I noticed another story related to experimental treatment for spinal cord injuries in an American paper yesterday. The Bellville News Democrat carried a story of an 18 year old paraplegic girl,Jacki Rabon, who was paralysed in a car accident in 2003. She travelled to Portugal in order to receive adult stem cell treatment. A procedure in which undeveloped nerve cells from the olfactory bulb in the patient's nose are removed and implanted in the injured area of the spine.
Jackie was confined to a wheelchair but is now walking with the aid of leg braces. Her mother had this to say: "If the U.S. would invest more money into spinal cord injury research, people like Jacki wouldn't have to go to other countries to get help. This surgery should be available here, but it's not, and that's sad."
It should also be noted that the surgery is experimental and the Lisbon team has not yet published any articles in medical journals describing its findings. However, the physicians have indicated that while there have been no dramatic cures, there has been improvement with many, but not all, patients. Improvement ranges from increased sensation or decreased pain to improved motor abilities or bowel and bladder function.
An Irish company, Remedi, which specilaises in exploring ways in which adult stem cells can be used in the fields of regenerative medicine and tissue engineering.
A recent report in the Irish Times newspaper highlighted the current research into treatment of spinal cord injuries using a method in which the spinal cord's nerves are encouraged to re-grow along temporary, hollow 'scaffolds' which have been implanted with the patient's stem cells. Over time millions of new nerves form and the scaffolds biodegrade harmlessly. The report is a very interesting read as it highlights the scope of treatments that adult stem cells may one may be able to be used for.
It's still very early days but these researchers are providing some hope that in aound 10 years this treatment will be ready to be trialed on humans.
Last month, Peter Irwin, a patient of ours from Australia, emailed to let us know that he was taking a vacation. Having undergone VesCell therapy, and obviously feeling as though he had a new lease of life, Peter had decided to take a vacation of a lifetime. But where to go? A tropical island? A safari in Africa? A trip to Paris? No, Peter chose a cruise . . . a cruise to Antarctica!
He's just returned, without suffering any medical problems despite enduring freezing conditions and 40 foot waves, and sent us this email:
From: Peter Irwin
Well we have returned from the frozen continent . . . Praise the Lord . . . I have come to the conclusion that God put the violent Southern Ocean there to stop us humans from being silly enough to go there????
No , it was a sight to see, but 7 days down in 40ft seas and 7 days back was not. Lots of sea sickness and as it was only a small ship [100 passengers] it was very roughI have called it expensive torture.
However I stood up to the ordeal fairly well and had no medical problems except for the sea sickness , good to be back in Aussie. Regards
Usually this blog a mix of news of developments in the adult stem cell field news from Theravitae interspersed with feedback from our patients.
Regular readers will have noticed that recently, it's been centrered more on patient feedback, simply because our patients are contacting us with news that deserves to be passed on to anyone considering VesCell therapy.
VesCell therapy is still an experimental treatment and many doctors are understandably skeptical when it comes to any new treatments especially those involving new technologies. A patient saying he feels better isn't good enough. Doctors want to see results which are measurable by accepted, medical tests.
With this in mind, it was good to recieve this account of a patient's visit to his cardiologist recently:
We are pleased with Dale’s results, the cardiologist insisted on running a Nuclear test on him yesterday as his final.
Now we all know Dr X. is not an enthusiast of cell therapy. But when the tests were all done yesterday he told Dale “You are definitely much better than you were.”
One again we are in your debt forever and Thank you from the bottom of our hearts to you and TheraVitae.
In late 2005, legendary Hawaiian crooner Don Ho was treated by TheraVitae, in Bangkok,using VesCell therapy. The story made headlines throughout the USA.
However, whilst we were treating Don Ho, another American patient, who's story of recovery is perhaps more remarkable, was also receiving treatment.
But George Efaw isn't a celebrity, he's a retired cropduster from Spooner, Wisconsin. George's hometown newspaper recently an article highlighting his amazing recovery. In it George descibes how, although he new he had problems with his heart, he ignored the warning signs.
