about their babies' stem cells and prudent management of the company with proven credibility also enables us to survive and excel in this new but exciting industry.
*Private banks are often accused of making parents feel bad for not banking their babies' cord blood stem cells, but forget that public banks are faced with difficult choices too in order to meet their respective targets.
I'll provide you with the start of the article and maybe you'll find it interesting enough to read the whole entry (which isn't long) and think through its perspectives... The first 3 lines were very provoking.
Cord blood banks are a lot like real ones. The more people participate, the better the value for everyone.
It's free to make a deposit, but withdrawals come with all kinds of fees.
US banks are pretty well regulated. The rest of the world has its colorful outliers.
People fear that India, which is coming into the cord banking world now with LifeCell, may not be too stringent on who gets to buy their blood -- and people may be dying to donate. Wired has the story:
Most experts agree that public cord-blood banking is a good idea. Stem cells from both cord blood and bone marrow treat many blood diseases, but cord blood is easier to obtain. Cord blood is also less likely to be rejected than bone marrow, which requires an exact match, usually from a family member. Similar to a blood bank, a cord-blood bank relies on donations to cover a broad range of immune types. The more donors, the more likely patients in need will find a match.
But in India, where female infanticide and body-organ sales are not uncommon, watchdog groups worry that a massive cord-blood bank like LifeCell's could create a dangerous demand for umbilical cords.
I believe that if good quality stem cell banking can be made available for a reasonable price, expectant parents would have no qualms about making the decision to store their babies's stem cells. Whilst greater popularity amongst investors should be a good thing, one of the challenges facing cord blood banks in many countries today is posed by ruthless competition, where price slashing may lead to a consequential cutting corners in a service which confuses the public and gives the entire industry a bad name.
At StemLife, we believe in providing value added services to our clients at an affordable cost and going the extra mile to make sure that the stem cell banking service is available to anyone who enquires. Our committment to our clients is that we care about their babies' stem cells and prudent management of the company with proven credibility also enables us to survive and excel in this new but exciting industry.
*Private banks are often accused of making parents feel bad for not banking their babies' cord blood stem cells, but forget that public banks are faced with difficult choices too in order to meet their respective targets.
Saturday, October 14, 2006
Do not misinterpret NHS Trust Doctor's stance on Cord Blood Collection
A quick search on cord blood reveals a number of articles citing a senior consultant obstetrician, Dr. Leroy Edozien, commenting on cord blood collection. I felt that the headlines proclaiming that he was totally against cord blood collection is unfairly represented by the press, as his actual comments relate mostly to the cord blood collected in public hospitals and its logistic issues poses to the doctors.
My analysis of the comments that I could find are as follows:
His concern: "Time spent on collecting cord blood is time away from the care of this mother, the baby, and, critically, other patients."
This may be true in government facilities as staff numbers are sometimes limited and due to the overwhelming load of patient deliveries, doctors and nurses often have to manage multiple ladies in various stages of labor. However, the time spent also does depend on the method of cord blood collection. Some companies provide syringes (cheaper) and expect the doctor to load the anti-coagulant prior to collection. However, StemLife makes this as easy as possible for one doctor/ nurse to perform the collection with sterile, pre-loaded blood bags with anti-coagulant which saves time and manipulation.
He adds: ""As well as being given a realistic assessment of the value of cord blood banking, parents need to know how their care, and the care of other women, can be affected by cord blood collection and what could go wrong during collection. There could also be risks that the cord blood could be contaminated or mislabeled, which could lead to legal action."
True, except that all cord blood stem cell banks should have already signed agreements with parents and counselled them sufficiently to understand that the collection of cord blood is never guaranteed. Some mothers may have emergency deliveries where it may be deemed that cord blood cannot be safely collected. Dr. Edozien's specialty is managing mothers with pregnancy problems and if these ladies requested cord blood collections, this may have bearings on the delivery process.
And not only do cord blood volumes vary from baby to baby (think small, large, long, short umbilical cords) but also despite thorough cleaning of the cord by the doctor, a single bacteria which may remain on the cord may enter the blood bag and contaminate the unit. This is not the doctor's fault nor the cord blood banks' as bacteria exist naturally everywhere, in the mucosa, vaginal tract and also in the digestive tract. All it would take would be a small amount of urine, poo or fart* to get the bacteria onto the cord and perhaps into the blood.
Cord blood banks do not usually accept contaminated units in accordance with good banking practices (StemLife does not, although I understand that there are some in asia who do...) and will discard them after informing the parents of the result. In this event, StemLife provides a full refund to the client and this happens in a small number of collections each month. I suppose if there was no refund involved, then not only would the client have lost the opportunity to bank the stem cell unit but also some money (the sum which is involved in the processing and testing of the unit).
Dr. Edozien also poses the concern of mislabelling but StemLife addresses this issue in 2 ways: 1) pre-labelling the cord blood kit with the mother's name prior to the birth of the baby and 2) ensuring that our collection team member checks on the name of the mother against our delivering database. I'm curious as to how the UK cord blood banks manage this point.
He says: "Even if the rapid pace of technological advancement results in today's speculation becoming tomorrow's reality, risk management, medicolegal, ethical, and public policy considerations militate against commercial collection of cord blood in NHS maternity units. It should therefore be NHS policy not to facilitate umbilical cord blood collection by its staff."
-If I had a child with thalassemia major and my next baby's cord blood could help treat the condition, would you prevent me from collecting the cord blood?
Can you guarantee a matching unit for my child in the public cord blood bank?-
....Its pretty tragic if no exceptions can be made in the NHS hospitals as there may be mothers who really require the service although they may not necessarily know it at the birth of their child. Private cord blood stem cell banks have already facilitated transplants for these patients and the numbers continue to grow.
He admits:"Increasing numbers of women in maternity units across the United Kingdom are requesting collection of umbilical cord blood at delivery to enable storage of stem cells for possible autologous transfusion in the future."
There is no denying that many mothers will come to know about cord blood stem cells. UK Mothers who wish to have cord blood stem cells collected may need to go to private centers. That would be a pity as it would be a step back from making another simple procedure routinely available for all mothers. I'm no expert on the NHS policies and I'm sure the doctors are doing the best they can under the circumstances available, but perhaps they could consider having those mothers who wish to have their cord blood collected check in to specific rooms and pay a small procedural fee to have a doctor, nurse or trained cord blood bank staff perform the collection. This may also provide some financial alleviation on the healthcare budget of the hospital.
*please excuse my use of this colloquialism
Wednesday, October 11, 2006
Updates on Cord Blood Stem Cell News
Congratulations to the St. Louis Cord Blood Bank which has just announced the 1,000th cord blood stem cell unit which has been exported for transplant!
