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Tuesday, December 05, 2006

Biopiracy: umbilical cord blood banking in India

Lifecell a company dealing with stem cell banking announced the launch of a ‘public banking’ of blood taken from umbilical cords. The company has been running a ‘private bank’ of stem cells for the past two years. In ‘private banking’, the parents of a child can choose to store the umbilical blood during delivery of the child. The blood is then stored in a bank, from which it can be retrieved, to treat various blood based disorders that the child may develop during the course of his lifetime.

In the proposed, ‘public banking’, the company plans to collect blood from donated umbilical cords, to form a bank. From this blood, stem cells will be extracted and categorised. Anybody in need of a particular category of stem cells for medical procedures can then contact the bank and get those cells for a fee.

Even though the company claims that it can treat up to ‘75’ disorders, the idea of stem cell banking it self is being questioned by the international medical community. According to the Royal College of Obstetricians and Gynaecologists, UK, stem cell based procedures can only be used in very specific cases which deal with particular genetic blood conditions that are know to be passed through generations in certain families (called ‘high-risk families’), they cannot be used for all disorders that company claims. Also the Royal College recommends that ‘there is still insufficient evidence to recommend directed commercial cord blood collection and stem-cell storage in low-risk families’. In the Indian scenario, the Indian Council of Medical Research (IMRC) has still not released any guidelines for stem cell banking or procedures based on it. Dr. Puneet Bedi, consultant pregnancy and foetal medicine, with 20 years experience dealing with families with genetic disorders such as like thalassimia and haemophilia, says “people are being told that diabetes and hypertension can be cured through this, though there is no scientific basis for it. Even for families with genetic disorders the quality and quantity of stem cell recovered is rarely clinically useful. Private blood banks have been here for over 2 years, they have no technical skill to preserve cells and the procedures are unproven.”

Apart from the scientific validity of umbilical blood banking and procedures based on it, there are also legal problems. As of now, the law does not recognise the ownership of the umbilical cord; it can be argued that it belongs to the mother or the child. Also the law does not define the liability of the storage bank in case the stem cells get damaged during storage. There are also ethical questions, as improper or ill timed umbilical cord blood removal can jeopardise the mother and child’s health.

Until guidelines from the IMRC are released, it is still advisable to properly understand the implications of umbilical cord blood based stem cell procedures before a donation is made. Meanwhile, a similar process is already in practice in the US, the catch however, is that the cost of stem cells there is up to $18,000, a price which very few Indians can pay. To this, Sumit Chaturvedi, manager marketing, comments “we plan to keep the cost nominal so that every body can afford this service”. As of now Lifecell has not disclosed the price.
Link:See what the Royal College of Obstetricians and Gynaecology has to say
Link: check LifeCell site

8 comments:

sheyalpandit said...

do you think stem cell research has a high potential to go the GM crops way?

Swathe said...

If I understand right, the first korean report of spinal cord injury repair in a 37 year old female patient was by using umbilical cord blood from another donor. But have such treatments already been used by umbilical cord storage unites in India? if so how much do they cost?

Arjun Jassal said...

The cord blood banking companies are not willing to release varifiable data on the number of operations. As for the cost, the hospital where the treatment will take place, will quote it. The banking facility just holds the cells till the patients buys the cells from them. In the US, the price is around $18,000.

Swathe said...

I read in a blog saying Umbilical cord blood unit is available for 2.5 lakh Indian rupees (http://answers.yahoo.com/question/index?qid=20070312024904AAZkfkg)which sounds very reasonable compared to the USD 18,000- price tag! But how many centres in India are able to treat patients with the umbilical cord blood? how many doing and what are the results?

Swathe said...

