A cure for Type 1 Diabetes - with Peripheral Blood Stem Cells

While researchers battle it out trying to prove the supremacy of various stem cell types (embryonic, mesenchymal etc.), it is worth remembering that so far, blood derived stem cells have been used for a great variety of cures (if you know of any human that has been actually cured with an embryonic stem cell, please let us know).

During my nocturnal, pre-bedtime web surfing (I suspect that I'm not the only one with this habit...), I came across a video describing the way blood stem cells* obtained from the same patient was used to provide a successful treatment for patients with recently diagnosed type 1 diabetes. This work isn't that new -I blogged about it back in 2007- but it is a very significant milestone in the history of stem cell transplantation.

Dr. Richard Burt's work is really quite demonstrative of how our blood and immune system plays a very significant role in whether our tissues and organs break down- and where stem cells obtained non-invasively from the same patient's own blood stream- have a clear role to play. I have yet to meet Dr. Burt in person but know him through his work and this video is the first I've seen of him providing a very clear insight into the trial that he is conducting. He highlights that 14 out of 15 patients were successful in treatment and this is an excellent base number to build on for the next clinical trial.

Dr. Burt published his work in the well renown and respected Journal of American Medical Assocation (JAMA), but instead of reading it I thought this video version sums it up really nicely for the non-medical and patient community.



If watching the video makes you more interested in reading the journal article, click on this link Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus.


*StemLife offers individuals the opportunity to bank their babies' cord blood or stem cells from adult blood for therapeutic use.

Bioengineering like the movies: Stem Cell Capturing Gadget

I'd hate to sound as if I was brought up on an entertainment diet of Hollywood movies, but back in the 1970's to 80's there was a real revolution in cinematic production and audience interest that led to a cult following of the science fiction genre.

Film directors often take what's probable in science and stretch them to the limits of our imagination, engaging us to just reflect on not only how far we've come but also how much further we can aspire. This next entry is a tribute to the 1987 movie "Inner Space"*.




In a recent announcement, MIT's bioengineers have designed an implantable device that is capable of capturing pure samples of stem cells from the circulating blood. The device is described as "a length of plastic tubing coated with proteins" which has been experimentally implanted into the bloodstream of rats.

The more accurate medical description of this plastic tubing is known as a "shunt" and the method of implantation would most likely involve the severance and reconnection of a small but high through-flow blood vessel. The proteins -known as selectins- attract and trap specific cells with the right signals on the surface (imagine a sticky mat). The cell capture devices are developed by chemical engineers led by Associate Professor Michael King from the Biomedical Engineering department at the University of Rochester. The technical details will be described in the March edition of the British Journal of Hematology.

(personal note: Mr. B.C. this is for you.)


WHY IS THIS DEVICE IMPORTANT?


The medical impact of this device could weigh in for cancer patients who may need to use autologous (one's own) stem cells for their treatment. These cancer patients are treated with chemotherapy to reduce and eliminate as many of the malignant circulating cancer cells as possible from the bloodstream and bone marrow. The treating doctor will collect the patient's own stem cells during this period of remission when the cancer load is at its lowest.

The patient's own stem cells are stimulated using GCSF (read about it here) and the stem cells are harvested and stored in anticipation of the possibility that the cancer cells will multiply again, requiring another round of chemotherapy which may damage the existing healthy marrow further. The collected stem cells will be infused back to the patient to ensure that the patient has sufficient stem cells to repopulate and replenish the marrow, thereby restoring normal cell levels to the bloodstream.

To address the concern that perhaps cancer cells from the patient might also be collected in the same fraction as the healthy stem cells (impossible to distinguish during harvesting) this device could lend a hand to filter out the cancer cells inside or out of the patient's body, i.e. the cancer cells would travel around the bloodstream until they reach the shunt, where they would then be immobilized.

Note though, that the inventors have conceded that this device will not be able to collect enough stem cells for a transplant, therefore the customary stem cell collection procedures will still need to be performed.


SOME INTERESTING STATISTICS


According the A/Prof. King, the shunt placed in an non-GCSF induced rat in a 2 hour period enabled the capture of 3-4 times the number of usual stem cells obtained in normal circulating bloodstream (approx 1%). Hence the device is thought to attract and specifically retain a significantly higher number of stem cells.

This stem cell number could be significantly higher in patients who have been mobilized.


WHAT ELSE CAN IT DO?


Well, it is a concept device which will be as good as its selectin coating. A/Prof. King has already forecasted the use of the device in trapping specific cancer cells in the body to prevent metastatic spread and layering in proteins which could help steer cell development processes by differentiating them while passing through the shunt. (analogy: think sticky mats for dust, sticky mats for cockroaches, sticky mats for cat fur...all requiring different levels of stickiness for its target)



WHEN CAN I BUY IT?


The entrepreneurial A/Prof. King has already started a company by the name of CellTraffix and the anti-metastasis implants are set for animal trials later this year in collaboration with bioengineers Professor Jeffrey Karp and Robert Langer at Harvard and MIT who will develop stable selectin coatings that will last over months than days. Meanwhile, the CEO of CellTraffix, Tom Fitzgerald has already announced that the company's first product for researchers to capture stem cells or cancer cells for lab experimentation will be marketed by early 2009, with clinical testing of the anti-cancer coatings in 2010.


Read how a chance encounter between a bioengineer and a haematology clinician gave rise to this work and watch the cells being captured here (note that you will need a high speed broadband connection as the video files are rather large).


*Why does this remind me of the movie Inner Space I hear you ask... well the term cell capturing device often conjurs up the image of a little machine (like the exploration submersible the protaganist uses) to grab and hold onto cells in circulation :)

First Ever Beijing Stem Cell Donor for Taiwanese Recipient

Despite any political maneuvering between China and Taiwan, it is articles like these (1, 2) that bring our minds back to the basics- which is that geopolitics aside, our genetic heritage links us and binds us eventually to a common fate.

Additionally, stem cell resources will always reside with the size and diversity of the population, hence China with more than 1.3 billion is a stem cell treasure trove for chinese people all over the world if we are able to thoroughly profile and screen the stem cells.


The article which I noted a while ago (sorry, it's a late comment, but I thought it worthwhile) reports the first time that stem cells were matched from a patients in Taiwan to donors in Beijing*. The two profiled donors were Ms. Hang from Jiangsu province and Ms. Xiaoyan from Hunan province. (click here if you'd like to know where the provinces are in relation to Beijing)

They were brought to Beijing and their stem cells were mobilized from their bone marrow to the bloodstream (you can read more on mobilization and collection here) and their stem cells collected via apheresis. Their stem cells were subsequently transported to Taiwan for the transplantation.

The second article provides a little more detail on the donors and their perceptions of stem cell harvesting and donation.

Ms. Hang who is a youthful 36 year-old is a registered blood donor who has donated blood several times in her life. Apparently, a marrow bank was established in her home province in 2003 but few people registered as donors. Ms. Hang signed up as a donor in the registry not only because her employer, Amway urged all employees to do so, but also because she saw it as "an opportunity to help others... why not do it?"