"By the time I decided I needed to do something, I figured I was in some pretty deep trouble." George even admits that he was in more than "pretty deep trouble", as his first thoughts upon arrival in Thailand illustrate "When I got there I knew I wasn’t coming home. I knew I was going to die in Thailand.”
In fact, upon being examined by Cardiologists in Bangkok, the doctors found that George needed an emergency heart bypass such was the severity of his condition.
George therefore became the first person to receive a heart bypass and VesCell stem cell therapy simultaneously. One final quote from George echoes the sentiments of many other patients whose stories of recovery have been included in this blog . . .
"If you’ve got grit, the will to live and want to get treated, it’s there for you. It is definitely a marvelous thing.”
A couple of news stories caught my eye over the weekend both of which highlight the current chasm between existing adult stem cell therapiess and ongoing research in embryonic stem cell therapies.
Firstly, a story in the Charlotte Sun Herald (USA) newspaper highlighted a fact that anyone interested in receiving stem cell therapy should bear in mind. According to the American National Institute of Health, adult stem cells are now being used to treat a total of 74 diseases. Whilst, despite the publicity, embryonic stem cells have yet to be used to treat any diseases in humans.
As companies such as Theravitae continue to make advances in the treatment of patients using adult stem cells, embyonic stem cell researchers are now left pondering the ongoing effects of the now discredited reseach undertaken by Prof. Hwang Woo-suk and his team. ABC News reported that although the promise of treatment using embryonic stem cells remains undimmed, basic research has been delayed by around 6 months as scientists re-check data:
"It does not dim the promise. It's just that we still have to do some basic things we thought we had done," said Sean Morrison, of the Howard Hughes Medical Institute and University of Michigan.
However, according to Dr. Leonard Zon, of the Harvard Medical School and Children's Hospital Boston, the discovery of embryonic stem-cell based therapies could be delayed by "as much as three years".
One has to wonder how many new adult stem cell therapies will already be in widespread use by the time the first patients are treated using therapies derived from embryonic stem cells.
"You are my heroes" that was the quote that leapt out from Doug's email to us today.
Patient's are informed that they should not expect immediate measurable results from VesCell therapy. Usually, they intrinsically know that they feel better and are more active within weeks of undergoing the procedure. However, results that are measurable scientifically often aren't seen until 3 months later.
But there are exceptions . . . as you'll see from this email - not only does Doug feel great, his cardiologists are "Bouncing off the walls"!! (I'd have loved to have seen the doctor's reaction when they saw the EF results.)
Sent: Monday, February 20, 2006 7:05 AM From: Doug R.
Everyone at Theravitae,
Just had my tests done today, echo and nuclear and my ejection fraction percentage was a whopping 41 %, up from 12 % when I was in Bangkok. That is less than three weeks and I feel great, you all are my heroes!!!!!!!!!
You should have seen Dr. C.'s and Dr. P.'s reaction, they were bouncing off the walls. Expect a call from Dr. P. about his hospital.
I will be sending some pictures and am really excited what could happen to others in my condition.
A bright note to end the week on. An email from a patient who undertook VesCell therapy in late 2005. Upon return to their home country our patients will undergo follow-up tests with their own cardiologists. Jim, from the USA, emailed us as soon as he returned from his check-up to let us know the startling results:
Dr. P,
I just visited with my heart doctor and he is very impressed with the results. I was able to do a stress test for 9 minutes and could have kept going. He said that my ejection fraction has climbed to 29% and that is only 2 months after my operation! He is very excited and looks forward to more tests in 3 months hopefully seeing progress.
It was with deep sadness that we learnt yesterday of the passing of a patient of ours, Billy Bob Williams, who received VesCell therapy in June 2005. Our condolences and thoughts go out to his widow, Marie, and family.
Billy Bob, of Brisco, Texas, had a history of heart problems, having had his first bypass surgery in 1977.Over the years his health deteriorated and by early 2005 his doctors informed him that they had done all they could.Not one to simply give up on life, Billy Bob opted for VesCell therapy, not as a ‘miracle cure’, but in an effort to improve the quality of his remaining time with his family and friends.
From being unable to walk for more than a couple of minutes without losing his breath, Billy Bob found he could soon walk for three blocks with relative ease.Not a long distance, but for someone for whom doctors had all but given up hope, this was a great achievement of a proud man.A man who simply refused to give up on the dream of once again having an active life.