It is the world's second-largest cord blood repository and its continued development is testament to the value of cord blood stem cells in disease treatment. The article states "Cord blood is a source of adult stem cells which are as effective as a bone marrow transplant in fighting leukemia and lymphoma. Cord blood is collected from the umbilical cord at birth."
The bank began shipping units of cord blood for exportation worldwide in 1997 and is a member of the NMDP, a consortium of public cord blood banks. Their website FAQ makes it clear that although donation does not cost the donor any money, the donor also has no exclusive rights to the stored unit, as it is in the bank's discretion to provide it to another patient in need or to a laboratory for research purposes. Most of the public banks charge patients for the release of units, with the cost typically being in excess of USD 21,000. So in this regard the St. Louis bank is probably the most cash-generative public access bank in the world, although the release fees probably still don't cover the high costs of operating this facility in the US.
In a separate article, a famous Netherlands-based medical researcher Dr. Pieter Doevendans criticized the practice of private cord blood banking, alleging that mothers have to pay a hefty fee for an idea that may not yield any results for another 50 years.
The press went on to quote him as saying "There is no proof that one can use cord stem cells to cure a disease, be it leukemia or thalassaemia...Storing cord blood cells may help 50 years down the line, but not before."
Dr. Doevedans is wrong, wrong, wrong. Who knows what his sources are, but if he had been reading this blog or the Malaysian newspapers, he could have learned about how in the last four years StemLife has assisted in two life-saving cord blood stem cell transplants; one for leukemia and one for thalassemia major. There have been similar leukemia transplants in Europe. Dr. Doevedan's mis-informed comments are a dis-service to patients, doctors and scientists seeking therapies using cord blood stems cells. Perhaps he should re-read the hippocratic oath.
Apparently, private banks in the Netherlands charge large sums to bank cord blood stem cells for a period of ten years and the same applies in India. In Malaysia our pricing is very reasonable (less than a teh-tarik per day!) and anyone who knows the costs of medical consumables and what it takes to run a good service would know that we're very prudent about managing the pricing to make stem cell banking affordable. Compare the upfront charge to the amount that public services charge, with no greater guarantees that the unit would be available, and the banking fee in Malaysia is actually very affordable.
Perhaps Dr. Doevendans comments are explained by the fact that instead of working with cord blood stem cells he works on highly speculative (though important) embryonic stem cell research to generate cardiomyocytes from pigs and mice. He is hoping that the research will result in tissues which are able to be sewn onto the heart within 5 years. Notably, he is also a scientific advisor to a Singapore company Embryonic Stem Cell International (ESI).
Umbilical cord blood stem cells have effectively been used to treat thalasemia and leukemia and a number of other illnesses. How many leukemia patients have been saved with embryonic stem cell transplants? NONE.
It is the world's second-largest cord blood repository and its continued development is testament to the value of cord blood stem cells in disease treatment. The article states "Cord blood is a source of adult stem cells which are as effective as a bone marrow transplant in fighting leukemia and lymphoma. Cord blood is collected from the umbilical cord at birth."
The bank began shipping units of cord blood for exportation worldwide in 1997 and is a member of the NMDP, a consortium of public cord blood banks. Their website FAQ makes it clear that although donation does not cost the donor any money, the donor also has no exclusive rights to the stored unit, as it is in the bank's discretion to provide it to another patient in need or to a laboratory for research purposes. Most of the public banks charge patients for the release of units, with the cost typically being in excess of USD 21,000. So in this regard the St. Louis bank is probably the most cash-generative public access bank in the world, although the release fees probably still don't cover the high costs of operating this facility in the US.
In a separate article, a famous Netherlands-based medical researcher Dr. Pieter Doevendans criticized the practice of private cord blood banking, alleging that mothers have to pay a hefty fee for an idea that may not yield any results for another 50 years.
The press went on to quote him as saying "There is no proof that one can use cord stem cells to cure a disease, be it leukemia or thalassaemia...Storing cord blood cells may help 50 years down the line, but not before."
Dr. Doevedans is wrong, wrong, wrong. Who knows what his sources are, but if he had been reading this blog or the Malaysian newspapers, he could have learned about how in the last four years StemLife has assisted in two life-saving cord blood stem cell transplants; one for leukemia and one for thalassemia major. There have been similar leukemia transplants in Europe. Dr. Doevedan's mis-informed comments are a dis-service to patients, doctors and scientists seeking therapies using cord blood stems cells. Perhaps he should re-read the hippocratic oath.
Apparently, private banks in the Netherlands charge large sums to bank cord blood stem cells for a period of ten years and the same applies in India. In Malaysia our pricing is very reasonable (less than a teh-tarik per day!) and anyone who knows the costs of medical consumables and what it takes to run a good service would know that we're very prudent about managing the pricing to make stem cell banking affordable. Compare the upfront charge to the amount that public services charge, with no greater guarantees that the unit would be available, and the banking fee in Malaysia is actually very affordable.
Perhaps Dr. Doevendans comments are explained by the fact that instead of working with cord blood stem cells he works on highly speculative (though important) embryonic stem cell research to generate cardiomyocytes from pigs and mice. He is hoping that the research will result in tissues which are able to be sewn onto the heart within 5 years. Notably, he is also a scientific advisor to a Singapore company Embryonic Stem Cell International (ESI).
Umbilical cord blood stem cells have effectively been used to treat thalasemia and leukemia and a number of other illnesses. How many leukemia patients have been saved with embryonic stem cell transplants? NONE.
Friday, October 06, 2006
"A 40-Year-Old-Man WITH 20-Year-Old-Legs"..... Rebuilding Muscle Strength with Stem Cells
Following the previous article published by the Times mentioning famous footballers banking their babies' umbilical cord blood stem cells, this article expresses why athletes apart from footballers may be interested in this area.
Stem cells can treat diseases and save lives, but now their full range of potential is being explored in tissue regeneration - not just in repairing organs that fail- but to heal soft tissue injuries (think aching muscles) and according to the article "boost strength, endurance, and provide a lasting edge over the competition".
Paul Griffiths, managing director of an umbilical cord blood stem cell bank called Cryogenesis International in the UK believes that injecting stem cells into healthy muscles might "increase their size and even restore them to their youthful capacity".
"You could potentially find a 40-year-old man with 20-year-old legs," Paul Griffiths said.
SPORTS ETHICS
It is already well-known that some athletes are at a greater advantage than others, by taking advantage of environmental enhancements. Those who have adequate sponsorship can pursue high-altitude training or have personal trainers and physiotherapists. Could stem cells be the next unfair advantage?