Amway's staff registration yielded 1,500 new potential donors and they report that 4 of them have already been called on as donors.

Ms. Hang's father is a doctor and said that the process of mobilizing and collecting stem cells was harmless and supported her decision to donate. The recipient was a 16 year-old girl and I hope that they collected as many stem cells as they could and that the patient has recovered.



*Taiwan has exported stem cells obtained from donor's cord blood, bone marrow and peripheral blood to patients all over the world. Cord blood stem cells obtained from a private company that facilitates the storage facility for databasing and sale, Stemcyte incur a charge of between RM 100,000 to RM 150,000 per unit (they have released in excess of 250 cord blood stem cell units). Some patients have also withdrawn 2 cord blood stem cell units to use in a double transplant when one unit is insufficient.

Malaysian patients have accessed this facility many times and have been able to find successful matches which has allowed life-changing stem cell transplantation to proceed.

Credit also goes to the Tzu Chi Taiwan Marrow Donor Registry, the third largest of its kind in the world, which has made over a hundred matches for mainland patients and patients in South East Asia.

Expert Hematologists Say Stem Cell Harvesting is SAFE

If you've been following this blog for a while, this probably isn't news to you, but I thought that this article only lends further credence to those patients concerned about whether stem cells are safe to collect.

Baby umbilical cord blood stem cells certainly are safe to collect, and very apparently so are adult stem cells. The article is so clear in its message that I thought it would be good to excerpt it here for you to read just in case they take it off line.



Experts At Hematologists' Congress In Vienna Say The Procedure For Donating Stem Cells Is Safe EHA Congress 2007
14 Jun 2007

Donating stem cells is almost free of risk for donors and is often the only chance of survival for many patients with certain severe blood or bone marrow diseases. This was the conclusion arrived at in an observation study conducted by the Medical University of Hanover and just presented at the Congress of the European Hematology Association in Vienna.

Stem cell donors can save lives. The only way to fully cure most types of blood cancer (leukemia) is through the transplantation of what are called hematopoetic stem cells, i.e. by transferring healthy blood-building cells from an appropriate donor. Physicians cannot call on cell donors in good conscience unless this procedure is free of danger. There have been isolated cases of donors reported in the past who themselves came down with leukemia several years after making their life-saving gift. Researchers undertook a number of different studies to determine if there was any connection here.

The Congress of the European Hematology Association (EHA), the leading association of experts on blood and bone-marrow diseases in Europe, is currently being held in Vienna. One of the speakers, Dr. Michael Stadler, senior physician in the Department of Hematology, Hemostaseology and Oncology at the Medical University of Hanover (D), presented the results of a recent study on this subject: "Since March 1994, we have examined nearly 600 donors of bone marrow or peripheral stem cells and determined that the donation of stem cells is a very safe procedure. We have not detected a single case of leukemia to date among our donors and unpleasant side effects occurred for a total of only one percent of these individuals."

The study involved 596 donors aged one to 71 (60% males, 40% females). Both common methods of hematopoetic stem cell transplantation were represented, namely classic bone-marrow transplantation and the modern method of peripheral blood stem cell transplantation.
"Bone marrow can only be extracted under general anesthesia and requires a one to two-day hospital stay," explained Dr. Stadler. "During this procedure, a half to one liter of a mixture of blood and bone marrow is suctioned from around the donor's iliac crest, not from the spinal cord, as is often falsely reported. This mixture is filtered and then transfused into the recipient by way of intravenous infusion. The intervention itself takes about one hour. The bone-marrow cells that are removed are replenished in the donor within about two weeks by subsequent cell growth."

Peripheral blood stem cell transplantation is an even simpler and more comfortable procedure for donors. The reason for the designation is that the stem cells are taken not from bone marrow but from the blood stream at the periphery of the body, e.g. from a vein in the arm. This procedure does require biochemical preparation, however. Dr. Stadler: "For a period of five days beforehand, the donor receives a substance called G-CSF, which stands for Granulocyte-Colony Stimulating Factor. G-CSF is a hormone the body produces itself and is released in the case of inflammations to stimulate the reproduction of white blood corpuscles. If administered as a drug in high doses, it accelerates the overall formation of blood and causes blood stem cells that are not yet fully matured to be detached from their environment in bone marrow, for lack of space you might say. These stem cells make their way to the peripheral blood stream where they can be fished out for the patient using a special separation method called stem cell aphaeresis."

G-CSF stimulation in particular was long suspected of being a possible trigger for leukemia in donors over the long term. In their long-time study, however, Dr. Stadler and his colleagues did not observe a single case of leukemia or a single case of death over a period of more than 12 years.


The risk of anything happening to you in harvesting your own stem cells is really minimal, so please don't be afraid to donate or bank your stem cells for yourself and your family members.

Type 1 Diabetics benefit from Stem Cell Transplantation

If you or one of your family members has diabetes, I'm pretty sure that the recent news on stem cell transplantation providing a cure for Type 1 Diabetes (Type 1 DM) has you sitting upright and your full attention. I've had a lot of positive feedback on this news which has appeared in our newspapers here, from clients asking if this would be a cure resulting in an insulin independent life.


REASON FOR OPTIMISM

I think that the news is very positive and certainly its a start to demonstrating that it may be possible to modulate diseases originating from a malfunctioned immune system through a patient's autologous (own) stem cell transplant. This concept has been tested before, systemic lupus erythmatoses for example is a case which has resulted in patients remaining SLE free after stem cell transplantation. In the case of Type 1 DM, experimental stem cell transplantation conducted previously on mice yielded results which indicated the prevention of the disease.


STEM CELL TRANSPLANTATION

It was based on these results* that the doctors Julio Voltarelli and colleagues from the Regional Blood Center, at the University of Sao Paulo in Brazil decided to initiate the study on how stem cell transplantation might assist in halting the deterioration of pancreatic beta cell function in newly diagnosed patients (patients who have had the disease for a long time may not have any pancreatic beta cells left as the immune system would have destroyed them all).


SOURCE: PATIENT'S OWN ADULT STEM CELLS

The stem cells were the patient's own stem cells, mobilized from their bone marrow to the blood stream where they were collected. Then, they were prepared for transplantation by suppressing their immune system (a form of chemotherapy) and wiping out their existing circulating immune cells. The stem cells were then administered back into their bloodstream. The patients stayed in isolation for 2 weeks, which is a typical length of time for the immune system to kick start (using stem cells from others would have taken more than 2 months to have the same result, barring no rejection issues).


SELECTION IS KEY

I have to tell you that patient selection is key in every trial, as not any one procedure will benefit everyone. Disease, timing and response varies from patient to patient and the trick is trying to find patients with similar symptoms and baseline measurements, but yet with no other organ complications. 15 patients were selected out of 100 initally screened, and took place over almost 3 years between November 2003 and July 2006, with observation up til February this year at the Bone marrow transplantation unit of the School of Medicine at Ribeirao Preto(otherwise known as Brazil's California... nice!).