Hi all,

I have been going through the issues pertaining to usage of Umbilical cord blood cells. The potentials and hurdles I am listing as much as I have come to know:

1. FOREMOST IMPORTANT THING WITH UCB is that if it matches, 100% matching is possible ONLY for the same person; Siblings have approximately 25% matching probability. Whether related or unrealted donated unit with partial matching, immunosuppression has to be used. At times the cost of the immunosupression drugs are more than UCB price, as it has sometime to be take life-long.

2. At present it has been on use ONLY for blood cancers and related diseases mainly with sporadic reports of them being used for spinal cord injury etc. There is going to be a clinical trial in HK and China with unrelated UCB for spinal cord injury (http://www.reuters.com/article/healthNews/idUSHKG34418720070308)
Also to be noted is the terrible setback of the first successful spinal cord injury patient treated with unrelated UCB in Korea (http://www.wesleyjsmith.com/blog/2006/01/more-bad-news-from-korea-this-time.html)

3. Even if the same person whose UCB is available in storage, is suffering from some genetic disease, in that case his/her own UCB cannot be used as the same genetically corrupt cells are their in store. At this stage, his/her sibling related unit if available may come to rescue.

4. Storage many, and to be very precise any one with investment capability can do. But the stored unit when is to be used, has its own limitations. The total no of cells stored could be around 200~600 Millions. This quantity may suffice a treatment to a kid. When the same person has grown larger, multiple units of same HLA type is necessary, which is ONE OF THE MAJOR LIMITATIONS.

Therefore research to expand the stem cells in vivo without them changing their genetic identity and other biological safety parametrers is very important.

There are various methods of expansion going on. One of the major lines is to cytokines for expansion. This though some people claim succeses, the cost of each cytikine vial may range from USD 10000~100000 which again makes the expanded cells VERY EXPENSIVE!

5. Public banking is one good solution to all these. But who should do the public banking? ONLY if the government does, it would be ideal, other wise conflict of interest and ethical issues are always likely to complicate the modus operandi.

Swathe said...

Hi all,

I have been going through the issues pertaining to usage of Umbilical cord blood cells. The potentials and hurdles I am listing as much as I have come to know:

1. FOREMOST IMPORTANT THING WITH UCB is that if it matches, 100% matching is possible ONLY for the same person; Siblings have approximately 25% matching probability. Whether related or unrealted donated unit with partial matching, immunosuppression has to be used. At times the cost of the immunosupression drugs are more than UCB price, as it has sometime to be take life-long.

2. At present it has been on use ONLY for blood cancers and related diseases mainly with sporadic reports of them being used for spinal cord injury etc. There is going to be a clinical trial in HK and China with unrelated UCB for spinal cord injury (http://www.reuters.com/article/healthNews/idUSHKG34418720070308)
Also to be noted is the terrible setback of the first successful spinal cord injury patient treated with unrelated UCB in Korea (http://www.wesleyjsmith.com/blog/2006/01/more-bad-news-from-korea-this-time.html)

3. Even if the same person whose UCB is available in storage, is suffering from some genetic disease, in that case his/her own UCB cannot be used as the same genetically corrupt cells are their in store. At this stage, his/her sibling related unit if available may come to rescue.

4. Storage many, and to be very precise any one with investment capability can do. But the stored unit when is to be used, has its own limitations. The total no of cells stored could be around 200~600 Millions. This quantity may suffice a treatment to a kid. When the same person has grown larger, multiple units of same HLA type is necessary, which is ONE OF THE MAJOR LIMITATIONS.

Therefore research to expand the stem cells in vivo without them changing their genetic identity and other biological safety parametrers is very important.

There are various methods of expansion going on. One of the major lines is to cytokines for expansion. This though some people claim succeses, the cost of each cytikine vial may range from USD 10000~100000 which again makes the expanded cells VERY EXPENSIVE!

5. Public banking is one good solution to all these. But who should do the public banking? ONLY if the government does, it would be ideal, other wise conflict of interest and ethical issues are always likely to complicate the modus operandi.

narendra said...

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To register, Visit http://www.netinfobase.com

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