The issue might be how to detect if an athlete has had stem cell injections for performance enhancement (sports doping) and whether it has any real effect on the long term sustainability of the athelete. Even if the athlete's own stem cells were injected back into the muscles, those muscles may only regenerate to a limited amount with a short space of time. So sports doping with stem cells is probably going to be difficult as it does take months to build up the muscles and the injected cells may have already blended into their new environment making it almost impossible to detect.
HEALING OF SOFT TISSUE
It has already been shown in animal trials that stem cells have been able to regenerate soft tissue such as ligaments, tendons and muscles. Whilst soft tissue has a very healthy rate of repair, som injuries are too great and lead to scarring and ultimately weak fibers that are unable to withstand much further tension.
RESEARCH FROM ITALY & CANADA
Separately, in an article published in The Genome News Network 2003 both Canadian and Italian scientists found that stem cells were able to regenerate damaged muscle to give rise to new muscle fibers. But the interesting work, in my opinion is what they discovered with muscular dystrophy.
EXTRACTED FROM THE ARTICLE: The research could lead to new treatments for muscle-wasting diseases, such as muscular dystrophy, and for restoring muscle strength in elderly people. Athletes may also be interested in the new findings, which lend credence to the “no pain, no gain” approach to strength training and may lead to new strategies for bulking up.
In one study, Giulio Cossu, of the Stem Cell Research Institute in Milan, Italy, and his colleagues restored muscle function to mice with muscular dystrophy. The researchers injected stem cells from the blood vessels of healthy mice into leg arteries of mice with muscular dystrophy. The stem cells, which they call “mesoangioblasts,” accumulated in the diseased muscle within hours and eventually gave rise to healthy muscle tissue.
The Canadian study demonstrated that the muscle's amazing ability to regenerate stems from a particular protein known as Wnt (if you are a molecular biologist, check this out), which is released from damaged muscles and stimulates the stem cells to form new muscles. However, as people age, these signals diminish and the cells lose their ability to regenerate. The understanding of this process could lead to new strategies for increasing muscle strength in both aging and diseases tissues.
One of the Canadian researchers has since started a company by the name of Stempath to discover drugs which can be used to stimulate muscle stem cell production. Those types of drugs used in athletes, could be certainly considered as "sports doping".
Coming full circle again, the younger the stem cells are, the better the chance of regeneration and repair. Whether you fancy yourself as a weekend athlete or a true sports professional, perhaps stem cells may be able to help with your condition. If its your own cells and not drug based, no harm in trying. :)
StemLife has banked stem cells for several keen tennis players and runners. We look forward to more healthy Malaysian athletic stem cell bankers in the near future!
Stem cells can treat diseases and save lives, but now their full range of potential is being explored in tissue regeneration - not just in repairing organs that fail- but to heal soft tissue injuries (think aching muscles) and according to the article "boost strength, endurance, and provide a lasting edge over the competition".
Paul Griffiths, managing director of an umbilical cord blood stem cell bank called Cryogenesis International in the UK believes that injecting stem cells into healthy muscles might "increase their size and even restore them to their youthful capacity".
"You could potentially find a 40-year-old man with 20-year-old legs," Paul Griffiths said.
SPORTS ETHICS
It is already well-known that some athletes are at a greater advantage than others, by taking advantage of environmental enhancements. Those who have adequate sponsorship can pursue high-altitude training or have personal trainers and physiotherapists. Could stem cells be the next unfair advantage?
The issue might be how to detect if an athlete has had stem cell injections for performance enhancement (sports doping) and whether it has any real effect on the long term sustainability of the athelete. Even if the athlete's own stem cells were injected back into the muscles, those muscles may only regenerate to a limited amount with a short space of time. So sports doping with stem cells is probably going to be difficult as it does take months to build up the muscles and the injected cells may have already blended into their new environment making it almost impossible to detect.
HEALING OF SOFT TISSUE
It has already been shown in animal trials that stem cells have been able to regenerate soft tissue such as ligaments, tendons and muscles. Whilst soft tissue has a very healthy rate of repair, som injuries are too great and lead to scarring and ultimately weak fibers that are unable to withstand much further tension.
RESEARCH FROM ITALY & CANADA
Separately, in an article published in The Genome News Network 2003 both Canadian and Italian scientists found that stem cells were able to regenerate damaged muscle to give rise to new muscle fibers. But the interesting work, in my opinion is what they discovered with muscular dystrophy.
EXTRACTED FROM THE ARTICLE: The research could lead to new treatments for muscle-wasting diseases, such as muscular dystrophy, and for restoring muscle strength in elderly people. Athletes may also be interested in the new findings, which lend credence to the “no pain, no gain” approach to strength training and may lead to new strategies for bulking up.
In one study, Giulio Cossu, of the Stem Cell Research Institute in Milan, Italy, and his colleagues restored muscle function to mice with muscular dystrophy. The researchers injected stem cells from the blood vessels of healthy mice into leg arteries of mice with muscular dystrophy. The stem cells, which they call “mesoangioblasts,” accumulated in the diseased muscle within hours and eventually gave rise to healthy muscle tissue.
The Canadian study demonstrated that the muscle's amazing ability to regenerate stems from a particular protein known as Wnt (if you are a molecular biologist, check this out), which is released from damaged muscles and stimulates the stem cells to form new muscles. However, as people age, these signals diminish and the cells lose their ability to regenerate. The understanding of this process could lead to new strategies for increasing muscle strength in both aging and diseases tissues.
One of the Canadian researchers has since started a company by the name of Stempath to discover drugs which can be used to stimulate muscle stem cell production. Those types of drugs used in athletes, could be certainly considered as "sports doping".
Coming full circle again, the younger the stem cells are, the better the chance of regeneration and repair. Whether you fancy yourself as a weekend athlete or a true sports professional, perhaps stem cells may be able to help with your condition. If its your own cells and not drug based, no harm in trying. :)
StemLife has banked stem cells for several keen tennis players and runners. We look forward to more healthy Malaysian athletic stem cell bankers in the near future!
Monday, August 28, 2006
Footballers are banking babies' stem cells for their own fix
My colleague from Thai StemLife emailed me this article published in the Sunday Times, UK about professional footballers who had banked their babies' cord blood stem cells for future use with 2 private cord blood stem cell banks. The article cites the footballers saying that they were banking their baby's stem cells was for future therapeutic uses, including for their own cartilage and ligament repair.
POSING A CHALLENGE TO THE ETHICS OF PARENTS?: Although some people are concerned that banking of cord blood stem cells for use by a parent would raise questions as to whether parents may conceive in order to obtain stem cells, I think that this is probably highly unlikely for the following reasons:
1) Baby's stem cells are a genetic blend from each parent- there is no guarantee that it will match either father or mother.
2) If the parent wanted to select the genes to match their own, this is probably very expensive and may not yield a successful preganancy.
3) It takes 9 months to carry a baby to term!