The patients were monitored and gradually reduced their need for injectable insulin. The interesting and exciting results were that 14 out of 15 patients were insulin-independent for lengths from 1 to 36 months, where the insulin free period was nearly 19 months.

The doctors are wondering whether the effect was due to a reprieve of the immune system on the pancreas (hence allowing the remaining beta cells to regenerate) or whether it was truly due to the immune system modulation, which allowed the pancreas cells to work, but eventually give up (organ under stress).


WHAT IF YOU HAD TO HAVE INJECTIONS EVERY DAY?

Whilst there have been those who have pointed out the lack of a control group, it is clear that at least for a short while, these type 1 DM patients experienced a time when insulin injections weren't a mealtime affair**.



*"Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus."
Júlio C. Voltarelli, Carlos E. B. Couri, Ana B. P. L. Stracieri, Maria C. Oliveira, Daniela A. Moraes, Fabiano Pieroni, Marina Coutinho,Kelen C. R. Malmegrim, Maria C. Foss-Freitas, Belinda P. Simões, Milton C. Foss, Elizabeth Squiers, Richard K. Burt. JAMA. 2007;297:1568-1576. Vol. 297 No. 14, April 11, 2007.

** Quite a lot of us can't bear injections once a year, so compare that to several injections per day. Transplant specialists, get ready for the phonecalls.


ps. I do apologise that I haven't posted for a while... yes it has been really busy here at StemLife (in a good way) :)

Adult Stem Cell Education Video

Did you like the animated graphics in the video in the last entry? Here's another one by the same author on adult stem cells and what they can do. It's just as good as the previous video and I think its really worth watching it once or twice just to make sure you don't miss anything..

I particularly liked the depiction of stem cells in the bone marrow, how the stem cells form matured red blood cells and how they move into the bloodstream to perform their function in circulation. The narrator also made a good point about how stem cells are important to the body in replacement of lost tissue either due to wear and tear, or by medical damage (say treatment by radiotherapy or chemotherapy). Essentially, if your stem cells are totally destroyed, all the parts will wear down really fast; And if you have the choice to keep a small bank of replacement cells in the event that it does happen, wouldn't you do it?

Drop us a line if you'd like to get your own stem cell account- StemLife makes the process as pleasurable as possible.

Take it from me... I've already banked mine ;)



Turn your speakers on and press play.......

Bill Spence- Heart Patient Improved with Adult Stem Cell Therapy

Given that heart disease is probably the number ONE lifestyle killer in all developed countries, it is thus highly appropriate that a fair number of entries are dedicated to the treatment of this expensive and progressive condition.

I've been following the Gary Schaer trial for a while now and been updating this blog on any new articles detailing the patients' progress. This latest article describes one of the thirty-three patients who has undergone stem cell therapy for his intense chest pain which is so bad that he is confined to his home and has no other viable conventional treatment options to explore (he's had 2 heart attacks, open heart surgery, a pacemaker and several stents inserted and takes more than 25 medications daily).


In the article, the patient tells us of what the pain is like:

Bill Spence, heart disease patient: "The pain starts in the chest, radiates through the back and up over the shoulder and down the arm."


The article also describes what the procedure performed on Mr. Spence, which is almost exactly like what StemLife is providing in Malaysia.

First, patients are injected with a drug that helps the body release stem cells. A special machine isolates the cells from their own blood. Doctors use this mapping system to inject the stem cells back into weak areas of the heart. The idea is to grow new blood vessels.


I was really pleased to see that in the pilot trial, more than 60% of patients reported less chest pain, which is significant as this could help them get back to doing the activities they enjoy independently. Furthermore, it could even mean that their health could take a turn and they could reduce their drug intake, saving healthcare industry funds to reach a wider audience that would otherwise be denied.

This is also StemLife's aim in making it affordable and accessible to all Malaysians and anyone with heart disease. We've also got some very good progress reports from our patients and look forward to helping put more patients back on their feet.

If you have heart disease or know someone who does -and would like to explore stem cell therapy- please don't feel shy to call us for a no obligations consult. Call us at +6012 2050 165 and ask to speak to one of our Adult Stem Cell Therapy team members. :)

Pop! Goes My Heart... Stem Cells for Carrol Payne & Hugh Grant

I have two happy videos to share about hearts today.

The first one is about a firefighter, Carrol Payne, whose heart wasn't quite functioning as well anymore. He describes having a heart attack, being admitted to hospital and enrolling in a study to use stem cells as the treatment.

There were a few notable points in the article. Firstly, the doctor recommends extraction of the bone marrow stem cells between day 6-9 of the heart attack. This probably allows the infarcted area to settle down a little and ensure that the patient hasn't got further complications as a result of the heart attack. Secondly, that the bone marrow is extracted under local anaesthesia but there is no mention of how much in terms of volume. Thirdly, that the stem cells were sent to the lab, separated and re-infused using a catheter. The treating doctor, Dr. Quyyumi believes that the stem cells may help to regenerate the muscles of the heart and heal the blood vessels to recover the edges of the heart.


I am really pleased that the patient is feeling much better, we also see very similar results with StemLife's patients who are symptomatic and undergo peripheral stem cell harvesting and therapy (but with no surgery).

I'm looking to more of the work from Dr. Quyyyumi, although I know it isn't easy to organize as there is a fair amount of coordination required between patient, doctor, lab and every single member of hospital staff in between.


The second video is a one which I really enjoyed (showing my age here) but to truly appreciate it, you'll have to go watch this movie in the theatres called "Music and Lyrics" which stars Hugh Grant and Drew Barrymore. I won't reveal the story here but felt that the music video was re-creating a heart attack* and has a certain amount of relevance to our topic on stem cells.


Watch this youtube version (its hilarious) and maybe try singing along to the lyrics that I adjusted for this blog entry... but I'm no lyricist so tell me if you can come up with a better stem cell version :)




[VERSE 1]
I never thought that I could be in so much pain,
Everytime that I do a bit of exercise.
A squeeze inside me that words just can't describe,
And there's no explaining.
There's something that's disturbing my sleep, I can't deny,
Every pill to my lips is a lullaby.
Angioplasty makes life worth while,
I feel cold and shiver.

[CHORUS]
I said I wasn't gonna eat the bread, but then
POP! Goes my heart.
I wasn't gonna take my pills again, but then
POP! Goes my heart.
And I just can't live with thick blood flow,
I just don't have the feeling.

[VERSE 2]
These precious moments, I have so few,
Let me go to see StemLife, where they can get your stem cells today.
You show to me that my vessels are new,
And there's no explaining.


*Author's note: Hugh Grant's heart attack in the music video can be classified as a heart break which mimics a heart attack. Ever felt one before? Read more about heart break attacks here.

Viacell ABANDONS Cord Blood Stem Cell Expansion Program

IS IT ENOUGH?

Whilst many cord blood banks rather unscrupulously hype up the possibilities of stem cell expansion (in order to get clients to store whatever they have and believe in their technology), I've always asked the StemLife team to take a very careful view of the science and the practical realities*.