RIP Billy Bob.Your optimism, positivity and sense of humour will be fondly remembered by all who met you at TheraVitae and ChaoPhyaHospital, Bangkok.
(An article on Billy Bob's treatment in Bangkok can be found here on the VesCell.com website.)
Today's article appeared in a local newspaper from the English city of Birmingham. It is a story of a patient undergoing successful stem cell treatment to relieve his symptoms of Multiple Sclerosis.
Due to the lack of availability of adult stem cell treatments in the UK, the patient had to travel to the Netherlands for his treatment. The startling claim is that within a few hours of the injections of stem cells, the patient, Mr Pear, was walking unaided. It's no wonder that Mrs Pear is now urging the British government to begin clinical trials of therapies such as this in the UK.
I'll leave it to the physicans to debate as to how much of the immediate impact of Mr. Pear's treatment was psychological and how much a direct result of the stem cell therapy. The simple fact is that prior to treatment Mr Pear was wheelchair bound or relied on crutches, post-treatment he is walking unaided.
Stem cell treatment helped me to walk
A multiple sclerosis sufferer who received pioneering stem cell treatment in Holland told yesterday how he can now walk unaided.
Malcolm Pear, a 51-year-old former chartered accountant who lives in Bromsgrove, Worcestershire, decided to opt for the treatment to try to relieve his symptoms from the illness.
The treatment, which cost £14,000, is not available in this country and uses stem cells from otherwise discarded umbilical cords which are injected into the spine.
Within hours Mr Pear, who has suffered from MS for ten years, said he was able to move unaided, despite having once needing elbow crutches to walk.
"I feel fine now. It all seemed so straightforward before the event and when I got there it was just a few injections and an intravenous drip, which put 1.5 million stem cells out into my body without any pain at all.
"I can walk around relatively well, whereas before I was in a wheelchair and on crutches, so from that point of view it has been a very dramatic improvement.
"Everyone keeps telling me how well I look and you get quite a buzz from that, so I am excited about how things are going."
Mr Pear criticised the lack of stem cell treatment in the UK.
"The treatment is not just for MS sufferers," he said. "There are about 80,000 sufferers in this country but there are so many other diseases.
"It is horrible that nothing can be done for people because there is not enough money."
Mr Pear's wife Lesley said she was thrilled by the treatment, which she said had returned the man she had married to her.
Since their arrival back in the country, Mrs Pear has answered a number of phone calls from well wishers and people wanting to know more about the treatment.
She said: "It's just been extraordinary. Malcolm got up out of his wheelchair, sat up bolt upright and walked around. He is now walking around the park with the dog.
"His memory is wonderful, he is taking responsibility for his own actions and going to the doctor.
"I am really thrilled, over the moon. Apart from all of these phone calls from all over the world, I feel quite redundant. I am not having to be as concerned that he is going to be walking and falling over.
"The change in him has been so immediate. He has had a couple of days where he has not been feeling quite as good but he is doing a lot more than he was.
"I have just seen him carrying his own drink into a room, something he would never have been able to do before the stem cell treatment.
"He actually remembered something the other day which I had forgotten."
Mrs Pear said she felt the NHS should at least test the treatment before saying it would give other patients false hope.
"I still strongly believe that they should at least be trialing it in this country. I have spoken to upwards of 80 people in the last three weeks who said they would be only too happy to put themselves up for trial."
Slowly but surely remarkable stories of recovery following adult stem cell treatments are making their way into mainstream newspapers.We try to bring you some of those success stories in this blog.
The article reprinted below is from the Associated Press news service, and was published in several US newspapers yesterday.In it Dr. Mark Zucker, director of heart failure and transplantation at NewarkBethIsraelMedicalCenter in New Jersey is quoted as saying:
“I believe Theravitae is on the right track. I think if the company has identified an efficient way to procure cells and expand them, the company's impact will be revolutionary.”
Israeli-Thai company uses adult stem cells in effort to heal failing hearts
By Laurie Copans ASSOCIATED PRESS 9:26 a.m.February 13, 2006
JERUSALEM – After 61 years of pumping blood, Marie Carty's heart was failing her.