4) There are no guarantees on the volume (or concentration) of umbilical cord blood that can be extracted during birth.
All that being said, cord blood stem cells are easily collected and it is a great source for newborn babies. Hooray to Thierry Henry, Arsenal Captain and France's renown striker who has banked his daughter Tea's (pronounced Tay-ah) stem cells for their own future use. If his children are sports personalities too, the stem cells might indeed come in handy for them in the future. Consider banking your own stem cells too Mr. Henry- you have a lot of fans cheering for your continuing illustrious career!
Hmm.. Now I'm wondering if David and Victoria Beckham banked their babies' cord blood stem cells too...
StemLife offers adult stem cell banking to individuals wishing to store stem cells for their own therapeutic use. These may include but are not limited to cancers, heart disease, diabetic foot ulcers. If you're an active sports person, you might like to consider banking your own adult stem cells for potential injuries. Admittedly whilst it may not be curative, your own stem cells may play an important role in repair of the injured site and make it less prone to re-injure again, with potentially less side effects than drugs and other painful remedial techniques.
POSING A CHALLENGE TO THE ETHICS OF PARENTS?: Although some people are concerned that banking of cord blood stem cells for use by a parent would raise questions as to whether parents may conceive in order to obtain stem cells, I think that this is probably highly unlikely for the following reasons:
1) Baby's stem cells are a genetic blend from each parent- there is no guarantee that it will match either father or mother.
2) If the parent wanted to select the genes to match their own, this is probably very expensive and may not yield a successful preganancy.
3) It takes 9 months to carry a baby to term!
4) There are no guarantees on the volume (or concentration) of umbilical cord blood that can be extracted during birth.
All that being said, cord blood stem cells are easily collected and it is a great source for newborn babies. Hooray to Thierry Henry, Arsenal Captain and France's renown striker who has banked his daughter Tea's (pronounced Tay-ah) stem cells for their own future use. If his children are sports personalities too, the stem cells might indeed come in handy for them in the future. Consider banking your own stem cells too Mr. Henry- you have a lot of fans cheering for your continuing illustrious career!
Hmm.. Now I'm wondering if David and Victoria Beckham banked their babies' cord blood stem cells too...
StemLife offers adult stem cell banking to individuals wishing to store stem cells for their own therapeutic use. These may include but are not limited to cancers, heart disease, diabetic foot ulcers. If you're an active sports person, you might like to consider banking your own adult stem cells for potential injuries. Admittedly whilst it may not be curative, your own stem cells may play an important role in repair of the injured site and make it less prone to re-injure again, with potentially less side effects than drugs and other painful remedial techniques.
Saturday, August 19, 2006
THE USE (AND ABUSE) OF STEM CELLS IN THE PURSUIT OF BEAUTY
Almost every time that I present publicly about what stem cells are and the services that StemLife provides, it is inevitable that someone in the audience will ask: "Can stem cells be used for anti-aging?". My honest reply is that StemLife is not currently working in this area which is dominated by botox, plastic surgery and implants. The next question often is more like a statement... "But other countries are offering stem cell therapy for anti-aging, aren't they?"
I'm no expert in this area of medical/surgical-enhancement but have heard rumours about many well-to-do individuals spending upwards of USD 70,000 on animal-derived stem cell therapy at special clinics in Switzerland which lasts for a year before they have to return for a 'top up'. Generally speaking, I don't have anything against people wanting to look young (aesthetics and proper grooming does play an important factor in finding mates, jobs etc.) and if stem cells can play a significant role in this area then it should be explored.
On the other end of the spectrum, I came across this article which reported that impoverished women were being paid USD 200 to abort the 8-12 week fetus and "donate" the fetus for stem cell extraction, which are then sold to exclusive cosmetic clinics. I find this practice disturbing - not only because abortion is morally complex and may be considered inhumane (let's not forget the health of the mother)- but also the concern of what diseases may be transmitted in the process.
My questions would be:
1) The source of the stem cells- is the source free of all infectious diseases and other transmissible conditions?
2) How are the cells collected and how are they processed?
3) Are there any additives and reagents used in the harvest or processing?
4) Does the final product contain cells or cellular extracts?
5) By which route is the product administered?
6) Possible allergic reactions or tumour formation?
THE POTENTIAL DOLLAR VALUE OF AN EMBRYO
The price set for obtaining fetal cells makes me wonder about whether embryonic stem cells obtained from discarded embryos have any assigned value. Some thoughts for those considering an IVF procedure- it might be good to check first on the facility's policies on what happens to the discarded embryos- if they are discarded or put through to commercial use or research.
HOW TO PREVENT THOSE EMBRYOS GETTING INTO THE WRONG HANDS
One thing that those going to IVF clinics could query is what happens to their discarded embryos? It may be clear to some people that these embryos have some value but then some lines may need to be drawn in a way that steers clear of any issues or processes that would be considered unethical or revealing in terms of genetic data.
StemLife's note:
With regards to the first 2 questions posed to me, I'll usually tell my audience that if you are taken ill and it is a condition treatable with stem cell therapy, healthy inside = healthy outside. Our cardiac stem cell therapy patients have been able to lead more energetic lives than before and as a consequence, reduced their dependency on vaso-dilators; our diabetic foot ulcer patients have also experienced a sharp decrease in ischaemic pain post stem cell infusion, thereby reducing their dependency on pain killers which can dull the mind and normal bodily activity.
However, we do not rule out the possibility that one day, cord blood stem cells or peripheral blood stem cells may be used by the individual who banked them, for purposes of tissue reconstruction or stimulation for repair. Never know, with all this interest and research investment globally, it might come sooner than we think!
I'm no expert in this area of medical/surgical-enhancement but have heard rumours about many well-to-do individuals spending upwards of USD 70,000 on animal-derived stem cell therapy at special clinics in Switzerland which lasts for a year before they have to return for a 'top up'. Generally speaking, I don't have anything against people wanting to look young (aesthetics and proper grooming does play an important factor in finding mates, jobs etc.) and if stem cells can play a significant role in this area then it should be explored.
On the other end of the spectrum, I came across this article which reported that impoverished women were being paid USD 200 to abort the 8-12 week fetus and "donate" the fetus for stem cell extraction, which are then sold to exclusive cosmetic clinics. I find this practice disturbing - not only because abortion is morally complex and may be considered inhumane (let's not forget the health of the mother)- but also the concern of what diseases may be transmitted in the process.
My questions would be:
1) The source of the stem cells- is the source free of all infectious diseases and other transmissible conditions?
2) How are the cells collected and how are they processed?
3) Are there any additives and reagents used in the harvest or processing?
4) Does the final product contain cells or cellular extracts?
5) By which route is the product administered?