[As a side note, here in Malaysia cord blood banks claiming to compete with us - operate on the cheap using non-FDA approved storage systems- promote the usage of vials as a storage medium on the pretext that cells can be selectively taken one vial at a time for future expansion. Read on to see why this is a disingenuous marketing ploy...]


THE CHALLENGES OF EXPANSION

The reason why StemLife has taken a cautious approach towards the expansion technology are three fold.

Firstly, in order to expand stem cells, you'll need enough cells -the more the better- in the first place. As a crude analogy, you'll need enough lactobacilli to make yoghurt (too little and it will take too long, allowing other bacteria to destroy the process).

Secondly, sterile technique is absolutely critical; when you're growing the cells, you have to make sure that it contains only the cells that you're growing and nothing else. This requires not only human precision, expensive facilities and sterile reagents, but most importantly, the money to maintain everything in exactly this pristine sterile condition (many, many zeros in any currency).

Thirdly, knowledge of cellular morphology and function is also very important. No one I know would like to risk having cells injected into the heart forming liver or kidney tissue instead. This means identifying the cells and providing the assurance that the cells are indeed stem cells and nothing else.

Hence, any organization, private or public has to be prepared to have deep pockets and a lot of patience when venturing into this technology.


HOW DEEP ARE YOUR POCKETS?

I've been following Viacell's (VIAC) progress in this area for some time, not only because they were one of the first stem cell companies to announce their sincere interest and demonstrate their financial committment in this area, but also because I was kindly shown around their big and beautiful facilities two years ago in Boston.

It is unfortunate therefore to see this press release by Viacell on their decision to terminate the cord blood stem cell expansion project CB001 despite its apparent reported success but on the grounds that the process and product was unaffordable and commercially inviable due to other alternatives.

"What's the alternative?" I hear you ask. The reason why Viacell made the tough commercial decision to cut their losses was that the preferred methodology by transplanters in the US is a dual cord stem cell transplant (using 2 cord blood stem cell units instead of just 1). The results of the expanded product were as good as and in some ways slightly better in the initial trial, but I suspect that the cost did not justify only small improved outcomes. I would say that it was a wise commercial decision by Viacell, and an acknowledgement that what scientists dream and love to do, is not always feasible for clinical practice.

I learned this a long time ago when I was still in research, that what looks good on paper does not necessarily transform into a money spinner despite the winning ideas and long hours of toil.


A GOOD CEO KNOWS WHEN TO QUIT

By cutting the budget for this research and focusing on service improvements, Viacell expects to finally achieve profitability in 2008 for the first time since their listing a few years ago (this is probably also true of many of the other cord blood banks which have committed much of their funding to very costly research, sacrificing their bottom line).


"Given these results and the shift in the treatment paradigm in transplant medicine from single cord to two cord transplants, ViaCell has made the decision not to advance CB001 in future clinical trials. As a result of the reduced clinical and development costs related to CB001, along with anticipated continued growth in its operating business, ViaCell expects to become cash flow positive in the first half of 2008."


Now, Viacell intend to focus on cord blood stem cells for cardiac applications, which I think is probably more interesting and may pose less life-threatening consequences for patients.


"We are committed to continuing to grow our operating business, advancing ViaCyte(SM) through a pivotal clinical trial, which, if successfully developed, will leverage our sales and marketing infrastructure, and working to advance our cord blood-derived cardiac program," said Mr. Beer. "We are already generating cash flow within our ViaCord business and we anticipate continued growth in 2007. As a result, given our reduction in clinical and development costs related to CB001, we expect ViaCord's contributions to the overall operation will allow us to turn cash flow positive in the first half of 2008."


So if you are specifically told by any stem cell company that stem cell expansion technology is available today, they aren't lying, but don't forget to ASK them whether:

1. Your unit baby's cord blood unit has sufficient stem cells to be expanded,

2. Who's offering the service (full due diligence here) and how successful the treatments outcomes have been and what assurances they provide otherwise;

3. And, specifically at what cost.


STEMLIFE BELIEVES IN CHOICES

The way I read the cord blood stem cell tea leaves, if you banked a unit of stem cells and it is not enough, seek other matching units to combine with your own or consider joining StemLife's adult stem cell banking program.

We believe in continually providing affordable and accessible options to our clients... and making stem cell banking a more than once in a lifetime opportunity. :)



*We do not turn away clients who express their wish to proceed but provide them with a cautious advisory to indicate if the stem cell counts are below what we would normally expect. StemLife also provides a full refund for those clients who decide not to proceed to store, and we usually ask them to let us know when they'll be having the next baby (success second time round).

StemLife has a joint research project with the National University of Singapore at very initial stages which differs from Viacell's approach, you can read more about it here.

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 :)

Part 4: Bangkok Conference on Stem Cell Therapy for the Failing Heart

MERRY CHRISTMAS EVERYONE!
Thought I'd share with you how we've decorated the office for the season. After a short break yesterday and a hearty dinner, I'm back to the blog...

Let's plunge right into it, the review of the last talk by a Tv representative. The CEO of Tv, Dr. Valentin Fulga didn't give away too much of the company's information or much on himself, except to review the cases done to date and also that he had some experience with the FDA and planned on getting approvals relatively soon. Much of the information he had was already mentioned in other talks and he used his time to credit them for their participation and active work.

THE QUESTION

I promised an answer to DTR's question and essentially I did pose this question at the very end of the symposium to Dr. Valentin Fulga, the CEO of Tv. Firstly, I commended him on successfully having Tv's stem cell technology effectively marketed the treatment to 180 patients to date. Logistics and coordination in itself is a real feat (flying the patient to Bangkok, flying the cells to Israel and back to Bangkok- wouldn't like to know their costs..), not to mention marketing the concept to doctors, hospitals and the patients from all over America. I noted also that almost all the patients were treated in Thailand, and curiously, none in Israel. I asked him why was this not the case as most lab services are derived out of its own community's requirements initially and then to serve a greater regional need.

THE ANSWER

He sort of woffled on for a few minutes and basically said that they were in the process of doing so but didn't really answer my question. I tried to assist by asking if perhaps it was a political issue in Israel that prevented them from doing any clinical work there; and his answer to that was that if there was a political problem he certainly didn't know about it as he hadn't been there in the last 2 months. Essentially, as Dr. Itescu pointed out to me later, there may similarly be many questions and queries on the validity of the work by Tv posed by Israeli doctors which is why they've taken their work to wherever they can.

I also spoke briefly to the president of their company in Thailand and the Asian region, a young trendy thirtysomething who goes by the name of Jimmy, he eluded to a fairly complex ownership structure of subsidiary companies and I wasn't entirely sure how he ended up in this business.

