News & Progress from Thai StemLife

Some of our avid readers have noticed that Dr. Kostas, Thai StemLife's Chief Operating Officer is featured as a new contributor to this blog. He's been very busy with the company lately and I've been reading some of their accomplishments online.

Thought it might be nice to share the news with you here, if you're interested to know how our Thai company is coming along.

Stem cells can effectively heal patients with diabetes
Thai StemLife has already been actively treating patients with diabetic foot ulcers successfully.

Stem -cell research wins prize
Undoubtedly one of the most innovative business services of the year :)

Stem cell bank bullish on Thailand
Thai StemLife looks to do well next year!


Congratulations to Thai StemLife on winning the top award in the "Top 10 Innovative Business 2006" from the National Innovation Agency (NIA) of the Ministry of Science and Technology!

The Importance of Intricate Scaffolds for Adult Stem Cell Culture and Expansion

A while ago, StemLife recognized the importance of 3-D scaffolding for cellular expansion and this led to the research project collaboration with Singapore National University's Department of Engineering, specifically the Nanoscience and Nanotechnology Department. Advances in nano-engineering technology and increased understanding of the cell's structural needs are evolving the way that scientists from different specialties work together towards a common goal of potentially reconstructing parts of the body. I'll keep you updated on our work as we go along.

It was therefore exciting to read this latest release from MIT regarding their research in 3-D scaffolds for the growth of stem cells. Researchers Zhang Shu guang and Fabrizio Gelain from Milan have created a scaffold made of protein nanofibers (made of amino acid fragments) which has successfully provided the growth bed for adult stem cells obtained from mice.

A 3-D system would not only better mimic the body's natural environment for the cells and the researchers expect that this aspect would assist in obtaining an accurate picture of how cells grow and behave in the body, but also allow the cells which have engrafted onto the scaffold to be transplanted directly into the body.

More interestingly, scaffolds will allow scientists to try seeding different cell types (such as teeth, bone, skin and other important excreting organs such as liver and pancreas cells) and maybe enable these cells to form the important supporting cell types which enable the organ to function biochemically as well as structurally.


MORE INFO:

If you'd like to know a bit more about Prof. Zhang, click here for his CV and contact details.

If you'd like to know more about the nanofiber scaffolds by Prof. Zhang's group, you can view the MIT presentation here. It would be better to listen to him in a presentation and some of the pictures in the slides are missing but you'll get the general idea.


If you're interested in seeing your own body's scaffolding ability, have a close look at your nails with its multiple layers and if you happen to take some of the skin off your lips- you'll also be able to see the intricate layers of protein which give the sheets its tensile strength and patterns. :)

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.

Part 3: Bangkok Conference on Stem Cell Therapy for the Failing Heart

In this entry, I will briefly discuss the one other Theravitae (Tv from now on) talks from the heart conference. Sorry to stretch out the entries on this particular event, but it is much easier for me to write bite-sized pieces rather than a really long one.



The next speaker from Tv was Don Margolis who is known as one of the founders of the company. I didn't get a chance to speak with him personally nor ask him his background but his speech was a deviation off the scientific road and took on a more political slant. He didn't have any slides but spoke sort of 'off-the-cuff' or maybe just from the heart (no pun intended). He spoke about the policies in the US for stem cell research and lamented slightly about how embryonic stem cells always seems to get much more attention than adult stem cells which he vigorously supports. He cited Tv patients such as Don Ho and how he has benefitted from stem cell therapy, but unfortunately not in the US. He touched lightly on how he started the company, in the search of doing something worthwhile to help sick people all over the world.

Who is Don Margolis?

I didn't see much stirring in the audience. Despite his rousing speech, he was speaking to a group of doctors and scientists who shared similar opinions and have vested interest in stem cells for therapy. Anyway, I searched google for a picture of him but couldn't find any- so I'm posting the one I took here. If anyone reading this has any comments on Tv or its founders, please feel free to post.

Next one up is the CEO of Tv- Dr. Valentin Fulga's talk.

Part 2: Bangkok Conference on Stem Cell Therapy for the Failing Heart

Thanks DTR, for prompting me to write another entry on the heart conference I attended in Bangkok. These next few entries will hopefully answer your questions, which are pretty much my own as well.