6) Possible allergic reactions or tumour formation?
THE POTENTIAL DOLLAR VALUE OF AN EMBRYO
The price set for obtaining fetal cells makes me wonder about whether embryonic stem cells obtained from discarded embryos have any assigned value. Some thoughts for those considering an IVF procedure- it might be good to check first on the facility's policies on what happens to the discarded embryos- if they are discarded or put through to commercial use or research.
HOW TO PREVENT THOSE EMBRYOS GETTING INTO THE WRONG HANDS
One thing that those going to IVF clinics could query is what happens to their discarded embryos? It may be clear to some people that these embryos have some value but then some lines may need to be drawn in a way that steers clear of any issues or processes that would be considered unethical or revealing in terms of genetic data.
StemLife's note:
With regards to the first 2 questions posed to me, I'll usually tell my audience that if you are taken ill and it is a condition treatable with stem cell therapy, healthy inside = healthy outside. Our cardiac stem cell therapy patients have been able to lead more energetic lives than before and as a consequence, reduced their dependency on vaso-dilators; our diabetic foot ulcer patients have also experienced a sharp decrease in ischaemic pain post stem cell infusion, thereby reducing their dependency on pain killers which can dull the mind and normal bodily activity.
However, we do not rule out the possibility that one day, cord blood stem cells or peripheral blood stem cells may be used by the individual who banked them, for purposes of tissue reconstruction or stimulation for repair. Never know, with all this interest and research investment globally, it might come sooner than we think!
Thursday, June 22, 2006
First Collective Interview of Adult Stem Cell Patients with Successful Outcomes
I read with great interest an announcement that a few successful adult stem cell therapy patients would be gathering in Washington to share their experiences and show how they have improved.
Many patients are tremendously shy when discussing their condition and I think its marvellous that they are willing to come forward. No doubt there may be a political slant to organizing this event (given that Senator Sam Brownback from Kansas and Dr. David Weldon who is from the House of Representatives will be giving keynote speeches), but if it is to promote awareness and funding for stem cell clinical trials and to further understanding of applications, I'm all for it.
There were 5 featured speakers:
Jacki Rabon- Stem cells used for treatment in her spinal cord (see previous entry)
Cathy Pell- Daughter Abby received cord blood treatment for cerebral palsy and used her own cord blood stem cells
Dr. David Foege- Heart failure patient who underwent Theravitae's stem cell therapy developed by Dr. Amit Patel in Pittsburgh
Mary Schneider- Son Ryan treated with his own cord blood when he was 2 for cerebral palsy at Duke University (same as Abby)
Stephen Sprague- Was diagnosed with CML 10 years ago and used cord blood stem cells for a transplant source and is well today
Apparently they shared phenomenal stories of success in their treatments and encourage more adult stem cell work to be done.
"To date, embryonic stem-cell research has failed to produce one successful treatment," said Paul Chaim Schenck, director of the national pro-life action center. "Conversely, adult and cord-blood stem-cell research has yielded over 65 successful treatments, including curing diabetes in some patients."
Interestingly, the session was organized rather innovatively as a wine-tasting session sponsored by a company called BOGO wines. Its owner, Bill Schneeberger is a Catholic from Ohio who donates $2 (USD) from every bottle sold to adult stem cell research. Check out the follow-up article here, it's got some interesting insights to the event but not much on the patients themselves.
I would have loved to be there to listen and ask them questions. If anyone reading this blog attended the session, I'd really appreciate if you'd share the information with me.
Many patients are tremendously shy when discussing their condition and I think its marvellous that they are willing to come forward. No doubt there may be a political slant to organizing this event (given that Senator Sam Brownback from Kansas and Dr. David Weldon who is from the House of Representatives will be giving keynote speeches), but if it is to promote awareness and funding for stem cell clinical trials and to further understanding of applications, I'm all for it.
There were 5 featured speakers:
Jacki Rabon- Stem cells used for treatment in her spinal cord (see previous entry)
Cathy Pell- Daughter Abby received cord blood treatment for cerebral palsy and used her own cord blood stem cells
Dr. David Foege- Heart failure patient who underwent Theravitae's stem cell therapy developed by Dr. Amit Patel in Pittsburgh
Mary Schneider- Son Ryan treated with his own cord blood when he was 2 for cerebral palsy at Duke University (same as Abby)
Stephen Sprague- Was diagnosed with CML 10 years ago and used cord blood stem cells for a transplant source and is well today
Apparently they shared phenomenal stories of success in their treatments and encourage more adult stem cell work to be done.
"To date, embryonic stem-cell research has failed to produce one successful treatment," said Paul Chaim Schenck, director of the national pro-life action center. "Conversely, adult and cord-blood stem-cell research has yielded over 65 successful treatments, including curing diabetes in some patients."
Interestingly, the session was organized rather innovatively as a wine-tasting session sponsored by a company called BOGO wines. Its owner, Bill Schneeberger is a Catholic from Ohio who donates $2 (USD) from every bottle sold to adult stem cell research. Check out the follow-up article here, it's got some interesting insights to the event but not much on the patients themselves.
I would have loved to be there to listen and ask them questions. If anyone reading this blog attended the session, I'd really appreciate if you'd share the information with me.
Sunday, June 18, 2006
Cord Blood Banking in the UK: Status and Directions of the RCOG
Its been a hectic week at StemLife and I apologise for not having updated the blog for a while. A few friends and family members kindly updated me with emails about the recent announcement by the Royal College of Obstetricians and Gynaecologists (RCOG) on cord blood banking.
Firstly, I'd like to clarify the role and function of the RCOG. Most relevant is that the RCOG sets the exams that all aspiring gynaecologists have to pass in order to practice. If you check out their website, its tagline is "Setting standards to improve women's health". Clearly, the focus of the College is on women and one of their roles is also to "reduce maternal and neonatal mortality and morbidity", i.e. to assess the risks involved in any gynaecological or obstetric procedures for both the mother and the doctor involved.
It was in this capacity that the College issued a recent statement reflecting the same sentiment that they had back in 2001- that they supported cord blood banking if for altruistic reasons- that is for donation and public use. From the statement made by the head of Department of Women's Health at King's College London and Chair of the RCOG expert group, Professor Peter Braude said that they "had a huge amount of commercial companies offering cord blood storage to parents and medical practitioners wanted guidance on the validity of some of the advertising claims".
I checked out the number of companies offering this service in the UK and found that there are now 7 (acknowledgements to Dr. Frances Verter's wonderful site) which is a significant number for 595,000 or so births per year. I can imagine that the clinics must get very crowded with brochures all claiming to be the better bank. There has also probably been some confusion amongst the doctors, nurses and hospital staff when parents come in requesting a collection from cord blood bank a,b or c.
