Stem Cell Banks - Hope for a Healthier Humanity – An Interview

It is generally believed that stem cell therapy is meant only to facilitate treatment of the rich. Could you explain the approximate cost factor for stem cell treatment?

We must bear in mind that stem cells are offered as a treatment option to only a few judiciously selected patients based on their clinical condition. Stem cells do cost a lot as the charge needs to cover the costs of collection, testing and finally cryo-freezing the stem cells for protracted periods of time.

The National Marrow Donor Program (NMDP) in the United States makes a unit of cord blood available for a price of US $47, 000 (2.1 crore rupees) including shipping costs. StemCyte charges around US $ 12,500 (56 lakh rupees).

In addition, hospital charges in India for about two months to enable stem cell treatment and post transplant care would cost roughly 20 lakh rupees. The cost of similar treatment in Singapore would be approximately 1.4 crore rupees . In view of the high cost involved, treatment is not an easily affordable option even if required.

We hope to supply HLA matched stem cells free of cost to those below the poverty line, and on a cost recovery basis for those who can afford it. We have already had stem cell matching requests, from France, Australia and Bahrain and while we have not had perfectly matched stem cells to release, it has reinforced the fact that there are several people all over the world who need stem cells. This challenges and motivates us to collect more cord blood samples.

Four million human embryos are lying unused in cold storage world over. Do you foresee something like that happening with bone marrow and cord blood stem cells stored in surplus?

That is unlikely to happen as stem cells have immense potential. Apart from the vast therapeutic potential, researchers and the pharmaceutical industry particularly have tremendous use for these stem cells. Organ creation and transplantation, banking for gene therapy, drug development and toxicity studies , studying neoplasms in vitro…..there are a whole gamut of possibilities for which these stored stem cells can be used.

Currently in developing countries like India the demand outstrips the availability of stem cells. Lack of suitable HLA matched donors when the patient doesn’t have a sibling donor, is a major limitation for stem cell transplants in our country.

HLA proteins are highly diverse and vary between different races. There is a greater likelihood of finding a match within the same ethnic population group and hence it is essential that every country has its own database and bank of stem cell donors. Only a miniscule 4% of cord blood that is stored is collected from Asians, and hence perhaps 1 in every 20 - 25 Asians looking for a perfect match is lucky. Compared to this, every alternate Caucasian (Europeans, Americans) is likely to find a match.

We have a heavy disease burden in India where 3-8% of the population have thalassemia with 8000-10,000 more thalassemics and a similar number of newly identified patients with leukemia are added each year. We need to raise public awareness on cord blood transplant as a potentially life saving treatment option for thousands of patients who depend on repeated blood transfusions for treatment of these illnesses.

Many gynecologists in India are unsure about cord blood and its potential use in future. What could be the reason for their lukewarm response?

There is always initial resistance to anything new and this is still a relatively new field for India. In addition there have been various questions raised by academic bodies on the marketing techniques employed by private banking companies the world over. These are possibly the reasons why several obstetricians are treading cautiously.

What are the medico-legal implications of the use of stem cells? This being an upcoming field especially in India, has the government of India drafted guidelines for the same? What kind of regulatory mechanisms are available to protect the people from unnecessary claims by many stem cell organizations especially in private hospitals?

We do have guidelines laid down by the Indian Council of Medical Research (ICMR). These have not yet been enforced. When the stem cells come from the person’s own blood or marrow as in autologous stem cell transplant (from self to self) there are few legalities involved. If the stem cell transplant is from another person, there are a few permissions that need to be obtained as shown in the figure. Most importantly, the mode of treatment and the risks involved should be clearly explained to the patient in a language understood by the patient and the patient should be allowed to make an informed decision and give his/her consent only after this.



For further details log on to: http://www.icmr.nic.in/stem_cell/stem_cell_guidelines.pdf

What is your dream that inspires you to propel Jeevan Stem Cell Bank on a fast track?

Fast track? Not so sure about that. Dreams – or rather hopes - certainly!

Initially the project was to set up a public cord blood bank. This having been completed, the next will be to set up a registry of bone marrow and peripheral stem cell donors. We will then need to link it to the global network of marrow donor and cord blood registries. Hopefully Jeevan Stem cell Bank will one day become a facility that will offer complete transplant care under one roof- ie from finding a match till the time the person returns home well on the road to recovery!!

“Those who do most, dream most.” - Stephen B. Leacock 

Medindia wishes Dr. Saranya Narayan on her quest to cross more milestones in improving the quality of lives of people—cured of diseases and disorders.

Source-Medindia
Thilaka Ravi/L