As the main sponsor of the conference, alongside Bangkok Heart Hospital, it was Theravitae's aim to showcase their technology and data to impress doctors from all over the world. Notably, the speeches were delivered by three company respresentatives. Namely Yael Porat (who is the chief scientist at Theravitae's lab in Israel), Dr. Valentin Fulga (CEO of Theravitae Ltd in Israel and Bangkok) and one of the founders by the name of Don Margolis.


Review of Theravitae talk by Yael Porat, Neiss Ziona, Israel

Yael Porat's talk was more "technically" based, giving some simple parameters by which they qualified their work. Essentially, they take a bag of blood (250 ml) from a potential heart patient, fly it over to Israel and leave it in Yael Porat's lab. In simple terms, she plates in out into cell culture flasks and lets the cells known as ACP's (angiogenic circulating progenitors) grow in the presence of growth factors such as EGF, VEGF, IGF and b-FGF. She stresses that no animal serum is used, only patient's autologous serum and some heparin (as an anti-coagulating factor).

After growing the cells several rounds in a GMP/ clean room type facility and achieving as much growth as they can without damaging the cell line, Yael resuspends the cells in medium (not sure what medium it is but it looks like serum), packages the cells in syringes and sends it to the hospital in sterile, bubble wrapped pouches and shhipped at 2-8 degrees Celsius. This final product is known as Vescell and is applied to the patient either via angioplasty or by direct intramyocardial injection.

She couldn't give much away in terms of information apart from showing how they labelled the cells and assuring the audience that the lab in Israel was par excellence. Her slides were mostly text based with just one picture of a biosafety cabinet in a clean room and the cells in syringes and a few staining images. The questions which followed her talk mostly pertained to the manipulation of the cells and its logistics. Manipulation* wise, it seemed like pretty standard cell culture techniques without much selection (although without further disclosure from them, I really wouldn't be able to confirm this) but in the US, FDA does not permit the use of any manipulated cells at this time.


QUESTIONS & ANSWERS


Dr. Doris Taylor asked about the logistics of the cells which have to travel from Bangkok to Israel and back, how would the cells be transported and how would they ensure quality without deterioration or even that they remained the same cells during the journey?

PACKAGING:
In a cooler bag with temperature logger throughout journey to ensure the cells are kept between 2-8 degrees C.

CELL IDENTIFICATION:
The answer that Yael gave was that Theravitae would check the cell numbers and their identity prior to shipment, but there would not be any necessary checking at the hospital when the cells arrive. (ie assumption that cells stay the same)

TRANSPORT:
Next flight out policy, and they have already checked how the cells in the collected blood (at the beginning) can still be viably used after 24 hours as Yael used to work on old/ expiring bags of blood obtained from the blood bank. As for bringing the cells back to the hospital, she says that the cells have to be packaged right and be shipped to the site within 24 hours by special courier.

Next was a question by Dr. Sujit Banyatpiyaphod, cardiac surgeon from Bangkok Heart Hospital. He asked if the cells could be frozen down? Reason being that some of the heart patients were in critical condition and if the patient needs to wait another 2-3 days after the cells arrive for the injection procedure, would the cells still be ok to use or can it be kept frozen for application at a later date.

Yael replied with a NO, the cells cannot currently be frozen down although they are trying to work on it. Right now, if the patient is unable to use the cells, then she would prefer if the doctor collected another round of blood and send it over to her again for culturing so that it is prepared fresh.


PRACTICAL & LIMITING CONSIDERATIONS


It seems to me that there are some practical considerations to this sort of cell therapy where time limitations and cell viability all play a sizeable role in the economic costs to patient, planning costs to the doctor and hospital. One thing Yael didn't volunteer, was whether this situation has arisen before and whether there is a company guarantee for another round due to unexpected circumstances.

Even if Theravitae builds a lab in Bangkok and shortens the logistics time, it is clear from this they will still need to overcome the issue of storage or of affordable 2nd time therapies. The way to understand this is to really understand cellular biology- cells are alive, metabolism keeps going and prolonged exposure to a different or manipulated environment has its own way of changing cellular fate. Obtaining fresh blood from the patient may not be difficult, but re-culturing them in time for the procedure (if its urgent) is a present challenge.


I'll be writing about what the CEO said in the next entry- and answering DTR's question posed in the last blog. :)


*Manipulation in this context means the alteration of the cells' environment, or selecting for certain cells in a mixture, or the addition of factors which may induce changes in the cell's composition or identity.

