FDA has approved only 10 types of Stem cell treatment which are mainly from hematopoietic stem cells. Various clinics around the world are marketing for stem cell therapy which is not FDA approved and are not proven safe in clinical trial hence it is necessary for patients to ask their physician about the Stem cell therapy they are going to conduct. I have listed some of the questions which are asked by peoples on various forums.
If you want to know more about the basics of Stem Cells refer my post stem cells and their Biology.
Refer my post for a more detailed explanation of Stem Cell Therapy and Pros and cons of Autologous and Allogeneic Stem Cell Transplant.
Are there any ethical issues with Adult Stem Cells?
No, adult stem cells are not embryos. They don’t have the potential to develop into a new human being. They reside in the bone marrow and fat and they exist in large quantities.
Where can I find the list of all the Stem Cell Clinical Trials?
You can find information on any clinical trial experiment related to any disease in the ClinicalTrials.gov which is a U.S. National Institutes of Health maintained the Public database for all the clinical trials. ClinicalTrials.gov currently lists 239,411 studies with locations in all 50 States and in 197 countries.
What is Cord Blood Bank Accreditation?
All cord blood banks are required to register with the U.S Food and Drug Administration (FDA) and should follow the FDA set international standards for testing and storing the cord blood.
The two main accrediting agencies for private cord blood banks in the United States are American Association of Blood Banks (AABB) and Foundation for the Accreditation of Cellular Therapy (FACT).
Will my insurance cover the cost of treatment?
No, Insurance companies do not cover adult Stem Cell Therapy. Stem Cell Therapy is considered as research activity hence your existing insurance will not cover Stem Cell Therapy. There are various insurance companies offering insurance covers especially for stem cell therapy which will be useful if you are looking for stem cell therapy.
How much does this treatment cost?
Treatment cost depends on the type of treatment required and the country in which transplantation is conducted. Generally, in the USA it cost around $6K to $8K but stem cell therapy is cheap in developing country like India.
Before going to transplantation beware of fake promises by some of the clinics.FDA has sent a strong message on fake clinics which are marketing for clinically unapproved Stem Cell Transplantation.
How soon can I go back to my regular activities?
Most of the Stem Cell Transplantation procedure consists of injection of cultivated stem cells into the body which is a same-day office procedure. Patients are usually sore during the first couple days after the injection. Patients can return to work next day, depending on the site of the treatment and a load of physical activity that is required from the patient at their jobs.
Where can I find the donor for my Stem Cell Transplant?
You can find the donor for your transplant therapy using Match View portal from the BE THE MATCH organization.
Also to find the list of Public Stem cell donor organizations around the world click here.
Can stem cells cause cancer?
Adult Mesenchymal stem cells are not known to cause cancer. Some embryonic tumors known as a teratoma (A teratoma is a tumor with tissue or organ components resembling normal derivatives of more than one germ layer) are reported rarely when embryonic stem cells are used.
What is Hemacord? What is the first FDA-approved Stem Cell Therapy?
Hemacord is the first licensed hematopoietic progenitor cells-cord (HPC-C) cell therapy from U.S. Food and Drug Administration. HEMACORD is indicated for use in hematopoietic Stem Cell Transplantation procedures in patients with disorders affecting the hematopoietic (blood-forming) system. For example, to treat patient with certain blood cancers and some inherited metabolic and immune system disorders.
What is PRP and why is it used with Stem Cell Therapy?
PRP (Platelet rich plasma) is blood plasma that has a high concentration of a group of cells called platelets. These cells release growth factors and other proteins that promote wound healing in bone and soft tissue. When injected, the high concentration of platelets delivers powerful doses of growth factors that accelerate and enhance tissue repair and healing. These growth factors also attract Stem Cells to the site of injury.
What is Novel therapy and what are Novel agent’s treatment and its use in Stem Cell Therapy?
Novel Therapy and Novel agents refer to use of FDA approved Novel Therapeutic agents for the treatment of multiple myeloma (MM) disease.
They are called novel agents because they target the myeloma – as compared to traditional chemotherapy that kills a wide variety of cells, including those that are good and that you don’t want to kill.
It has been concluded by the clinical trial that, a combination of novel drugs with Autologous Stem Cell Transplantation (ASCT) in a sequential treatment approach can attain long-term survival and perhaps cure a subset of patients.
Do I need to stop drinking after Stem Cell Transplant?