Months earlier she had given up her two-mile walk on the boardwalk of her New Jersey hometown along the Atlantic Ocean. She could barely make it from the parking lot to the view of the water.
Although Carty knew she needed a new heart, she was afraid hers wouldn't last during the long wait for a transplant.
Desperate for an alternative, Carty found the Israeli-Thai company Theravitae, which has begun performing an experimental procedure that multiplies stem cells taken from a patient's own blood and injects them into the ailing heart in hopes of strengthening it.
The procedure performed by Theravitae and a handful of other companies could offer new hope to hundreds of thousands of heart patients around the world.
The U.S. Food and Drug Administration has not yet approved the procedure for use in the United States, and though doctors hope it can be a substitute for heart transplants, the permanence of the repairs has yet to be ascertained.
“It's too early to know the long-term effects of these types of procedures,” said Dr. Vincent Pompili, director of interventional cardiology at CaseWestern ReserveUniversity in Ohio.
Several teams of doctors around the world – including at least three in the United States – say they are seeing promising results in similar trials using stem cells extracted from bone marrow.
Proponents of Theravitae's newer procedure say it is simpler and less painful to get stem cells from blood than extracting the cells from bone marrow.
The procedure involves no risk of rejection since the cells are the patient's own. It also does not use embryonic stem cells, an idea that has raised moral objections since they require the destruction of human embryos.
Many scientists believe stem cells could herald a new era of regenerative medicine, leading to cures for conditions from diabetes to Parkinson's disease.
After a two-week trip last fall to Thailand for the operation, Carty is once again walking two miles on the boardwalk in Little Silver, N.J. – and her strengthened heart led doctors to remove her from the transplant list.
“The change is like night and day,” said Carty, who works in property management. “I feel myself again, more energy, more stamina.”
Carty is one of 70 people who have undergone Theravitae's procedure, said Valentin Fulga, chief executive of the company. All have shown improvement, he said.
The list also includes Hawaiian crooner Don Ho, who underwent the operation in early December in Thailand.
“I'm feeling much better and I'm so happy I came up here to do it,” the 75-year-old entertainer said in a statement after the procedure.
Fulga said patients who get the procedure are generally heart transplant candidates or people who have undergone bypass surgery without positive results.
“We believe that these cells have the capacity of turning into blood vessels,” Fulga said. “The treatment seems to be not only very safe, with no side effects, but also effective because they improve.”
Fulga agrees, however, that with the procedure in trials for less than two years, there is still a lot to learn. For instance, he said, it's possible that over time the cells that repair the heart could lose their effectiveness.
Fulga said it also is not known exactly how the cells inserted into the heart improve the patient's condition. But it is believed they help reconstruct blood capillaries and vessels and the heart muscle itself, capitalizing on the body's natural healing processes, he said.
The treatment involves withdrawing blood from a patient and placing it in a centrifuge to separate out – by weight and size – a group of cells needed for the procedure. This batch of cells, called VesCell by the company, is composed of stem cells and other cells beneficial to the process.
Fulga and Thai entrepreneur Robert Clark founded Theravitae in 2003. Patients travel to Thailand for the extraction of the blood and wait less than a week while it is sent to Israel. There the stem cells are harvested and expanded and then shipped back to the Thai hospital where the operation to insert them is performed.
The total cost is about $35,000, including airfare and lodging, Fulga said.
Fulga said he expects to meet with FDA officials within six months and hopes to get approval to begin conducting trials in the United States.
Dr. Mark Zucker, director of heart failure and transplantation at NewarkBethIsraelMedicalCenter in New Jersey, said therapy using adult stem cells is the way of the future. His center is considering working with Theravitae.
Zucker said that if doctors at Theravitae have discovered how to make stem cells heal heart tissue, this could be a real solution for tens of thousands of Americans, since only 2,300 hearts become available for transplant in the United States each year.
“I believe Theravitae is on the right track,” Zucker said. “I think if the company has identified an efficient way to procure cells and expand them, the company's impact will be revolutionary.”
