Flesh and blood

An umbilical cord blood storage facility, promising stem cell therapy for serious ailments, is coming to town, reports Subhro Saha

http://www.telegraphindia.com/1070708/asp/calcutta/story_8026365.asp

A lab technician holds a sample of processed cord blood ready for storage at CordLife’s cord blood bank in Singapore. (Below) Cord blood samples being lowered into the cryogenic tank. Pictures by Subhro Saha

Little Treta (not her real name) has been undergoing blood transfusion for beta thalassaemia since she was two-and-a-half months old. Not yet two, she would have had to continue the painful process for the rest of her life. But now she has a ray of hope. Treta’s parents, young professionals, could opt to store the cord blood (blood from the umbilical cord) of their second-born to try and cure her blood disorder. Her mother, a few weeks pregnant, is going to AIIMS in New Delhi for a test to rule out thalassaemia in the second child. If all goes well, the cord blood of the second child can give the sibling a new lease of life.

Cord blood, collected after the umbilical cord is severed from the child, is a rich source of stem cells. These cells are found at different stages of foetal development and are also present in several types of adult tissues. Stem cells are the master cells of our body, which have the ability to grow into other tissues and have the potential to cure about 75 serious ailments, from blood disorders to heart and eye ailments to Type 1 diabetes.

If Treta’s parents decide on storing their second child’s cord blood after a proper HLA (human leukocyte antigen, through which the immune system recognises “self” and rejects “non-self”) match, the stem cells could be transplanted into Treta’s blood to cure her thalassaemia. That is stem cell therapy, which is being billed the future of medicine. However, to store her sibling’s cord blood in a bank now, Treta’s parents would have to travel to Gurgaon, Mumbai or Chennai, where banking facilities exist. Or store it with a Chennai-based company that collects the cord blood from the city. But things look set to change for Calcutta by the year-end — with a cord blood bank being set up in the city for the first time.

The bank is being set up by CordLife Sciences India Pvt Ltd, a wholly-owned subsidiary of CordLife, a company focused on tissue and cord blood banking based in Singapore and Australia. The facility, coming up off Diamond Harbour Road about 7 km from the Indian Institute of Management campus, is nearing completion. It will be able to offer cryogenic storage facilities for 40,000 samples to begin with. “However, we can go up to four to five times that capacity once demand picks up,” said Meghnath Roy Chowdhury, managing director, CordLife Sciences India, representing the local partners, Strassenburg Pharmaceuticals Ltd.

It means that parents from this part of the world can store the cord blood stem cells of their children, at a cost, but quite easily. Before delivery, the parents have to pay an initial deposit of Rs 35,000- Rs 40,000. The annual rental will be 10 per cent of the deposit and there will be the option of paying 18 years’ rental up-front to “avail discounts”. If that sounds like just another transaction, it holds the promise of a lot of health, for you, for your family. Actress Raveena Tandon and MP Priya Dutt have banked their newborns’ cord blood. Dutt has compared cord blood to “life insurance”.

There are mainly three kinds of stem cell transplantation — of adult stem cells, embryonic stem cells and cord blood cells. But stem cell research is in an embryonic stage in the country and there are debates on the efficacy of various kinds of stem cells. (As there is an absence of uniform guidelines; cases of malpractice have been reported from different parts of the world.) Adult stem cells, mainly from the bone marrow of the patient, are mostly in use in India. Harvesting stem cells from the embryo is considered unethical in many quarters. Advocates of cord blood stem cell transplants believe that they are less prone to rejection than bone marrow or peripheral blood stem cells (another source of adult stem cells), perhaps because the cells do not develop the features that can be recognised and attacked by the recipient’s immune system.

Stem cell therapy is also a huge market, estimated to go up to $20 billion by 2010, according to a Frost & Sullivan study. The Indian market is estimated to touch $540 million by 2010. That is one reason why so many private players are into cord blood storage.

There are several cord blood storage facilities all over the country but the city’s advantages are clear to the Singapore company, which runs Southeast Asia's first AABB-accredited (the industry gold standard) cord blood bank in the island nation. “We needed a city, which is similar to us politically, in terms of the ability to allow us and our partners get things done. Besides Calcutta is geographically close to Singapore,” said Simon Hoo, India coordinator from CordLife. He added that this is “one of the first projects to materialise as part of the Singapore-Bengal initiative” kicked off by the chief minister’s Southeast Asia trip.

V.R. Chandramouli, CEO of LifeCell India Pvt Ltd, the cord-blood banking company headquartered in Chennai that collects samples from the city, agreed there’s a crying need to build capacity and is bullish on Calcutta as well. “Collection from Calcutta has been growing at 30-35 per cent month-on-month,” he said.

“Our presence in Calcutta will be a good start towards establishing a strong network. We think the Indian market is huge, specially with the fast-growing middle class, rising disposable income in major cities and a genuine increase in concern for the welfare of the children,” Steven Fang, CEO and executive director, CordLife, told Metro in Singapore.

The project has a lot of support. Director of drug control Sajal Roychowdhury feels that the bank “will open up a new vista” in treatment of critical diseases. “We will extend all necessary support,” he says. The medical community is on its side too. “This is the future of medicine. Stem cells form part of our blood and immune system and they rejuvenate other cells in our body’s system and thus can be a potent cure for cancer,” says city-based gynaecologist Ranjit Chakraborti. He feels the cord blood bank in “our own backyard” will inspire more confidence among clinicians. He hopes the company will also address the needs of the economically weaker sections.

Stem cell faqs

Why is every one so caught up with stem cell therapy?
Stem cells transform into the range of specialised cells that define us. Many of the most severe disorders occur because of problems during this process. Scientists believe that the disorders can be cured with the re-application of the stem cells, from the stored cord or extracted from bone marrow or from the small number of such cells present in the bloodstream.

What are the various kinds of stem cell therapy?
In Blood, 2005, one of the latest scientific papers available on the topic, the chance of use of cord blood samples for cell therapy was reported as one in 400. Past medical opinion had put the rate at around one in 20,000. One reason for the growing number of cord blood transplants is the greater ease of matching donors and recipients compared to bone marrow. “Cord blood banking can help us build capacity of haematopoietic stem cells, which are in huge demand for treating blood-related disorders,” said paediatric haematologist Arpita Bhattacharyya.

For bone marrow, a perfect 6 out of 6 HLA match is required, to prevent tissue rejection. In the case of cord blood, in some cases for some diseases, as few as two out of six match will suffice. But as cord blood can only be collected immediately after the birth, it’s scarce. There’s research to establish cord blood being applied in case of heart failure and diabetes, the two most potent killers in India.

What diseases can be cured with the therapy?
Cord blood stem cells are commonly used to treat different types of blood cancers, other blood disorders and various inherited disorders. Study has shown adult stem cells can also be used to treat autoimmune diseases such as lupus, multiple sclerosis, Crohn’s disease and rheumatoid arthritis. Clinical studies suggest these can even help avert corneal degeneration and restore vision in cases of blindness, can help restore proper cardiac function to heart attack sufferers and improve movement in patients with spinal cord injury.

What are the facilities of storing cord blood in Calcutta now?
LifeCell India collects samples from six medical facilities, including the Bhagirathi Neotia Woman and Child Care Centre, Belle Vue Clinic, Woodlands and AMRI Dhakuria.