Danger, Stem Cell Tourists: Patient in Thailand Dies From Treatment

By Eliza Strickland | June 18, 2010 12:47 pm

kidneysA woman with kidney disease has died after receiving an experimental stem cell treatment at a private clinic in Thailand, and a postmortem examination of her kidneys revealed that the treatment was almost certainly responsible for her death. Last week we reported that Costa Rica’s health ministry had closed a stem cell clinic that catered to foreigners, which sparked lively debates around the Internet about whether patients should be able to willingly take on risks associated with experimental treatments. This new case offers a sobering reminder of what can happen when patients travel abroad looking for a miracle cure.

The woman suffered from lupus nephritis, a disease in which the immune system attacks the kidneys. When medications no longer controlled her disease, she went to a still-unnamed clinic in Bangkok where doctors said they could treat her disease using stem cells drawn from her own bone marrow. There was some medical rationale for this:

Bona-fide trials in European clinics about six years ago showed that some people with similar kidney disease benefited if stem cells from their own bone marrow were injected into their blood. The body’s immune system was first deliberately destroyed with powerful immunosuppressive drugs, then the reinjected stem cells helped to stop the attacks on the kidney by rebuilding and rebalancing the immune system. [New Scientist]

However, the Thai clinic didn’t inject the stem cells into the patient’s blood stream, instead they injected them directly into her kidneys. That means the stem cells did nothing to stop the immune system’s attack on the organs–and they instead produced never-before-seen side effects.

According to a paper about the case just published in the Journal of the American Society of Nephrology, the woman went into a decline soon after her treatment. Within three months she required dialysis, within a year one kidney had failed, and within two years she was dead. A team of Thai and Canadian researchers performed a postmortem analysis of the kidneys, and found no evidence at all that the treatment had benefited the woman–and they found strange lumps and lesions at the sites of injection. Further investigation revealed that the masses were tangled mixtures of blood vessels and bone marrow cells.

Dr Duangpen Thirabanjasak, from Chulalongkorn University, who led the research, said: “This type of lesion has never been described before in patients, and we believe that this is either formed directly by the stem cells that were injected or that the stem cells caused these masses to form.” [BBC]

Susan Quaggin, who wrote a commentary about the case for the same nephrology journal, says this tragic incident doesn’t cast a pall on reputable medical research on stem cell therapies, as animal trials and safety studies are built in to the system to protect patients.

But she says that the Thai results are yet another reminder that sick people should not gamble with their safety, and money, by turning to stem-cell tourism peddled by unscrupulous operators. “The sad part is that many people are desperate, and what makes it even worse is that it costs lots of money,” says Quaggin [New Scientist].

Related Content:
80beats: Stem Cell Tourists Denied: Costa Rica Stops Treatment at Top Clinic
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80beats: UK Aims to Create “Unlimited” Supply of Synthetic Blood from Stem Cells
80beats: FDA Approves the First Clinical Trials Using Embryonic Stem Cells
DISCOVER: Stem Cell Science Takes Off

Image: iStockphoto

CATEGORIZED UNDER: Health & Medicine
  • Jumblepudding

    legions=lesions? This sounds awful. Didn’t a black market treatment result in China result in a teratoma (a deformed mass of miscellaneous fetal parts) in another patient?

  • Ron

    If your disease has “progressed” to the point where accepted treatments are ineffective, then why not go for experimental treatments?

    Of course, the idea is to go for *treatments*, not scams, but that’s a different story…

  • Jorge

    Why not go for experimental treatments? Cause you might live longer without treatments that someone pulled from their nether regions.

  • Arc

    This report reads biased and with a compromised neutrality.
    The patient died two years after the treatment, and the Thai/Canadian team couldn’t assure that the patient in question actually died from those abnormal growths. Such growths certainly didn’t killed her instantly.

    May I remind the readership that the patient suffered from lupus nephritis AND she had already been treated with medications until the point of losing controlof the disease? She was already sick and she lived 2 more years under this experimental treatment.

    I am not taking sides, but if people in Europe and/or the United States take such concern for these patients, may I suggest doing something more constructive than to cause panic and missinformation?

    Gambling their lives? First of all, it is THEIR lives they are gambling… what’s it to you? They are DESSPERATE people whom their countries and their health regulations have turned their back on them. They would rather take a shot in the dark than to quietly die without a fight.

    Be empathic for once instead of, again, spreading FEAR and missinformation.