The company presented its findings at a conference of the American Heart Association in Dallas in November. It has been chosen along with 35 other companies as a technology pioneer for 2006 by the World Economic Forum.
Pompili, of Case Western Reserve University, said he was working through a company called Arteriocyte on a similar procedure harvesting stem cells from bone marrow. He said his company and two other teams of doctors in the United States were conducting FDA trials using stem cell therapy to heal heart tissue.
Every week stories appear in the American press relating to grants being given to fund stem cell research, huge sums of money are mentioned, frequently in the tens of millions of dollars.But what most articles fail to mention is how decisions are made as to whom grants and funding for research are given.
However, a recent article in the Washington Post gives us an insight into how one state, Maryland, proposes to grant up to $20 million to stem cell researchers:
The board of the state Technology Development Corporation, ‘Tedco’, will consider grants for research using embryonic stem cells, as well as adult cells.The main aim is to fund research that has the best chance of success.
A seven-member advisory panel of academicians and representatives from biotech and venture capital companies will set policy and make final decisions about the funding whilst a second panel of experts in stem cell biology, related research and entrepreneurial businesses would review proposals and make recommendations. (That board would be modeled on the scientific peer review panels of the National Institutes of Health and the National Science Foundation.)
Grants ranging from $500,000 to $1.5 million, for up to three years, would be awarded on the recommendation of the peer review panel.
Taxpayers will be relieved to know that members of the Maryland General Assembly have confirmed that the state won’t simply provide $20 million without some strings being attached.Democratic Delegate Frank S. Turner is quoted as saying “It's unrealistic for us not to do anything and just say, 'Here it is. Go spend it'.”
The main aim of all companies that are engaged in stem cell heart disease treatments is to provide a better quality of life for patients for whom, until recently, there has been little hope of recovery.TheraVitae’s goal is to give these patients a new lease of life and the chance to once again enjoy activities which they never thought possible.
Quantifiable results of treatment can be measured scientifically by patients’ doctors. But it’s emails, such as the one we recently received from Kathy, the wife of a patient who received VesCell treatment, that show the real, immeasurable effect that stem cell therapy can have on a close knit family. An extract from Kathy’s email is below:
++++
From: Kathy L. Sent: Wednesday, February 08, 20068:09 AM To: Suzanne
“ . . . Enjoying grandchildren is the reason we appreciate the added time Theravitae has given us. They are Emma, 4, Grace, 4, Amanda, 2, Macy and Jake who are 18-month-old twins. We also enjoy the time with and the communication from our daughters, Gretchen and Julie and our sons-in-law, Dave and Jeff. We are quick to count our blessings.
We would go again to Thailand. We enjoyed our stay there and appreciate the medical procedures and we enjoyed being treated so well by everyone there, especially the nurses at ChaoPhyaHospital.”
It’s always good to hear of new developments in the field of autologous stem cell treatment. But, claims in the report below of ‘radical heart surgery’ and a ‘world first’ from an Australian company treating patients with coronary heart disease may draw some skepticism from anyone who’s been keeping an eye on developments in this field, as treatment using stem cells derived from bone marrow is a practice used by many companies.
However, VesCell therapy is unique in that it uses stem cells derived from a donation of the patients own blood, rather than a painful bone marrow extraction.
Stem cell heart jab
Kate Jones 07 Feb 2006
TWO patients have had radical heart surgery using adult stem cells in what scientists claim is a world first.
Doctors implanted 100 million of the patients' own stem cells into damaged heart muscle.
The cells were extracted from bone marrow using a technology pioneered by the Melbourne-based biotech company Mesoblast.
Scientists hope it will repair and regenerate damaged tissue in patients with severe coronary artery disease.
The operation was performed under local anaesthetic on the two male patients last week as part of a clinical trial. . . .
Last week, the 'Mumbai Mirror' carried a lead article on the upcoming visit of Dr Amit Patel to Mumbai, India. As grateful as we are that both Theravitae and our proprietary treatment, VesCell, were highlighted in the article we would like to clarify three important points:
1) Treatment using VesCell does not require the painful extraction of bone marrow in order to obtain stem cells. A simple, painless donation of 250cc of the patient's blood is all that is required.