However, the biggest problem that I forsee is not so much that parents might come in with different kits, but rather for the three following reasons:
1) Most deliveries requesting cord blood are at NHS (government) hospitals where doctors are on rotation duty (leading to point 2)
2) The doctors delivering the babies are not necessarily the same as those seeing the patient in the clinic (which doctor gives consent to collect?)
3) Most doctors are not trained to collect cord blood for this purpose and may not always be successful (whom does the client/patient hold responsible?)
Clearly, these pertinent issues warrant the intervention of the RCOG due to the potential risk taken by the doctor in collecting the cord blood when the doctor may not know what to do and that he/she has to do it. It is the slight confusion that happens which can result in really bad taste for both patient, hospital and doctor. Therefore, to protect the reputation of the doctors and lessen the paper procedures (which are already a big hassle for the hospital staff), the RCOG has taken the stand that cord blood should be donated to the NHS, and that if NHS hospitals choose to permit cord blood collection, they have to draw up their own guidelines on what charges there should be and who bears the liability. I think that a fair payment made to the hospital and doctor for successful procedures would be acceptable to the requesting client (full refund if unsuccessful for the avoidance of doubt on anyone's part).
A MIS-INTERPRETATION
Unlike what has been proclaimed on the headlines of news articles(BBC, Times), the RCOG is not against cord blood banking but rather prefers that in its NHS hospitals, cord blood is donated for the public's immediate use- instead of banking it for a possible future use.
One of the messages that the RCOG then helps to advertise is that the NHS provides banking of donated cord blood at the following hospitals, where staff are available to assist and ensure that its done right.
I found the list of hospitals from this site and here's an extract:
NHS cord blood banks centres currently collecting donor cord bloods in UK
Although antenatal patients may offer to donate for unrelated transplantation, the option of altruistic cord blood banking for the National Blood Service banks is, for logistic reasons, currently undertaken only at the following hospitals: Northwick Park Hospital in Harrow, Barnet General Hospital, The Luton and Dunstable Hospital, and the Mater Infirmorum Hospital in Belfast.
Is collecting cord blood as dangerous as the RCOG articles proclaim?
StemLife Malaysia has already successfully banked more than 6000 units of cord blood with the assistance of doctors and nurses with the mutual understanding that cord blood collection can only take place if it is safe and does not alter the process of birth by the mother nor affect the baby's aftercare. I'm not sure about the UK, but having worked with private hospitals in Malaysia, care of the mother and the baby is always the doctor's first priority. Cord blood is collected in utero to ensure that the blood is collected without clots and only as much as the umbilical cord is able to yield. Furthermore, doctors also respect the patient's wishes and knows that they may play a part in the welfare of the child subsequently in life (StemLife has a story about this, but I'll tell you about it at a later date).
Additionally, I checked out the College of Paediatrics website too to see what the role of its doctors are supposed to play. I found that one of the roles would involve the education of the public about the potential use of cord blood stem cells in the child's life.
Duties of a paediatrician:
Paediatricians, whatever their specialty interest, should understand their particular responsibilities for the holistic and life-long health of children who come under their care: each contact is an opportunity for health promotion and disease prevention.
Paediatricians should be aware of current medical and political affairs affecting the lives and health of children.
We have supportive paediatricians here and I'm delighted to say that they are increasingly aware that stem cells could play a role in helping siblings and the child itself should it take ill with a condition treatable with stem cells.
You can read the actual message from the RCOG here, but bear in mind that it takes into account the fact that the NHS is already an overburdened government healthcare institution. In the appeal for funding for the NHS cord blood bank, if the potential use of cord blood stem cells is as small and insignificant as they say, why bother putting anymore money into something which might never be used?
The NHS has had structural and economic issues* for a while and we should not find it surprising that if you try to overlay a private service (like cord blood banking) on top of a public-funded healthcare system, there will undoubtedly be tensions as to what services are on offer at public hospitals and, at what cost to the system.
*UK Health Secretary Patrcia Hewitt has announced earlier this month that the NHS's overall deficit is GBP 512 million (approx. RM 3.4 billion).
Firstly, I'd like to clarify the role and function of the RCOG. Most relevant is that the RCOG sets the exams that all aspiring gynaecologists have to pass in order to practice. If you check out their website, its tagline is "Setting standards to improve women's health". Clearly, the focus of the College is on women and one of their roles is also to "reduce maternal and neonatal mortality and morbidity", i.e. to assess the risks involved in any gynaecological or obstetric procedures for both the mother and the doctor involved.
It was in this capacity that the College issued a recent statement reflecting the same sentiment that they had back in 2001- that they supported cord blood banking if for altruistic reasons- that is for donation and public use. From the statement made by the head of Department of Women's Health at King's College London and Chair of the RCOG expert group, Professor Peter Braude said that they "had a huge amount of commercial companies offering cord blood storage to parents and medical practitioners wanted guidance on the validity of some of the advertising claims".
I checked out the number of companies offering this service in the UK and found that there are now 7 (acknowledgements to Dr. Frances Verter's wonderful site) which is a significant number for 595,000 or so births per year. I can imagine that the clinics must get very crowded with brochures all claiming to be the better bank. There has also probably been some confusion amongst the doctors, nurses and hospital staff when parents come in requesting a collection from cord blood bank a,b or c.
However, the biggest problem that I forsee is not so much that parents might come in with different kits, but rather for the three following reasons:
1) Most deliveries requesting cord blood are at NHS (government) hospitals where doctors are on rotation duty (leading to point 2)
2) The doctors delivering the babies are not necessarily the same as those seeing the patient in the clinic (which doctor gives consent to collect?)
3) Most doctors are not trained to collect cord blood for this purpose and may not always be successful (whom does the client/patient hold responsible?)
Clearly, these pertinent issues warrant the intervention of the RCOG due to the potential risk taken by the doctor in collecting the cord blood when the doctor may not know what to do and that he/she has to do it. It is the slight confusion that happens which can result in really bad taste for both patient, hospital and doctor. Therefore, to protect the reputation of the doctors and lessen the paper procedures (which are already a big hassle for the hospital staff), the RCOG has taken the stand that cord blood should be donated to the NHS, and that if NHS hospitals choose to permit cord blood collection, they have to draw up their own guidelines on what charges there should be and who bears the liability. I think that a fair payment made to the hospital and doctor for successful procedures would be acceptable to the requesting client (full refund if unsuccessful for the avoidance of doubt on anyone's part).
A MIS-INTERPRETATION
Unlike what has been proclaimed on the headlines of news articles(BBC, Times), the RCOG is not against cord blood banking but rather prefers that in its NHS hospitals, cord blood is donated for the public's immediate use- instead of banking it for a possible future use.