Part 1: Bangkok Conference on Stem Cell Therapy for the Failing Heart

I returned from a heart conference in Bangkok last weekend organized jointly by the Bangkok Heart Hospital and a company providing stem cell therapeutic services in Thailand to American patients known as Theravitae.

There were several interesting presentations, from Thai doctors in academic institutions and also several renowned doctors who were also associated in some form with private enterprises. One of the companies presenting their work was BioHeart. The speaker Kristin Comella gave a talk on how it was their company's belief that Myoblasts (ie muscle stem cells, obtained from the thigh) were the way forward in treating heart disease.

They presented a lot of animal data, which look very convincing, except that the company was asked to stop their trials in the US after several of their patients required the surgical insertion of a pacemaker after the procedure. I admit that their theory sounds attractive, take 10 grams of muscle from the thigh (not that I would want a scar on my thigh), culture the cells and place it in the heart by way of an angioplasty or direct intra-myocardial injection.

Interestingly, Bioheart revealed that they are in the process of manufacturing a machine which separates stem cells from fat. I stood up to ask if it was the same as what Cytori Therapeutics offers and Ms. Comella said YES. I suppose myoblasts from thighs are taking too long to get into commercial application and it would be easier to work with plastic surgeons instead.

I'll review a few other presentations in later entries of the blog as I'm a little tired tonight. Going to catch some sleep... zzz.

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. :)

StemLife Blog now in Beta mode!

Hi Everyone!

I'm delighted to mention that Google has finally offered me the option of upgrading StemLife's Blog to Blogger beta version which I'm quite pleased about. The main feature which I was really after was the "label" and "tag" feature which allows me to categorize the entries. So if you are looking for something specific cited on stem cells, you can try clicking on the label which will call up any relevant articles.

I'm in the process of labelling, it might take me a bit to get it all done. So if all fails, use the search blog function available at the top of the page. :)

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.

Growing New Arteries - Brains, Legs and maybe even Erections

Its been known for a while now that cytokine stimulated stem cells typically used in bone marrow transplantation can be harnessed for vascular regeneration. This particular capacity has been demonstrated in the heart and also in diabetic patients with peripheral vascular disease (PVD). However, due to poor circulation in the area of interest, stem cells need to be "transplanted" from the source of stem cells to the site of the problem.

This latest article mentions the use of GCSF in the regeneration of blood vessels in patients with vascular disease. Citing the administration of this cytokine as a "new treatment", a farmer by the name of Tom Reynolds who was 77 years of age had poor circulation and leg pain. Concerned and afraid about possible gangene infection and limb amputation, Mr. Reynolds tried GCSF injections.

Administered by Dr. Arshed Quyyumi, a cardiologist, Mr. Reynolds has since experienced improved circulation and less pain.


Extracted from emedicine.com:

"Vascular disease may manifest acutely when thrombi, emboli, or acute trauma compromises perfusion. Thromboses are often of an atheromatous nature and occur in the lower extremities more frequently than in the upper extremities. Multiple factors predispose patients for thrombosis. These factors include sepsis, hypotension, low cardiac output, aneurysms, aortic dissection, bypass grafts, and underlying atherosclerotic narrowing of the arterial lumen.

Emboli, the most common cause of sudden ischemia, usually are of cardiac origin (80%); they also can originate from proximal atheroma, tumor, or foreign objects. Emboli tend to lodge at artery bifurcations or in areas where vessels abruptly narrow. The femoral artery bifurcation is the most common site (43%), followed by the iliac arteries (18%), the aorta (15%), and the popliteal arteries (15%)."

I learned from a renown urologist in Malaysia that erectile dysfunction is one of the most common indicators of heart disease and vessel occlusion (small vessel involvement). Diabetics often are unable to enjoy intimacies because of this physical obstruction in blood vessels. I wonder if the doctors will follow up on other aspects of Mr. Reynold's quality of life...? :) That would be an interesting anecdote indeed.

Another Cord Blood Stem Cell Application: McGuckin's Hope for Livers

Recent news from the UK has led me to think that stem cell research is beginning to yield some fruits. Prof. Colin McGuckin (blogged about him here) and Dr. Nico Forraz have been able to generate small sections of liver-like cells from cord blood derived stem cells.

Though the cells are not in sufficient quantities to provide tissue for organ replacement now (apparently penny-like sizes), the doctors have set up a company called Conostem which plans to market the cells to pharmaceutical companies for drug testing. The aim is to permit the application of drugs to the cells in order to assess toxicity to liver cells prior to human trials (animal cells may behave differently to pharmaceuticals than human cells).