    -Arc

  • ron

    with the lupus she was good as dead already… better a fighting chance than a certainty.

    i would prefer that the more experimental treatments be possible in the states where should something go wrong; the patient has a better chance at survival. but our system wont allow for it because of things like insurance premiums both the ones patients pay and the malpractice insurance rates. the sad fact is doctors aren’t encouraged to innovate quite the opposite, because trying to help might lead to higher malpractice insurance rates if something/anything goes wrong, but making the patient comfortable and sending them home that’s just dandy.

    look at polio the original vaccines and research… how many got the disease from the attempt at preventing it? even after the numbers were known still people wanted their kids to get the vaccine, why because the risk of polio was such that they deemed it worth it. that wouldn’t happen now. now Salk would have lost his license or atleast not been able to be insured which would be the same thing.

  • Albert Bakker

    #2 – No actually it’s not a different story but a part of the same story. It’s a false dichotomy you implicitly put forward by suggesting there’s treatments and there’s scams. There is a whole range of possibilities in between, having to do with the amount of risk you are willing or wanting to take. (There does not exist a medical procedure worth the name without risk.) If not there is a sufficient understanding of the risks involved – and subsequently the way that is communicated back to the patient – then there might be a calculated risk taken to skip part of the testing stages of developing a treatment. And as shown in this story even the decisions taken based on the knowledge of how to actually technically/ clinically perform the procedures need not be flawless. Even so that does not imply necessarily total irresponsibility, let alone deliberate malpractice. Obviously the financial incentive here is unlikely to work in a mitigating way in the decision making processes and in pressure put on the medical staff, as understandably aren’t the patients.

  • qroberts

    #4 Lupus is not a death sentence.

    This woman had many options besides a risky, out of country stem cell treatment.

    In fact, if the bone marrow ablation and autologous stem cell transplant had been performed correctly, she had a good chance of reconstituting her immune system and living for many more years.

    The procedure she should have undergone is not without risks, but it is performed regularly and with great success in the united states for leukemia’s and other blood and immune disorders.

    Doctors are definitely encouraged to innovate, in fact, all of the major teaching hospitals are constantly involved in statistical and research projects to try and develop new therapies for recalcitrant diseases. However, doctors are required to innovate within the boundaries of current scientific opinion and under the oversight of the FDA.

    Why do you suppose most of these stem cell clinics are located in countries with lax medical regulation? The plain and simple answer is that no sophisticated nation would allow untested, unproven treatments like this to proceed. The risks, particularly with pluripotent stem cells are extreme. Rats treated for spinal cord injuries have regained movement only to develop progressive, lethal neuromas. The fact of the matter is, we have no idea what these stem cells are going to do when injected into a person. They could replace necrotic cardiac myocytes, or they could clog the kidneys with disordered marrow and vascular tissue, or they could do both.

    The vaccine argument is unrelated. Polio was a pervasive, terrifying disease that had the potential to disable anyone without immunity. The vaccine was pushed because of the terrible fear that had gripped a society where no children were safe.

    Stem cell therapy is applicable to a small segment of unfortunate patients with intractable disease. Of course it’s unfortunate that there are no attractive options for many of these people and we can all understand their frustration but science moves along at a methodical pace and cannot be rushed to meet the needs of a small portion of the population especially when the stakes are so high.

    Also, Salk’s vaccine was a killed virus which could not under any circumstances cause infection. Sabin’s vaccine was live attenuated virus. The rate of paralysis in vaccinated individuals was estimated to be between 1 in 750,000 to 1 in 2.5 million. Regardless, you are correct that the administration of these relatively untested vaccines was highly controversial and would not be allowed in this day and age and that is exactly the point.

    We the people needed an agency to protect us from improperly researched medical procedures and we got it in the FDA. To suggest now that the agency is somehow withholding potentially curative treatment from the population is ridiculous. There are many phase 1 and 2 trials investigating stem cell treatment currently in the pipeline and these careful investigations are the only way we can say for sure whether these kinds of therapies will ever be efficacious, or safe.

  • ray hartman

    qrobert:

    Yeah my sympathy … you are a death sentence to anyone gravely ill. Might as well shoot-‘em in the gut for all the good your don’t-ask-don’t-cure mindset can contribute.

    Science is a method … **not** an end-to-itself. So as desperate measures are needed bring on the juju-witch_doctors.

