What are stem cells?

Our bodies are made up of millions of cells. Most of these cells are specialized to particular locations and functions. The cells in your brain are different from those in your stomach. Heart muscle cells are different from bone cells. And so on.

If a part of the body needs repair, tissue of the same types of cells may be used. Two well-known examples are grafts and transplants. A piece of blood vessel or bone may be grafted from one part of the body to repair another. Or an entire organ may be transplanted to replace a defective organ.

Stem cells are a promising new approach to repairing diseased or defective tissue. Unlike other cells, stem cells are generally not yet specialized. They are like generic “blank” cells that can be adapted and reproduced according to what they are needed for. Imagine being able to “grow” replacement tissues that match a patient’s damaged bone, muscle, or brain cells! This gives you an idea how stem cells might work, and why people are so excited about their potential. 

Currently there are a few medical applications of stem cells that have been proven effective and are in use at Bumrungrad and other advanced hospitals. Other stem cell applications are the subject of research and clinical trials around the world. Despite the vast potential for stem cells, there are several issues that need further study.  For example, factors and mechanisms of how stem cells differentiate into specific tissue and organs are not yet clearly understood. 

What are the potential uses for stem cells?

There are a variety of diseases and injuries in which a patient’s cells or tissues are destroyed and must be replaced by tissue or organ transplants. Stem cells may be able to generate brand new tissue in these cases, and even cure diseases for which there is currently no adequate therapy. Conditions that could see revolutionary advances from stem cell treatment at some point in the future include Alzheimer’s, Parkinson’s, diabetes, spinal cord injuries, some heart diseases, stroke, arthritis, cancer, and burns.

Stem cells may also prove valuable in genetic and pharmaceutical research.

What benefits of stem cells have been proven?

Stem cell therapy has proven useful in the treatment of certain cancers and diseases of the blood such as leukemia, Thalassemia, and certain immune deficiency diseases.

Stem cells in these cases can help restore the production of blood cells by the body. Blood cells are produced and developed by bone marrow, the soft tissue inside bones. The body’s ability to supply itself with enough normal blood cells can be affected by blood diseases and blood cancers. Blood cell production can also be damaged as a side effect of chemotherapy or radiotherapy in cancer treatment. Stem cells harvested from bone marrow or processed from circulating blood can help offset this damage.

While it is a widely accepted treatment, bone marrow transplantation remains a risky procedure with many potential complications. It has always been reserved for patients with life-threatening diseases.

How is stem cell treatment regulated in Thailand?

There is no specific law governing scientists researching human stem cell applications in Thailand. Existing Thai FDA regulations do not cover stem cells because they are not a food or drug.

To correct this lack of oversight, the FDA formed a working group in September 2007 to consider that stem cells are a new kind of disease treatment that should be classified and regulated by the Drug Act, and may need additional laws to regulate.  The FDA Director General stated that physicians and institutions will be governed by the Medical Council’s Medical Practice Act and the Department of Health Service Support’s Sanatorium Act. A central committee will be set up at the national level to oversee clinical research on stem cells. 

In the meantime, it is up to each institution to follow international ethics and guidelines for clinical research involving humans. Clinical studies on stem cells should be approved by each institution’s review board or research ethics committee, and then by an independent, national level reviewer. Research must be conducted to rigorous scientific and ethical standards.  For example, institutions must clearly inform patients of the unproven nature of the treatment; patients must be able to weigh the risks and benefits, in the absence of inducement, coercion, or profit motive.

Several good studies of stem cell treatments are being conducted under these conditions in the European Community and the US.

What is Bumrungrad International’s position?

Bumrungrad International is optimistic about the future potential of stem cells to treat various diseases. Where stem cell treatments have been proven effective in clinical studies – for example in the hematological diseases mentioned previously – Bumrungrad offers expert treatment by experienced physicians. In other stem cell applications, our doctors are following international clinical trials closely to determine if and when treatments prove safe and effective.

We will develop capabilities and offer such treatments to our patients when they are accepted by the international medical community. If our clinical research program does participate in any trials, we assure our patients of the following:

Experimental treatments must be approached very cautiously, especially when they are sought by families as a “last chance” treatment for loved ones in critical condition. Patients and their families must be able to trust that their doctors and hospital have evidence supporting such treatment. The evidence cannot be merely that “some patients seem to have benefited from the treatment.” It must be subject to the stricter rules of scientific inquiry.