2) Treatment costs are almost 50% lower than the figure of $60,000 mentioned in the article.
3) Over 80 patients have now successfully been treated in Bangkok, Thailand using VesCell.
Take heart, pioneer of stem cell therapy will be here
Indian-born doc will discuss his unique treatment, wherein stem cells drawn from a patient’s body are used to strengthen his or her heart muscle
Joeanna Rebello
Dr Amit Patel, one of the pioneers of stem cell therapy for heart disease, a revolutionary treatment currently being researched in the US, is coming to Mumbai in February to discuss the unique treatment and help Indian patients. Patel, 33, a doctor of Indian origin is director of the Cardiac Stem Cell Therapies at The McGowan Institute for Regenerative Medicine, University of Pittsburgh Medical Center. He will be addressing a conference hosted by the Reliance Life Sciences Centre (Navi Mumbai) on February 27 and 28.
Dr Patel and his team are developing a procedure whereby adult stem cells from a patient's bone marrow or blood are injected directly into the damaged tissues of the heart.
“I will highlight my method of treatment with references to how my patients are faring. I will also address ways of helping patients in India. If people here are open to the method, we can begin treating Indians within the next six to twelve months,” Dr Patel said. His visit could also result in a possible collaboration between the Pittsburgh Medical Center and the Life Science Centre, although the doctor maintained that he was only coming down in his capacity as a speaker. Incidentally, the Center is the first in America to receive approval from the US FDA to conduct clinical trials of adult stem cells injected directly into the heart during surgery.
How stem cells repair hearts
Stem cells are undifferentiated cells, which retain the ability to differentiate into other cell types. This allows them to act as a repair system for the body, replenishing other cells. Adult stem cells are found throughout the body — in the brain, bones, muscle, skin and blood. When a person suffers from heart failure, it means his or her heart cannot pump blood efficiently. In the stem cell process researched by Dr Patel and his team, stem cells are extracted from the patient’s hip bone and injected into the heart at 25 to 30 sites, where the heart muscle is damaged. The cells help build new arteries, thus helping the heart to pump more blood.
Dr Patel uses a technology called VesCell (from an American-Israeli company called TheraVitae). Although the procedure is still being evaluated, it has been successfully applied in 35 operations. However, the procedure can be performed only in Bangkok and costs around $60,000 (Rs 26,40,600). And Dr Patel warns that the procedure is not effective for everyone. “I have been selective about the patients I have treated — these are ones with severe heart disease, but no other medical problem like cancer or diabetes, or kidney or liver failure. A patient I treated four years ago has recovered fully (I used his bone marrow stem cells), and another that I treated with blood stem cells seven months ago has also shown progress. After clinical observation, these patients appear to be safe — no abnormal growth or side effects.”
Universal acclaim
Several leading publications, including Time Magazine and the Boston Globe, and news channels like ABC News, have recognised Dr Patel’s path-breaking work, and acclaimed his method as significant in stem cell application to the human condition. He has been active in this area of research since 1994, when he graduated from Youngstown State University.
A VesCell patient's treatment success was cited by Dr. Amit Patel yesterday at a major stem cell therapy conference in New York City.
..."According to lead researcher Dr. Amit Patel, of the University of Pittsburgh, three months after the procedure, LV ejection fraction rose from a patient average of 27 percent to 45 percent -- a significant increase. This benefit has been maintained over the longer term, Patel added, with most patients able to cut back on at least some of their heart medicines.
However, Rose cautioned that this study -- conducted at a heart center in Thailand but involving U.S. patients -- was "very small, and had no control group...."
Stem Cells Offer Hope Against Heart Failure
By E.J. Mundell HealthDay Reporter Thu Feb 2, 7:03 PM ET
THURSDAY, Feb. 2 (HealthDay News) -- In theory, it seemed simple: Doctors would transplant stem cells into diseased hearts to create new, healthy tissue that could reverse heart failure. But experts gathered in New York City recently for a major conference on stem-cell therapy agreed that such a "cure" is proving elusive.
While small studies show modest benefit from these cell-transplant therapies, major improvements in heart function haven't yet materialized.