Yes. Avoid alcohol or use alcohol only in moderation, usually less than 2 drinks per day.
What impact does smoking have on Stem Cell Transplants?
Many transplant complications are more severe in patients who smoke. This includes mouth sores and lung problems that can be life-threatening. If you smoke, you must stop.
Why should I go to the dentist prior to blood/bone marrow transplant?
If you have not had a recent dental check-up, you should make an appointment with your local dentist. If you have low blood counts, make sure that your dentist knows. Ask your dentist to look for any possible sites of infection in your teeth and mouth. Unhealthy teeth and gum tissue can become a serious infection problem during transplant.
Do I need to go for Allogeneic or autogenic Stem Cell Transplant?
Patients with Autoimmune Disease and Bone Marrow related disease can’t use their own stem cell for the Stem Cell Transplantation hence Allogeneic transplant is useful for the patient with autoimmune diseases.
It’s good to contact your doctor to find which type of transplantation suites you.
Can blood and bone marrow transplants affect fertility?
Yes. Most, but not all, transplant conditioning regimens (chemotherapy and or total body irradiation) can cause the transplant patient to become infertile as a result of treatment. There may be options to consider if you wish to have children in the future. For men, sperm banking, a process which involves freezing and storing your sperm, is an option you might want to explore. For women, if there is enough time before treatment of your cancer is required, it may be possible to freeze either your eggs or embryos before you undergo your treatment.
Is pregnancy an option during Blood and Bone Marrow Transplant?
No. You should not become pregnant or father a child at any time during your treatment. The medicines used can be harmful to an unborn child.
What are some of the side effects of Stem Cell Transplantation?
A Stem Cell Transplant is an effective treatment for some types of cancer. But it can cause side effects. Side effects are different for everyone. Side effects of a Stem Cell Transplant will depend mainly on:
- The type of chemotherapy drugs used
- If radiation therapy was given before the transplant
- The type of transplant used
- Your overall health
Side effects from an Autogenic Transplant:
- Infections, Nausea, and vomiting, Mouth Sores, Fatigue, Low levels of platelets, anemia caused due to low levels of red blood cells, Diarrhea.
Side effects from an Allogeneic Transplant:
- Infection, Graft-versus-host disease, Veno-occlusive disease, Lung problems, Infertility, Thyroid problems, Risk of developing another cancer.
Is there a risk of immune rejection from Stem Cells?
Yes, Transplanted stem cells, like any transplanted organ, can be recognized by the immune system as foreign and then rejected. The likelihood of the immune system rejecting a transplant of embryonic stem cell-based tissue depends on the origin of that tissue. Stem cells isolated from IVF embryos will have a genetic makeup that will not match that of the person who receives the transplant. That person’s immune system will recognize those cells as foreign and reject the tissue unless a person is on powerful immune suppressive drugs.
Is it painful to be a Bone Marrow Donor?
Bone marrow donation is done under general or regional anesthesia so the donor experiences no pain during the donation procedure. Discomfort and side effects after the donation vary from person to person.
Will a Stem cell donation affect future pregnancies?
No, The body will replenish the stem cells or bone marrow within a few weeks and there are no long-term side effects.
Can I register as a bone marrow donor if I am pregnant?
Yes, you can still register as a donor. However, you will not be allowed to donate during your pregnancy.
After delivery, should I consider donating my baby’s cord blood?
Yes, it’s recommended to consider donating the baby’s umbilical cord blood as another way that they can help in the fight to save lives through Stem Cell Transplantation. Similar to bone marrow, cord blood is rich in blood-forming cells that can be used to treat patients suffering from the various blood diseases such as leukemia.
When can I expect to feel better?
Most patients feel no improvement for at least 3 weeks and possibly 6-8 weeks. Once you feel improvement, you will notice continued improvement expanding over 6 months.
How long it takes to regain immune system post Stem Cell Transplantation?
After two to four weeks, the new stem cells graft to your bone marrow and start to make new white blood cells. Next, your body starts making platelets, then red blood cells.
Generally, until 6 months to 1 year, your immune system in the body is null to very low and susceptible to infections hence will be given with chemotherapeutic drug to fight against infections.
How many treatments will I require and how often will I receive them?
With Bone- Marrow and Adipose Derived Stem Cells, most people need only ONE treatment. With PRP, most people require two to six treatments done every four to six weeks to achieve the desired result.
If you have any questions and suggestions, post a comment or write to me directly.