Anyway, since the cells are autologous and the treatments don't seem to be more risky than standard heart bypass procedures, I wish them well in their business as they may set an interesting price and model to shape how people in the US perceive stem cell therapy... preferably, with a vacation in Amazing Thailand. :)


StemLife also offers stem cell harvesting, processing and therapeutic services with renown Malaysian doctors for patients with heart failure and ischemic heart disease. If you're interested to learn how your stem cells can help your failing heart, please feel free to call us at +603 2163 8800 during office hours or ask your doctor to contact us at info@stemlife.com.


ps. If you missed the other parts of the conference entries, click on the label for "conference"

Multiple Myeloma Stem Cell Transplant for Beth Morgan

A lady by the name of Beth Morgan was reported to be raising funds for the International Myeloma Foundation (IMF), her reason for doing so was because she was diagnosed with myeloma and given a 10 year survival rate of 1%.

The only procedure that will help her improve her chances is a stem cell tranplant and she has already undergone the harvesting of her own stem cells for a transplant in the near future.

Interestingly, she believes that her cancer arose from her work in the semiconductor industry for four years, handling radioactive materials. I wonder if others in her workplace have also reported a higher than usual incidence of myeloma. Ms. Morgan went to have her stem cells harvested from her peripheral blood at Wake Forest University Baptist Medical Center and is undergoing chemotherapy to remove most if not all the cancer cells, before the stem cells are transplanted back into her body. Unfortunately, the chemotherapy has affected her nerves, not only leaving her permanently numb in her hands and feet but also affecting her mind.


I really hope her stem cell transplant goes well and that she gets her wish- which is to live to 80.


You can read about Beth's fund raising campaign here.

Young Blood. Muscle Repair. Count Dracula links Immortality, Youth & Rapid Healing

I came across this very interesting article describing what some Stanford researchers have been working on earlier this year. In an interesting experiment designed to examine aging and stem cell research, the researchers drew blood from young mice and injected them into genetically identical older mice (imagine storing your young blood and injecting it when you're older).

The result was exciting in that the young blood activated stem cells in the old mice's muscles, allowing them to recover from injury much fast than they used to.

"It's not so much about making people live longer," said Dr. Thomas Rando, associate professor of neurology at Stanford University School of Medicine. "But if some older person gets a broken bone or skin wound, maybe we could improve their recovery rate. Maybe there's a chance to enhance the potential of old tissues."

However, the blood supply was over a lengthy period of six weeks and wasn't as straightforward as a simple blood transfusion. But what the researchers also discovered was that there are "youth-inducing" molecules in the young blood that are responsible for switching on stem cell capabilities in old muscles, which will be the next project. Essentially, injecting stem cells alone may not be the only way to get muscles to repair, and it may be a combination of the right growth factors that also help to get the stem cells to work faster or better.

An excerpt from the article:
Rando and his colleagues studied muscle stem cells called satellite cells, which in young mice and humans induce repair when injury strikes. Rando found in previous work that satellite cells exist in older muscle, but they don't respond to a muscle's cry for help after injury. In the new study, the presence of younger blood helped the satellite cells work more like they do in young mice.


According to Dr. Rando, "Many stem-cell applications in people include diseases of old people," he said. "So if the environment of the heart, brain, liver (and) pancreas is less conducive (to healing) than that of a young person, it would be important to know that in advance."

It was thought that Bram Stoker was writing about patients with the genetic condition porphyria, where they are symptomatically anaemic and have hypersensitive skin, making them averse to sunlight (Vampires burning in sunlight- check out the movie Blade for some very cool effects). In the previous centuries, those with these condition thought that drinking blood of others would ensure their survival, and systematically robbed fresh graves seeking their cure. Now, those diagnosed with this condition congenitally may undergo a stem cell transplant for a cure.

But for immortality, Count Dracula recognized that only the young that provided this elixir (hence pursuing Mina). So was Count Dracula after the young blood or the growth factors in young maidens? I suspect that it was probably both.

Count Dracula Blood Quote on Blood and Immortality:
"Blood... Blood... Life... Years of life."

Count Dracula Blood Quote on Blood as a Food:
"We must survive, all of us. The blood of a human for me, a cooked bird for you. Where is the difference?"



If you'd like to contact Dr. Rando, you can find him here.

If you'd like to contact StemLife about storing your youthful blood, you can contact us at (6012) 2050 165. :)

11 Year-Old Malaysian Girl Provides Stem Cell Match for Brother With Acute Myeloid Leukemia

Its not often that we get news on Stem Cells in Malaysia but I do think that ever since we've started highlighting the applications, many more doctors are beginning to speak out about the important work that they do.

I read yesterday in the Star about a little girl by the name of Siti who has undergone a peripheral blood stem cell harvest to help her 17 year old brother Muhammad, who was diagnosed 5 months ago with Acute Myeloid Leukemia (see Angel's story).

You can read Siti's story here but I thought that it would be good to pick up on a few key points in the article which supports our preemptive peripheral blood and cord blood stem cell banking service. Its all about providing options for yourself in the future.

The treating haematologist Dr. Ng Soo Chin describes the chances of finding a match within the family:


STEM CELL MATCH

"A blood test, called HLA typing, is done to test whether a potential donor is a match. “There is a 25% chance of a sibling being a match to the patient,” Dr Ng notes. However, parents and half-siblings are usually not such good matches. "

I thought that it was a very well written article and Dr. Ng points out clearly that bone marrow harvesting- which is painful and very unpopular- is on a decline and that now peripheral blood stem cell harvesting is the way to go.


NO MORE PAINFUL BONE MARROW

"Not too long ago, the idea of donating stem cells frightened many people, not least because it required general anaesthesia and painful extraction of the stem cells directly from the bone marrow. Now, 90% of stem cell transplants use peripheral harvesting, instead of bone marrow,” Dr Ng assures. Peripheral harvesting means that the stem cells are collected from the blood stream in a procedure called apheresis. "

Peripheral blood stem cell collection is much preferred over bone marrow because doctors can be assured of a decent harvest. Very often bone marrow extractions require a lot of manipulation and may not obtain a reliable amount of cells for a transplant. Clotting of the blood is often one of the problems, a long with trauma bleeding, anaesthetic risk and patient discomfort.


PERIPHERAL BLOOD STEM CELLS - A VERY SAFE PROCEDURE

Dr. Ng says: “It’s like blood donation, except that it takes longer. However, the actual volume of blood that you donate is only about 50-100ml,” he explains, insisting that this is a very safe procedure.

And he also describes why using one's own stem cells are preferred, although this option is not always available:

When the patient is both the donor and the recipient of the stem cells, there are fewer risks involved – namely, no graft-versus-host disease, no immunosuppression needed and fewer infections.


TRANSPLANT ALREADY PERFORMED

Siti's stem cells had already been transplanted into her brother at the time of the publication and I do hope that he recovers and tells his story so that others may also know how a matching set of stem cells was critical in making the procedure possible.


StemLife provides stem cell collection and banking from the peripheral blood for healthy individuals and families. We also provide services for patients seeking treatment in collaboration with qualified medical specialists.

Please feel free to call us for a no obligation consultation at +603 2163 8800 or at 012 2050 165. We'd be happy to help.