Interestingly, the cells are grown in a Nasa designed "microgravity bioreactor" which mimicks weightlessness which is said to aid in its creation. Their work has won a local business award but as it has not yet been published, many other scientists and doctors have voiced their opinions that it is still too early to consider it for therapeutic use which may be a decade away. Nonetheless, it may just be a matter of time and sufficient effort in understanding the cells and their behaviour when implanted into the context of the body.

I am wondering how long it took them to grow the penny-sized cells and how many cells they required as a seed culture. It must be expensive, if not the cytokines that are involved then the bioreactor can't be cheap to run. But, this is exciting news because it may open up the realm of tailored therapy for autologous cord blood stem cell use (for all those babies who may grow up to be drinkers*?!) if it becomes commercially applicable and affordable.

Compared to adult stem cell infusions which they are trying in London, this might still be an expensive proposition.


Note that until today, drug companies are purchasing excess human liver cells (from surgical procedures or biopsy) for diagnostic research and pharmaceutical testing. It doesn't happen in every country but generally where the healthcare rules are more relaxed and perhaps surgeons are drafted in to provide the tissue for clinical trials.


*It is estimated that up to 10% of the UK population have problems with their liver - most are linked to lifestyle factors, such as heavy drinking and obesity.

STEM CELLS for Parkinson's Disease: Michael J Fox check out China

While Michael J Fox has been campaigning fervently in the US for the Democratic vote on the issue of embryonic stem cell research, out pops an article so perfectly timed that reveals the potential of NON-embryonic stem cells for Parkinson's disease.


HOSPITAL PROVIDES SURGICAL OPTION FOR PARKINSON'S DISEASE

Apparently, a hospital -co-owned by a company known as the American Pacific Medical Group*- known as Tiantan Puhua Neurosurgical Hospital located in Beijing is able to procure donor retinal stem cells from the Stem Cell Research Center at Beijing University for transplantation.


FIRST AMERICAN PATIENT OUT OF THIRTEEN

53 year-old Penny Thomas from Captain Cook (Big Island, Hawaii) suffered from Parkinson's disease for almost ten years. She had surgery on May 16 and had 3 million stem cells stereotactically implanted via a 12-inch needle into the center of her brain. The procedure performed by Dr. Xiaodi Han, costed her USD 26,000 (RM 98,800) and took one and a half hours. She had to stay in China for 2 months and seems to have recovered significantly from her previous symptoms.


"I TRIED MEDICATIONS. THEY WEREN'T WORKING FOR ME"

Her doctor, Dr. Cliff Arrington from Kealakekua, vouches for her progressive worsening tremors and encouraged her to explore treatment options available overseas. Her husband and 15 year-old daughter had to do almost everything for her including cutting up her food, getting dressed and showering.

She said: "Getting ready for bed would take almost an hour every night. I tried everything holistically possible and finally went to different doctors. I tried medications. They weren't working for me."

The hospital's vice-president Sherwood Yang released a statement to say that although stem cell treatment is unable to eliminate all symptoms of Parkinson's disease, Penny Thomas' shaking is reportedly reduced, has significantly less muscle tension, increased strength and no freeze-ups. Since then she reports regularly to the hospital and is slowly reducing her medication under the guidance of the Chinese neurological team and Dr. Arrington. She is supposed to have a follow up check up in May next year to see what has happened to the implanted stem cells.

Due to the reduction in medication, her tremors returned but the doctors seem optimistic that the stem cells will do their work. I'm not sure what medication she is on but if its able to put her back on the track of normal life without too much side effect, that might already be a boon to many Parkinson's sufferers out there.

About 6 years ago, I met my friend's grandmother residing in Sydney who had Parkinson's. She would shake in waves so much that she couldn't get out of her wheelchair nor hug her grandson properly. It was my first time meeting a Parkinson's patient and it affected me greatly.


It has been postulated that stem cells obtained from the retina may be able to transform into brain cells, but although several surgical procedures have been conducted, I have yet to see the follow up articles reporting their recovery rates and long term success. I await the final verdict on the engraftment of the stem cells next May and hope that the program may shed some light on how this condition may be treated. But in the meantime, maybe MJ Fox might want to take a closer look.


*The American Pacific Medical Group may sound like an American company but is really one which was set up in 1992 by a group of 35 enterprising doctors who were trained in the US. You can read about them on their website here.

