Stem cell therapy seems to come from the stuff of science fiction. Patients suffering from incurable disorders have been cured of their conditions after taking stem cell therapy. It seems that with scientific advancement, we humans will not be able to die so easily.
Today, the websites of many stem cell clinics around the world are packed with glowing testimonials accompanied with pictures of smiling patients. Yes, many have benefited from stem cell therapies, having been cured of various diseases.
However, the truth is that there is no guarantee that a patient will be cured. For example, in 2010, the All India Institute of Medical Sciences reported only a 50% success rate of treating its heart patients with stem cell therapy. This example is not intended to run down the Institute but to point out that stem cell therapy has its limitations.
A recent horror story that was reported in the UK-based Telegraph online concerned the voluntary closure of XCell-Center in Dusseldorf, Germany. In August last year, an 18-month year old baby was injected with stem cells and died. The doctor is under criminal investigation, and the incident has spurred German authorities to tighten the country’s laws on stem cell treatments.
So what is stem cell actually? It is a special “originator” cell that does not have any specific function as yet. When it divides, each new cell can either remain a stem cell or become another type of cell with a specialized function, such as a muscle cell, a red blood cell, or a brain cell. Stem cells are the most fundamental structure for every cell, tissue and organ in our body. They can be used to repair or replace damaged tissue, thus reversing diseases and injuries. A child has over 70 million stem cells; a middle-aged adult has only 35 million stem cells left to repair the body. That is why as we age, we are more prone to diseases.
Types of Stem Cells
There are two types of stem cells: embryonic stem cells and adult stem cells. Embryonic stem cells are obtained with patients’ permission from leftover embryos that develop from eggs that have been fertilized in vitro (from fertility clinics) and then donated for research purposes with the consent of donors. They are not derived from eggs fertilized in a woman’s body. These embryos are created and exist entirely outside the body. Embryonic stem cells can develop into any kind of cell type or tissue in the body.
Adult stem cells are rare cells found in only some developed organs or tissues. An adult stem cell is an undifferentiated cell found among differentiated cells in a tissue or organ, and which can renew itself. It can also differentiate to morph into some or all of the major specialized cell types of the tissue or organ. The primary function of adult stem cells are maintaining and repairing the tissue in which they are found.
Uses of each type
Embryonic stem cells can develop into any kind of cell type or tissue after being exposed to specific growth conditions. Therefore, they can be utilized to reverse numerous diseases and injuries. However, adult stem cells can only be used to repair the types of organs or tissues from where they came. Also, embryonic stem cells can be replicated outside the body in a laboratory, so that they can ultimately be used by many patients, whereas adult stem cells cannot grow outside the body and have to be immediately frozen or transplanted into the patient.
A course of stem cell treatment can vary from two to five days or more, depending on the diagnosis of the disease, history and other complications. Treatment is usually performed via a drip-feed or an intravenous injection in the arm.
Choosing a stem cell centre
Apart from Western countries, stem cell therapies and treatments are also available in Malaysia, Singapore, Thailand, India, Philippines and China. How do you choose and evaluate a stem cell centre? The International Society for Stem Cell Research, a non-profit body, has suggested a list of questions that patients should ask the centre. Part of the questionnaire is reproduced below:
(A) The treatment
— Is the treatment routine for this specific disease or condition?
— What are the alternative treatment options for my disease or condition?
— If I have this treatment, could it affect whether I am able to have another
— What are the possible benefits I can expect? How will this be measured and how long will this take?
— What other medications or special care might I need?
— How is this stem cell procedure done:
— What is the source of the stem cells?
— How are the stem cells identified, isolated and grown?
— Are the cells differentiated into specialized cells before therapy?
— How are the cells delivered to the right part of the body?
— If the cells are not my own, how will my immune system be prevented from reacting to the transplanted cells?
(B) Scientific evidence
— What is the scientific evidence that this new procedure could work for my disease or condition? Where is this published?
— Have there been earlier clinical trials? What was learned from these trials?
— Can you provide me with several names of scientists and clinicians who can give me independent advice?
— Is there any independent body overseeing the facility where the cells are processed?
— Is there approval from any regulatory body for this treatment of this specific disease?
(C) Safety and emergencies
–What are the risks of the procedure itself, and the possible side effects both
immediate and long-term?
— What will be done if an adverse reaction (bad side-effect) develops? Who is the person to contact in an emergency or research-related injury? Who will provide emergency medical care?
— Is the clinic adequately prepared to handle emergencies such as a serious allergic reaction?
— What follow-up treatment will be received, and for how long? What will I need to do?
— Who is the doctor in charge of the treatment? What specialized training does this doctor have? How well trained are the other doctors and the technical support staff?
(D) Patient rights
— What are my rights as a participant—for example confidentiality, my right to be informed of any new information that might come up, my right to withdraw from the treatment process?
— What compensation am I entitled to if I am injured as a result of taking part in this treatment?
— What are the costs of the treatment? What does this include? What other costs will I incur?
— What would be the costs of emergency treatment if something goes wrong? Who would provide this and pay for this?
According to the Medical Development Division of the Ministry of Health, there are guidelines for stem cell research and therapy. The extracts below are of relevance to potential patients:
“(a) Private healthcare facilities and services intending to perform or performing stem cell or cell based therapies shall be licensed under the Private Healthcare Facility and Services Act 1998.
(b) It is recommended that these centres perform internal and external audits to ensure quality, viability, purity, safety, reproducibility and efficacy of the end-products.
(c) The procurement and processing of stem cells shall comply with the National Standards of Procurement and Processing of stem cells.
(d) Laboratories performing gene therapy research involving the use of viral vectors shall comply with the Biosafety Level 3.
(e) Personnel performing stem cell transplants shall be adequately trained and proficient and shall acquire privileging status from the respective institutions.”
Stem cell therapy certainly holds great promise but, unfortunately, it is not cheap.
Depending on the type of treatment it can cost from RM50,000 to RM100,000. As a matter of interest, a private hospital in a neighbouring country charges US$15,000 for a diabetes treatment package.
Possible Cures by Stem Cell Treatments
* Parkinson’s disease
* Spinal cord injury
* Retinal disease
* Multiple sclerosis
* Sickle-cell anemia
* Hodgkin’s disease
* Bone marrow failure
* Severe Burns
* Muscle dystrophy
* Ovarian cancer
* Heart muscle loss
* Breast cancer
* Liver disease
* Sports injuries
* Bone injuries