Dad dies waiting for matching stem cells

This article is a sad one. A young 32 year old father, Paul Sim (two sons, 13 & 8 years old) was a wagon driver who broke his hip and twisted his knee. During a two and half month stay in hospital for his treatment, his bone marrow stopped producing the necesary replacement cells (condition known as aplastic anemia) and he had to have blood and platelet transfusions. The aplastic anemia could have been a result of his medication or perhaps a viral infection.

However, his condition continued to deteriorate and a donor could not be found despite his countrymen's best efforts at identifying a suitable match. The doctors probably did try to match his sister Angela's stem cells and his children's but to no avail. Hundreds of people came forward but they didn't match either.

The best thing would have been for Paul to have had banked his own stem cells prior to the accident. He could have called on them immediately for the transplant, saving precious money, time and giving himself the best chance of success.



From the Mayo Clinic Website:
Bone marrow transplantation — replacing diseased bone marrow with healthy bone marrow from a donor — may offer the only successful treatment option for people with severe aplastic anemia.


Many people ask me when the best time is to store their stem cells. Frankly in my personal opinion, there is no time like NOW, because one can't predict when these accidents can occur nor how serious small infections might become.

Adult Stem Cells Help Repair Radiation Damaged Tissue

I was excited to see this news release by the Director of the Clinic for Radiation Therapy as a result of the 25th Annual Congress of the European Society for Therapeutic Radiology and Oncology (ESTRO) held in Germany on the 9th of October.

In a nutshell, adult stem cells when infused after radiation therapy for cancers helps to alleviate the side effects of mucosa (think nasal passages, throat, digestive tracts etc) and skin.


The news release was so clear in its message that I'd like to post it almost in its entirety:

"Stem cell research will have many consequences for various fields of medicine", predicts Catherine Verfaillie, Director of the Stem Cell Institute of the University Leuven (Belgium), in a review lecture during the Presidential Symposium of the ESTRO conference on October 9. For example, stem cells that settle in the organ systems could be stimulated and then repair tissue damage. Radiation therapists have been following this track for some time in various projects that are presented at the ESTRO conference.


Even though the results were obtained in studies on mice, I hope that the radio-oncologists are taking note...!


INTERNATIONAL PROJECT. Rob Coppes of the University Groningen (The Netherlands) presents an EU-sponsored international undertaking at the conference, which is called the "FIRST Project" for short. (FIRST stands for "further improvement of radiotherapy through side effect reduction by stem cell transplantation").

The researchers have discovered that the side effects of a radiation therapy on various healthy tissues, such as skin and mucosa, can be reduced by treatment with adult stem cells. The stem cells migrate to the radiated tissue and support its regeneration. If studies confirm that this stem cell effect also occurs in humans, this would expand the treatment options for tumours because currently valid radiation dosage limits could be surpassed.

For instance, a radiation-biological research team led by Wolfgang Dörr of the Clinic for Radiation Therapy and Radiooncology at the Technical University Dresden reports that adult stem cells can reduce the side effects of radiation therapy on the mouth mucosa in mice. The scientists observed that the radiation tolerance of the mucosa was clearly increased if the animals received a bone marrow transplant prior to or during a fractionated radiation - during which adult stem cells are also transferred practically automatically.

A comparable effect was also observed by the scientists when they lured the stem cells from the bone marrow of the radiated animals into the blood circulation by injecting a growth factor, called G-CSF for short.


MESENCHYMAL STEM CELLS PROTECT. A team led by Dr. Michèle Martin of the Service de Génomique Fonctionnelle from Evry (France) also reports on studies in mice. The researchers had treated the animals with a radiation dose that led to tissue damage of the skin within three weeks. Without treatment, it took eight weeks until this damage had healed. Part of the mice was injected by the researchers with human mesenchymal stem cells 20 hours after the radiation exposure. The stem cells were adult stem cells from, e.g., the bone marrow that can differentiate into fat, cartilage, tendon, skin or muscle cells.

The scientists noted that the skin damage in the treated animals healed faster and better than in the untreated animals. In addition, the scientists examined tissue samples from the damaged skin areas. The stem cells - so the result - had indeed migrated to the radiated skin regions. As Martin reports, their morphology was similar to that of the epithelium.

I have a few friends who are currently undergoing chemo and radiotherapy. If eating and breathing could be made more comfortable, I'm sure they'll want to know about it. I'll tell them about it tomorrow.

If you have a twin brother, he can donate his adult stem cells to you

I was reading some of the news that's published on the web (my usual after-dark activity) and came across this very interesting account of a journalist whose brother was diagnosed with multiple myeloma and was called upon to donate his stem cells. It really is rather well documented and very emotional description of what his feelings for his brother, the process that he went through for stem cell harvesting and also the potential huge amounts that would have been spent had he not been able to donate.

Having read his story, I think that the doctors should have banked some of his own for him -whilst he is healthy- just in case he also develops the cancer and requires his own stem cells for a transplant. I've copied the story here in full text, just in case the link goes off-line, and I've also added in my own thoughts in italics just to share with you the experiences we've had at StemLife.

THE STORY:

My brother, Gene Berthelsen, was born at 5:13 p.m. on Oct. 4, 1937. I was born 20 minutes later at 5:33, although it could have been the other way round. We're not sure.

That's because when our mother brought us home from what was then Siskiyou County Hospital in Yreka, and bathed us for the first time, she took the hospital-supplied identification bracelets off both of us. Once finished, she told us decades later, she discovered we were so identical that she couldn't figure out which was which. One of us arbitrarily became Gene and the other John, which was disconcerting. Even though we were separated only by minutes, over the years, as we grew up in the remote mountain town of Etna, near the Oregon border, we developed an older brother-younger brother relationship -- he steadier and more responsible, I more rebellious and immature; he has lived his life in California, I have spent much of mine in Asia. He is also one of Northern California's most prominent traditional jazz musicians. I play CDs on the stereo.

We are monozygotic, or mirror twins. I am left-handed, he is right-handed, a sign that we originated from the same ovum. Because we have suffered almost exactly the same diseases at nearly identical times, when he was stricken with bone marrow cancer last year I was filled with dread. The multiple myeloma he contracted became a foe we both would fight. Our remarkable similarity, we hope, appears to be a key to prolonging my brother's life. This is a story of our unique advantage in battling cancer and the very real danger that what happens to one could happen to the other. Since I live on one side of the planet, he on the other, the fact that we share the same DNA has brought us into more intimate contact with each other than we have known for decades.

In the face of vastly differing diets, climates and lifestyles, our body weight has usually been within a pound of each other. Despite the fact that our careers have separated us by a third of the globe, we remained largely identical for many years -- enough so that once, rounding a corner and unexpectedly encountering a full-length mirror, he asked it what I was doing there. Even after we broke our noses in separate childhood accidents, his curved slightly to the right, mine slightly to the left, maintaining the mirror image. On meeting us together for the first time, his oncologist, Dr. Ginna G. Laport, did a double-take and asked which of us was which, despite the fact that at that point he had lost most of his hair and I am bearded.