  • http://blogs.discovermagazine.com/80beats/ Eliza Strickland

    @ Jumblepudding: Sorry for the typo. Yes, I meant to write “lesions.” Fixed now.

  • Jessica

    Having read through all of these comments, I believe everyone is saying the same thing – better treatments and improvement in the lives of patients living with chronic disease or other illnesses…innovation is key..and we should all encourage governments to invest dollars into the best research..it is an incredibly exciting time for stem cell research, and there will be fantastic breakthroughs over the next few years..we need to support this..

    The sad reality is that the private clinics and the individuals who have created them, do not care about innovative treatments, but instead, are ‘in it’ to make a quick ‘buck’ ..no different than many other ‘medical offerings’ over the centuries

    The danger is that these private clinics will put a cog in the wheel of true innovation, starting panic and creating worry that will lead to additional barriers to research. True science and innovation is not built as a business..but comes from a passion and a desire to make a difference in the lives of patients.

  • Tom

    I applaud the research out there on stem cells as it provides a realistic alternative to the invasive treatments for most life threatening diseases.

    It seems lately there is a real attempt to cast doubt upon the efficacy of the research and potential life saving abilities of stem cell therapy by throwing in the fear factor to debunk said treatment.

    I suspect that when drug companies corner the market on stem cells, we will suddenly have access to the use of them and at a much higher cost.

  • Albert Bakker

    #11 – Stem cell research holds great promises, and I don’t see anyone here denying the possibilities, either. But that is no excuse to throw all caution overboard, turn a blind eye to the dangers of stem cell tourism in particular and be deliberately silent about cases where it does go (terribly) wrong, because otherwise you’d be “throwing in the fear factor” in an otherwise healthy discussion about miracle therapies and evil drug companies. As a famous comedian once said: “come on now.”

  • Drew Turu

    The Bible-thumping right wingers have a massive fear of fetal cells being used for such therapies, so looks to shut stem cell therapy at every possible turn. Ironically, they are the ones who usually have the biggest fear of dying; meeting their Maker.

  • http://www.biogenesisinstitute.com Dan Morgan

    Without a way to regulate these facilities then everything is a crap-shot. There needs to be a way to find the good stemcell facilities, like the BioGenesis Institute

  • FILTHpig

    Um… gross. Unfortunately, this sounds like a plot from a bad sci-fi movie. Poor lady. Although, I can’t wait till they get these treatments to work, then we’ll live forever! Or, at least, a little longer than we should.

  • Idlewilde

    Stem cell ‘tourists’….funny. I’m imagining fools in kahkis and leis right now.

  • rachanee

    I have a son just had an accident one month ago, he broke his neck, no.c5-c6, doctors said that he is completed unable to walk or move from neck down to legs, I am looking for Stem cell that can help him, however, my knowledge of the stem cell is limited, anyone from this pages kindly advise me, I have learned that they are a good Stem cell in China and that I would like to know if they are really successful.

  • Jason

    @ qrobert – The FDA as a determiner of what is ‘safe’ treatment? LMAO.

    ” …protect us from improperly researched medical procedures…” Hahah, I haven’t seen Naivety like that in some time. Perhaps you’d like to purchase a CDO or buy and hold your investments in an open ended fashion as well?

  • Richard James

    I have stage three Heart Disease and was told that I was not a canidate for heart transplant. I am seeking Stem Cell treatment to help me. I have read many article’s and testimonials true are not about being helped with the treatment most say it is safe. However, I think the doctors made a mistake in this ladies treatment. I have no other alternatives they say my condition gives me a max of 5 years. Give me the Stem Cell treatment I take the rish what else is there. My only Hope. I have tickets to Thailand and now their treatmeant has been stopped by the Thai government.
    Their prices were the only ones afforable to me. Mexico is 3 times more so I guess it is now hopeless. I tried the research approach at Texas Univerisity and the one in Florida they but rejected me because of my Hep C I contracted through the Military with a transfusion during Vietnam. I do not have liver disease it is still formant but lurking. I cannot get treatment for it either because of my heart disease catch 22 again. So for the patient’s at their end stages I vote to make it available to them as it has been proven to be effective. Or like the other guys says shoot them might as well as you have taken away their hope of life.

  • http://bestmountainbikeunder500.com/feed best 500

    Without a way to regulate these facilities then everything is a crap-shot. There needs to be a way to find the good stemcell facilities, like the BioGenesis Institute

  • http://None darion mograine

    Lol

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