One of the messages that the RCOG then helps to advertise is that the NHS provides banking of donated cord blood at the following hospitals, where staff are available to assist and ensure that its done right.
I found the list of hospitals from this site and here's an extract:
NHS cord blood banks centres currently collecting donor cord bloods in UK
Although antenatal patients may offer to donate for unrelated transplantation, the option of altruistic cord blood banking for the National Blood Service banks is, for logistic reasons, currently undertaken only at the following hospitals: Northwick Park Hospital in Harrow, Barnet General Hospital, The Luton and Dunstable Hospital, and the Mater Infirmorum Hospital in Belfast.
Is collecting cord blood as dangerous as the RCOG articles proclaim?
StemLife Malaysia has already successfully banked more than 6000 units of cord blood with the assistance of doctors and nurses with the mutual understanding that cord blood collection can only take place if it is safe and does not alter the process of birth by the mother nor affect the baby's aftercare. I'm not sure about the UK, but having worked with private hospitals in Malaysia, care of the mother and the baby is always the doctor's first priority. Cord blood is collected in utero to ensure that the blood is collected without clots and only as much as the umbilical cord is able to yield. Furthermore, doctors also respect the patient's wishes and knows that they may play a part in the welfare of the child subsequently in life (StemLife has a story about this, but I'll tell you about it at a later date).
Additionally, I checked out the College of Paediatrics website too to see what the role of its doctors are supposed to play. I found that one of the roles would involve the education of the public about the potential use of cord blood stem cells in the child's life.
Duties of a paediatrician:
Paediatricians, whatever their specialty interest, should understand their particular responsibilities for the holistic and life-long health of children who come under their care: each contact is an opportunity for health promotion and disease prevention.
Paediatricians should be aware of current medical and political affairs affecting the lives and health of children.
We have supportive paediatricians here and I'm delighted to say that they are increasingly aware that stem cells could play a role in helping siblings and the child itself should it take ill with a condition treatable with stem cells.
You can read the actual message from the RCOG here, but bear in mind that it takes into account the fact that the NHS is already an overburdened government healthcare institution. In the appeal for funding for the NHS cord blood bank, if the potential use of cord blood stem cells is as small and insignificant as they say, why bother putting anymore money into something which might never be used?
The NHS has had structural and economic issues* for a while and we should not find it surprising that if you try to overlay a private service (like cord blood banking) on top of a public-funded healthcare system, there will undoubtedly be tensions as to what services are on offer at public hospitals and, at what cost to the system.
*UK Health Secretary Patrcia Hewitt has announced earlier this month that the NHS's overall deficit is GBP 512 million (approx. RM 3.4 billion).
Sunday, June 11, 2006
Cavan General Hospital Gives in on Harvest of Cord Blood Stem Cells
Hurray for Catherina MacCauley's newborn baby!
Caven General Hospital which had previously refused its patient's request to collect umbilical cord blood stem cells has given in to media and industry pressure and agreed to permit its own hospital staff to perform the collection procedure after a confidential waiver was signed. The baby has already had its cord blood stem cells collected and banked.
The reason stated for not permitting the procedure in the first place was that hospital management was worried about liability should the procedure fail.
There are 2 salient points which I'd like to highlight here:
1) The converse liability of not permitting a patient a choice to bank- could the mother sue the hospital if her baby was diagnosed subsequently with a condition which its own cord blood stem cells could be used to treat? (..and possibly died as a result of not having the stem cells for therapy?)
2) I'm surprised that the bank Ms. MacCauley chose did not have a waiver already prepared for the doctor and hospital to sign. (StemLife has this in place for all doctors, hospital staff and everyone involved in the collection. Umbilical cord blood is not collected in the event where the safety of mother or baby is compromised)
That lawyers and risk management specialists had to be consulted on something which is pretty routine (cord blood is currently collected for neo-natal testing for G6PD and TSH), which poses no significant harm to mother or child (proven in probably almost a million babies cord blood stem cells collected and banked worldwide over the last 17 years) and with support from their own staff would take so much to achieve.
Having said that though, its always about education and whether this topic touches a personal and compassionate nerve. Many articles cite the minimal chances of use and some doctors cite these articles to their patients. But while a balanced view must be presented to every patient, so should its corresponding opportunity for patients to bank their babies stem cells.
The chances may be slim for cancer (last published estimates several years ago are 1:20,000, but I seem to have many friends whose family members have had cancer so I think this statistic is out of date) but think about the other uses which may come online for the healing and repair of damaged tissue (accidents? sports injuries? infection related injuries?) or for degenerative conditions such as heart, liver, joints or eyes. In these cases, drugs or surgery can help reduce the pain and prolong life, but once the damage is done, most patients are never able to return quite to the lifestyle they had before the onset of the symptoms. It is this return to active life that stem cells aims to achieve in conjunction with current modes of therapy.
Most of us are likely and lucky to be born healthy, but it is down to our own pre-emptive action to stay healthy which is what keeps us productive and alive.
Caven General Hospital which had previously refused its patient's request to collect umbilical cord blood stem cells has given in to media and industry pressure and agreed to permit its own hospital staff to perform the collection procedure after a confidential waiver was signed. The baby has already had its cord blood stem cells collected and banked.
The reason stated for not permitting the procedure in the first place was that hospital management was worried about liability should the procedure fail.
There are 2 salient points which I'd like to highlight here:
1) The converse liability of not permitting a patient a choice to bank- could the mother sue the hospital if her baby was diagnosed subsequently with a condition which its own cord blood stem cells could be used to treat? (..and possibly died as a result of not having the stem cells for therapy?)
2) I'm surprised that the bank Ms. MacCauley chose did not have a waiver already prepared for the doctor and hospital to sign. (StemLife has this in place for all doctors, hospital staff and everyone involved in the collection. Umbilical cord blood is not collected in the event where the safety of mother or baby is compromised)
That lawyers and risk management specialists had to be consulted on something which is pretty routine (cord blood is currently collected for neo-natal testing for G6PD and TSH), which poses no significant harm to mother or child (proven in probably almost a million babies cord blood stem cells collected and banked worldwide over the last 17 years) and with support from their own staff would take so much to achieve.
Having said that though, its always about education and whether this topic touches a personal and compassionate nerve. Many articles cite the minimal chances of use and some doctors cite these articles to their patients. But while a balanced view must be presented to every patient, so should its corresponding opportunity for patients to bank their babies stem cells.
The chances may be slim for cancer (last published estimates several years ago are 1:20,000, but I seem to have many friends whose family members have had cancer so I think this statistic is out of date) but think about the other uses which may come online for the healing and repair of damaged tissue (accidents? sports injuries? infection related injuries?) or for degenerative conditions such as heart, liver, joints or eyes. In these cases, drugs or surgery can help reduce the pain and prolong life, but once the damage is done, most patients are never able to return quite to the lifestyle they had before the onset of the symptoms. It is this return to active life that stem cells aims to achieve in conjunction with current modes of therapy.