In February, I flew from Hong Kong, where I live, to the United States to donate adult stem cells to be injected into him in an attempt to restart his bone marrow production and re-create my immune system in his body. Interestingly, it is also expected to give him any allergies I might have acquired over the years. Thus, whatever physical divergences we have undergone over almost seven decades and wide geographic separation are about to end. We are about to become one again.

The story began on May 27, 2005 when, after complaining for several weeks of what he thought was a severe charley horse, my brother received a chilling diagnosis, multiple myeloma, or cancer of the plasma cells. As the cancer grows, it tends to clump up within the marrow and eat away the bone. He required the immediate insertion of a titanium rod in his left femur within hours. If the operation hadn't taken place, his doctors said, the bone could have disintegrated in an instant simply from walking. Later, cancer also would be discovered in the marrow of his pelvis and rib.

Until fairly recently, a diagnosis of multiple myeloma was almost a death sentence. Even today the survival rate is only three to four years, according to the American Society of Hematology. That was enough to send my own blood racing, not only out of concern for my lifelong doppelganger, but because our medical histories are so similar. In 2002, for instance, when I entered the hospital for a triple bypass operation to clear blocked arteries, he was operated on just three weeks later for the same problem. Could cancer be an inevitable part of my future?

Indeed a very valid question and at StemLife, we provide banking services to enable healthy adult donors to bank their own stem cells for a potential future need, alleviating the daunting prospects of having to hunt for a donor.

Dr. Laport, an oncologist at Stanford University Medical Center Bone Marrow Transplantation Program, says nobody really knows today how much of a role genetics plays. Certainly there is an obvious genetic predisposition among siblings, especially among those who share identical DNA. But, Laport said, unidentified environmental factors play an equally vital role -- or played, probably 20 to 30 years ago -- an irony for us, as my brother spent his life in the relatively clean surroundings of Northern California, while I have spent much of the last three decades in several environmentally degraded Asian countries.

DTR a fellow blogger is extremely concerned about HK's continually degrading environment, check out his blog on this here.

Fortunately, my brother is a member of Kaiser Permanente, one of the biggest health maintenance insurance plans in the United States. Despite controversies over limitations of care to some patients in other areas, Kaiser was willing to pour vast and expensive resources into his care.

For several months, Kaiser doctors sought to control his cancer through chemotherapy, with mixed results. Then, in December, they were elated to discover that he had a twin brother whose DNA was identical. Unfortunately, that brother was 7,000 miles away. Exhaustive physical examinations ensued in Hong Kong, including the drawing of 12 vials of blood to test for such afflictions as AIDS, syphilis and others. I emerged clean and ready for California.

Until relatively recently, close siblings and those who shared identical DNA underwent bone marrow transplants rather than stem cell transplants. Fortunately, that is no longer necessary. Bone marrow donations are excruciatingly painful. The donor is anesthetized while holes are drilled in the back of the pelvic saddle for the extraction of marrow. That pain has largely been eliminated through the substitution of transplanted stem cells for bone marrow.

Bone marrow extraction is quite painful (sometime excruciatingly so) and involved a surgical procedure which can be traumatic to a child or an adult. This procedure is now quite unpopular and many donors have turned down donating their stem cells due to the pain and risks involved. Those who donate their marrow once, very rarely will undergo the procedure a second time.

The common misperception is that stem cells are found only in the nuclei of human ova. The stem cells found in the human ovum are embryonic stem cells, which are even more immature and less differentiated than hematopoietic stem cells, which promote the formation of blood cells. Hematopoetic stem cells are found in the bone marrow of all humans. Over the past 15 years, doctors have discovered that they can increase the production of immature hematopoietic cells by the injection of a hormone called granulocyte colony stimulating factor, known commercially as Neupogen.

If no independent donor can be found, cancer patients donate their own stem cells, which can be manipulated and processed to remove cancer cells, and then transplanted back into the patient. But, according to Adele Ullner, a Stanford Blood and Bone Marrow Center nurse, it is difficult to remove all cancer cells from a stricken patient's cells. Having an independent donor with identical -- but cancer-free DNA -- is far preferable and gives the patient a far better chance for longer remission.

They also have a relatively cheap donor. Finding an independent donor with similar DNA costs about $300,000, about triple the cost of that from an identical twin. The cost for the remainder of his oncological care, including the removal and replacement of his femur, probably ran to another $100,000. Our medical situation is certainly unusual, although we are not particularly rare, since about four of each 1,000 live births result in identical twins, a pattern that seems to have held steady across different ethnic groups for ages. Stanford's cancer program, Ullner said, has been doing marrow transplants for 16 years. To her knowledge, this is the first time an identical twin has been found as a donor.

Neupogen injections to stimulate stem cell production are no picnic. Although often they involve little pain, at odd times they involve pain so acute, Ullner said, that some receiving the shots call the hospital in the belief that they are having heart attacks.

These pains strike at odd times. For me, I was lying in bed watching television. I got up momentarily to discover that every single heartbeat was sending what seemed to be a pulsating electric shock through my body. I was reminded of a time when I was a child on our father's dairy farm and on a dare I touched an electrified cow fence. Painkillers such as Vicodin help, but there are times when even Vicodin doesn't slow those electric shocks. Another possible side effect is an enlarged spleen. (Indeed, those injected with Neupogen are warned not to fly for at least three days after the process because one patient who didn't wait suffered a ruptured spleen while in the air. The 14 1/2-hour flight back to Hong Kong was no place to experiment.)

I wonder what dose of Neupogen was administered, StemLife clients who have been stimulated do not always experience any side effects- perhaps it is because we use a lighter dose.

At the end of the five days comes "apheresis,'' the harvesting of those stimulated cells. It is mainly boring -- sitting in what vaguely resembles a dentist's chair, a tube in the left arm draining off blood, which then runs through a centrifuge that separates out blood stem cells before the remainder of the blood is returned through the right wrist. About 9 ounces of blood is outside one's body at any given time. The blood is chilled before being returned, which for some odd reason makes your nose itch. Over about four hours, the 4,750 cubic centimeters of blood in my body circulated through the centrifuge more than three times, passing 15,045 cubic centimeters through the machine to produce what my brother needed.

The process does indeed take up an afternoon, we usually recommend that donors bring their own DVD's or select from our wide range of entertainment ranging from a 2 hour foot reflexology, amusing conversations with our team members or music to make the time go by effortlessly. All whilst in the care of a very professional team.

I was surprised to discover how much the process had weakened me. On my first trip back to the elliptical trainer, where I usually exercise for an hour, I lasted only 15 minutes before staggering off. It would be weeks back in Hong Kong before I found myself fully recovered.

Interesting, on the contrary, our stem cell bankers return to normal work the very next day. Perhaps it is age? The author is 69 years old. However, our eldest donor is a very jolly 88 year old gentleman who didn't report any exceptional tiredness or side-effects..!