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.

Stem Cells for the treatment of Ischemic Heart Disease

Finally it looks like the hospitals in the US will soon have results that will get the FDA to approve stem cell therapy as a potential first liner for ischemic heart disease. This report states that approximately 15-20 sites in the US through their respective divisions of cardiology and pathology are investigating 200 randomly selected patients from across the country, harvesting their CD34+ cells and injecting the cells into the heart to investigate the extent of which new blood vessels are formed.

The patients are selected from an existing pool where usual and conventional treatments have already been applied but failed or where no surgical procedures are thought to be helpful. Myocardial ischemia is one of the most severe forms of coronary artery disease, which is the leading killer in the U.S., according to University Hospital officials.

"This is a study to try and reduce chest pain in people that have this coronary disease and have no other options," said Mark Anderson, director of the Division of Cardiology and associate director of the Cardiovascular Research Center, who is involved in the research.

"By increasing the number of those cells present, it encourages the heart to create biological bypasses to connect with another source of blood," he said. "The area of the heart causing pain is not dead. It is alive, but starved."

The disease causes arteries to tighten so that not enough blood passes to areas of the heart, which leads to chest pain and potentially to heart attacks. The stem cells, researchers hope, will spark new paths for blood to get through.

The treatment method is called Autologous Cellular Therapy CD 34-Chronic Myocardial Ischemia Trial or ACT34-CMI, and is funded by Baxter Healthcare Corporation. Appropriately so as Baxter has its own line of products for stem cell harvesting and processing. Increasing the applications for this line of service beyond cancer would add a new revenue stream for the company.

The American Heart Association estimates that 125,000 to 250,000 people with coronary artery disease develop myocardial ischemia each year. In Malaysia, the estimates would range about 12,000 to 25,000 annually. I hope that they would come to us early so that we can help them salvage as many of those starving cells as we can.


On another note, I found this site which tells us what to do if someone is having a heart attack. Could come in handy.

Adult Stem Cell Therapy for Cardiac Patients in Gujarat, India

I like these kinds of stories because firstly, it shows the forward thinking doctors who are willing to pioneer the concept of stem cell therapy in their geographical location and secondly (more importantly) because their work may have genuinely benefitted the patients.

Essentially, two Gujarati patients aged 35 and 58, Lakshmanbhai Bharwad and Ratanbhai Prajapati respectively, were the first to receive stem cell therapy for their failing hearts. Both patients had poor ejection fractions of 18% and 30% (versus the normal 60-70%), felt exhausted all the time and thus were generally quite unproductive.

The doctors Dr Shalin Thakore together with embryologist Dr Himanshu Patel, of the Krishna Heart and Super Specialty Institute had performed angioplasties for their patients and immediately after diagnosing and widening the relevant blocked arteries, proceeded to mobilize the patient's stem cells and collect them.

The article cites that "About three to four days later, stem cells were cultured into cardiac stem cells and reinjected into the newly reopened arteries via another angiography." I find this rather suspect reporting as I don't think its currently possible to culture and differentiate cells in 3-4 days and identify them morphologically. In any case, the stem cells were re-injected by angiography soon after harvesting.

The patients' ejection rate quite amazingly increased very dramatically, rising from 18% to 45% and 30% to 55% within two months, which is the highest jump that I have ever seen reported.

This rapid increase is unlike any that we've experienced and I am wondering if they are willing to publish their work. One important parameter that is likely to influence the outcome is the number of cells delivered to the injured site and the timing of the delivery.

My questions would be:

How many mobilizing injections did they give?
How many cells did they harvest and use?
How did they measure the ejection fraction? (some equipments are said to be notoriously variable in result)
Does this increase in EF only apply to those who have stem cells within 15 days of the heart attack?

Dr. Thakore's final statement was that this was a one-time procedure but could be repeated in 3 months should the results not meet expectations. Very interesting. I'm waiting to hear if they proceed with more cases and long term follow up.


StemLife currently offers stem cell therapy for cardiac conditions with 2 leading centers in Malaysia, HSC Medical Center and Gleneagles Intan Medical Center and look forward to serving more. Our patients have reported significant symptomatic improvements on 3 and 6 month follow ups.

If you would like to have stem cell therapy for your cardiac condition, please contact us at +6012 2050 165 and we'll be happy to refer you to a doctor or open the dialogue with your doctor in the hospital of your choice.

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

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.

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.