Most of us are likely and lucky to be born healthy, but it is down to our own pre-emptive action to stay healthy which is what keeps us productive and alive.
Sunday, May 21, 2006
Lack of Cord Blood Collection Services at Cavan General Hospital in Ireland
I was most disappointed to read about the case of Catriona McCauley, a stem cell scientist who has worked in stem cell research for multi-national pharmaceutical companies and is in the know of the benefits of stem cells.
THE CASE:
Ms. McCauley had already signed up for stem cell banking with an Irish cord blood bank and the doctors at the hospital where she is due to deliver have denied her request of assisting with the cord blood collection (which, by the way, only takes 5-10 minutes of the doctor's time and is "extremely easy" see quote in article by Obstetric doctor Gerry Rafferty).
She said that she will have to extract the blood herself after she gives birth (how ridiculous!!) as the doctors and management staff of the hospital believe that there is "insufficient" evidence to support cord blood stem cell storage. Additionally, they are concerned about the ethics, logistics and potential litigation.
All of these points can be simply addressed:
Ethics: It is collected with patient's consent -causing no harm to the baby- from the placenta and umbilical cord which contains blood that's going to be discarded anyway. The patient will also be paying for all costs involved.
Logistics: Irish cord blood stem cell bank and parents should be able to sort this out, it isn't the hospital's responsibility to send it to the processing facility.
Potential Litigation: Typically the patient signs a waiver for the collection, indemnifying the doctor, hospital and anyone related to the facility. As long as all the factors of non-viable collection are properly explained, most parents understand.
THE RATIONALE:
Critics of this service always quote the figure of a child ever needing its own stem cells to be in the range of 1 in 20,000 but what diseases does that take into account? Only cancer? And in what span of time? How about projecting forward for a lifetime? (think heart disease, stroke, joints, limb ischemia*... all conditions not to be sniffed at).
Doctors may also wish to acknowledge that patients have a right to invest in the various types of insurance policies for their children, but unlike any traditional insurance policies, the possible applications of stem cell therapy continues to grow every month.
I wonder if they would permit the cord blood collection if she already had a child who needed the stem cells for therapy?
My medical director gave me an analogy in his area of specialty. Recall the days when epidurals (spinal anaesthesia) first started, it was believed by many that you would suffer spinal damage for the rest of your life. Now, with the improved instruments and greater imaging power to guide doctors in training, the technique has become so commonplace that all hospitals offering anaesthesia provide the service as another tick on the delivery checklist (yes international readers, Malaysian obstetric care is quite up to-date).
Cord Blood Collection should be a tick on a hospital checklist; hospital management should actively take part in continual medical education to keep up with the scientific pace and be on the lookout for revolutionary healthcare services.
Ms. McCauley, get your cord blood stem cell bank to help with the collection if they can**. Otherwise, you could consider selecting a hospital that has a sympathetic management and clinical team who will facilitate your request.
*While no stem cell banks can guarantee that your baby's cord blood stem cells will cure the diseases mentioned (eg. heart disease, cancer, anemias, etc.), I don't know of any doctor, surgeon or hospital who would guarantee the success of any existing invasive procedure conducted in their facility either.
**StemLife acknowledges our tireless collaborators. Obstetric doctors and nurses who make StemLife's cord blood collection service available for patients (in Malaysia, Thailand, Indonesia & Singapore) and do their utmost to ensure that their patients have the greatest number of stem cells for future therapy with minimal risks of contamination. You have already helped save 2 StemLife family members.
THE CASE:
Ms. McCauley had already signed up for stem cell banking with an Irish cord blood bank and the doctors at the hospital where she is due to deliver have denied her request of assisting with the cord blood collection (which, by the way, only takes 5-10 minutes of the doctor's time and is "extremely easy" see quote in article by Obstetric doctor Gerry Rafferty).
She said that she will have to extract the blood herself after she gives birth (how ridiculous!!) as the doctors and management staff of the hospital believe that there is "insufficient" evidence to support cord blood stem cell storage. Additionally, they are concerned about the ethics, logistics and potential litigation.
All of these points can be simply addressed:
Ethics: It is collected with patient's consent -causing no harm to the baby- from the placenta and umbilical cord which contains blood that's going to be discarded anyway. The patient will also be paying for all costs involved.
Logistics: Irish cord blood stem cell bank and parents should be able to sort this out, it isn't the hospital's responsibility to send it to the processing facility.
Potential Litigation: Typically the patient signs a waiver for the collection, indemnifying the doctor, hospital and anyone related to the facility. As long as all the factors of non-viable collection are properly explained, most parents understand.
THE RATIONALE:
Critics of this service always quote the figure of a child ever needing its own stem cells to be in the range of 1 in 20,000 but what diseases does that take into account? Only cancer? And in what span of time? How about projecting forward for a lifetime? (think heart disease, stroke, joints, limb ischemia*... all conditions not to be sniffed at).
Doctors may also wish to acknowledge that patients have a right to invest in the various types of insurance policies for their children, but unlike any traditional insurance policies, the possible applications of stem cell therapy continues to grow every month.
I wonder if they would permit the cord blood collection if she already had a child who needed the stem cells for therapy?
My medical director gave me an analogy in his area of specialty. Recall the days when epidurals (spinal anaesthesia) first started, it was believed by many that you would suffer spinal damage for the rest of your life. Now, with the improved instruments and greater imaging power to guide doctors in training, the technique has become so commonplace that all hospitals offering anaesthesia provide the service as another tick on the delivery checklist (yes international readers, Malaysian obstetric care is quite up to-date).
Cord Blood Collection should be a tick on a hospital checklist; hospital management should actively take part in continual medical education to keep up with the scientific pace and be on the lookout for revolutionary healthcare services.
Ms. McCauley, get your cord blood stem cell bank to help with the collection if they can**. Otherwise, you could consider selecting a hospital that has a sympathetic management and clinical team who will facilitate your request.
*While no stem cell banks can guarantee that your baby's cord blood stem cells will cure the diseases mentioned (eg. heart disease, cancer, anemias, etc.), I don't know of any doctor, surgeon or hospital who would guarantee the success of any existing invasive procedure conducted in their facility either.
**StemLife acknowledges our tireless collaborators. Obstetric doctors and nurses who make StemLife's cord blood collection service available for patients (in Malaysia, Thailand, Indonesia & Singapore) and do their utmost to ensure that their patients have the greatest number of stem cells for future therapy with minimal risks of contamination. You have already helped save 2 StemLife family members.
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