The Stanford Blood and Bone Marrow Center itself, where the procedure took place, is a remarkable institution, seemingly paying as much attention to patients' emotional and spiritual needs as their physical ones. Patients are provided with voluminous information about their afflictions, with complete descriptions of the emotional issues they face both prior to and after recovery, of sadness and depression two to three months after the transplant is completed. Extensive counseling services are provided both to recipients and donors. Gene's doctors at the facility set out to destroy the cancer cells in his bone marrow, and along with it the entire marrow itself, as well as his immune system. In the early years of the program, cancer patients were sequestered in sterile rooms for 100 days, because any contact with any kind of virus would kill them, before regenerated bone marrow cells were injected back into their bodies.

That, thankfully, is no longer necessary. Huge doses of antibiotics allow patients to live relatively normal lives, although they must wear inhalators when outside.

Nonetheless, it is a horrific process. For months, he underwent chemotherapy that cost him his hair and much of his vitality. He was required to drink three liters of water a day to flush out his liver and kidneys. If he didn't, the chemicals could destroy his vital organs.

Then, starting on March 15, the process of destroying the cancer cells accelerated drastically when a cocktail of virulent drugs was injected through a catheter in the center of his chest. The drug also delivered immediate side effects including nausea, vomiting, decreased appetite, diarrhea, fatigue, sores in the mouth and throat, and decreased blood cell counts. Later possible side effects could include sterility, cataracts, hypothyroidism, scarring of the lungs and second malignancies.

High-dose therapy, as it is known, kills all cells that form newly reproducing elements of the body -- not only bone marrow but hair, fingernails, semen, saliva and blood cells that reproduce to fight disease. It results in infertility because of the permanent damage to sperm cells in men and ova in women. In other words, the medical process comes as close as possible to killing the patient in an effort to eradicate the cancer cells.

On March 23, the process continued with the transplant of my DNA into my brother's body to seek to re-create his bone marrow and immune system. The toxicity of the chemotherapy was now so high that he required the constant injection of fluid through a catheter to keep the poisons from destroying his vital organs.

Would he make it? In the cold language of the disclosure statement of the Stanford University medical consent form, if both my DNA and the cells he donated as a backup failed to grow, "then this complication would be expected to result in death."

He ultimately grew so ill that the Stanford doctors became concerned that his body was rejecting my cells. He lost 26 pounds in two weeks, or nearly 15 percent of his body weight. But finally, on April 7, after virtually nonstop vomiting and diarrhea, his white blood cell count started to rise. "Engraftment,'' as his doctors called it, had begun. My cells had been transplanted, prompting a weak joke from him that he had suddenly become left-handed, as I am.

On April 21, he was finally able to return to his Sacramento home, weak, debilitated and raspy-voiced but on the mend. Along with everything else, the chemotherapy had destroyed his ability to produce saliva, making him sound like he had aged 20 years in a matter of weeks. He said he looked more like Uncle Fester of the Munsters than Yul Brynner.

Now, however, he is recovering his old vitality -- along with his hair, which oddly is coming back in different colors. He has regained 13 pounds, although he has continuing neuropathy -- numbness in his hands and feet -- and he is dizzy when he stands too quickly. But tests in mid-July showed that levels of IG (g) protein, an indication of his kidney function in battling myeloma, had fallen to healthy levels, meaning he is now cancer-free.

Ultimately, the process, according to Laport, should dramatically extend his time in remission, at which time other therapies should come into play.

On Sunday, April 30, two weeks after the final process was completed, Gene was able to return to the musical stage at a jazz festival in Jackson, pick up his cornet and front the Catsnjammer Jazz Band, as they have been called for nearly 30 years. He didn't play long, but he played. After all, in the 1920s, jazz cornetist Joe "King" Oliver wrote this song:

Hello central, give me doctor jazz

He's got the thing for me, I'll say he has

So when I'm in trouble and when I've got the blues

He's one who makes me put on both my dancin' shoes.


You saved your brother with your adult stem cells. Thank you for sharing your story. It is so important that more people understand the process of stem cell collection and use in cancer treatment and to know that it really isn't hocus-pocus or useless. Perhaps you might like to come bank your own here with us in KL!

StemLife Blog Updates! Two Happy Stem Cell Patients

My apologies for the long hiatus! Its been very busy here at StemLife and I was reminded by colleagues that the StemLife blog was in need of my attention and that they were keen on knowing what news there was to share. The world of stem cell technology does not rest and whilst the recent events of war in the world have grabbed headline news, patients and stem cell followers have also had their fair share of updates.

In addition to the cord blood stem cell derived insulin secreting cell blog entry that I just published, I did see two other articles which I thought worthy of a mention.

ONE: Well done Dr. Suradej Hongeng in Thailand who has performed Thailand's first and most complicated triple stem cell (2 cord blood units + bone marrow from patient's mother) donor transplant for Thalassemia major. At only seven years old, the little boy who underwent the transplant at Ramathibodi hospital is already considered well enough after only 2 months in hospital. The cord blood units were only 80% matched with the patient's tissue type but the transplanted stem cells were well accepted and functioned after just 5 weeks post transplant.

In previous work, Ramathibodi had successfully treated 10 patients with blood disorders or cancers using cord blood stem cells from only one donor but has performed about 430 bone marrow transplants since the program commenced in 1989 according to Saengsuree Jootar. The limiting factors are almost rhetorical- high costs of the procedure ranging from Bt 300,000 to Bt 700,000 (approx. MYR 30K to 70K) and the well known challenges of finding a matching donor. The hospital does run a charity program of free transplants in honour of the Queen, in which 34 patients have already benefitted from the procedure.


TWO: Remember the Gary Schaer trial for heart that I keep mentioning? Well, in the last entry I asked how Rev. Eugene Carter was doing and I got my answer (it would be nice if he's decided to answer us because of the question posed in this blog!). He's doing just fine :)

EXCERPT:Last February, Carter needed his faith when he had a heart attack. He says, "I believe that anything that comes my way is there for a reason." So when doctors asked him to be in a study on stem cells just days after his heart attack, he said yes.

"The promise of stem cells is the promise that these cells could be given to grow new parts of the body that have been damaged," Gary Schaer, M.D., an interventional cardiologist at Rush University Medical Center in Chicago, tells Ivanhoe.

Dr. Schaer and colleagues are giving heart attack patients stem cells from a healthy adult donor. The cells are delivered through an IV. Once infused, they zero in on damaged heart muscle and repair it. Stem cells have shown great promise in fixing damaged heart muscle in pigs.

"I have been doing this for a little more than 20 years, and this is the most exciting new development in a very exciting field," Dr. Schaer says. Studies have shown using a patient's own stem cells can treat heart failure. He says using a donor's stem cells to treat heart attacks is a new frontier.

Carter feels lucky to be part of the study. "What an opportunity to do something positive," he says, and if the treatment helps, he'll have even more to preach about.


Excellent news. Okay, now back to StemLife work!

Heart Muscle Stem Cells Update: The Gary Schaer Trial

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

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


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

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

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

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

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

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

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


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

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


Why your Stem Cells are your very own Obi wan Kenobi

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

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

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