"Nothing that I've seen at this meeting, with regard to cell therapy, show that it prolongs the life of heart-failure patients," said Dr. Eric Rose, chairman of the department of surgery and associate dean of translational research at Columbia University College of Physicians and Surgeons, in New York City. He also co-chaired a special symposium on the therapy during the conference.
Despite the lack of major breakthroughs, Rose stressed the field is still in its infancy -- barely five years old.
And he said the fact that many heart-failure patients in clinical trials have benefited from stem-cell treatments shows the strategy still has great promise.
"For some patients, cell therapy may improve their quality of life," he said. "Those are the kinds of early signals that you look for in a field that's this young."
Heart failure occurs when the heart cannot pump blood fast enough or efficiently enough to meet the body's needs. In many cases, heart failure involves some kind of residual damage to heart muscle, such as that occurring after a heart attack. Restoring function to dysfunctional cardiac tissue is the goal of stem cell research.
Leading researchers from centers around the world presented their findings at the conference symposium. Some used stem cells sourced from the patient's bone marrow, while others turned to cells cultured from cell lines in a laboratory. Others used cells found in the peripheral blood supply, a much less invasive method.
The researchers also presented a variety of cell-delivery methods, the most common being injecting the cells directly into dysfunctional areas of the heart, either through invasive surgery or less invasive catheterization procedures.
The real problem usually arises after the cells reach the targeted tissue, however. Experts estimate that because this damaged tissue area is often inflamed or otherwise hostile to stem cells, up to 95 percent of the cells will perish before they can do a patient any good. Much of the work presented at the meeting examined the role of cytokines, kinases and other cellular compounds in this process.
The bottom line? "We just don't know what the best, most plausible recipe is" for maximizing stem-cell therapy's potential, said Rose, who is also surgeon-in-chief at NewYork-Presbyterian/Columbia Hospital, in New York City.
Still, positive results from small clinical trials are keeping hope alive.
Dr. Gustav Steinhoff, of the University of Rostock, Germany, presented six-month results from his phase 2 trial comparing outcomes of 20 heart-failure patients who received bone marrow stem cells, delivered via traditional balloon angioplasty to the heart.
Compared to 20 patients who received traditional angioplasty without stem cells, the stem-cell recipients gained a modest improvement in left ventricular (LV) ejection fraction -- the amount of blood forced out of the heart's left ventricle. Ejection fraction rose from an average of 37 percent before the procedure to 47 percent six months later, Steinhoff said.
An even bigger improvement was seen in a second study of 10 heart-failure patients treated with peripheral blood stem cells, delivered laparoscopically via a catheter to the heart. All of the patients had tough-to-treat non-ischemic heart failure -- a progressive form of the disease that's unrelated to a previous heart attack.
According to lead researcher Dr. Amit Patel, of the University of Pittsburgh, three months after the procedure, LV ejection fraction rose from a patient average of 27 percent to 45 percent -- a significant increase.
This benefit has been maintained over the longer term, Patel added, with most patients able to cut back on at least some of their heart medicines.
However, Rose cautioned that this study -- conducted at a heart center in Thailand but involving U.S. patients -- was "very small, and had no control group."
He also noted that many of the patients were former heavy smokers who had given up the habit prior to undergoing treatment. "Everyone knows that quitting smoking is a formidable treatment for heart failure in itself," Rose said. "This study needs a lot more replication."
A major clinical trial will come, he said, as soon as experts arrive at a consensus on the right stem-cell therapy "recipe." And he noted that there's real momentum toward that goal. "At the American Heart Association's annual meeting five years ago, there were just five presentations on cell therapies," he pointed out. "This year, 25 percent of all papers presented were on stem cells or regenerative therapies."
So how long till the promise of stem-cell therapy becomes a reality? Rose said he remains cautiously optimistic.
"It's likely to be less than 10 years before there will be some routine form of this being used at the bedside, at least for some narrow [therapeutic] indication," he said. "And I think there are going to be a lot of cell therapies used in 25 years."
In late 2005, legendary Hawaiian crooner Don Ho was treated by TheraVitae, in Bangkok,using VesCell therapy. The story made headlines throughout the USA.
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