Vietnam uses stem cell transplant to treat cerebral palsy

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Doctor Nguyen Thanh Liem (R) works on Vietnam’s first stem cell transplant on a cerebral palsy patient at Vinmec hospital in Hanoi. Photo courtesy of Lao Dong

A Hanoi hospital has used stem cell transplant for the first time to treat cerebral palsy and the 13-month-old patient is doing well, doctors say.
International hospital Vinmec performed two transplant sessions on Bui Duy Nghia, using his own bone marrow, on March 21 and 28, 2014.
He has gained consciousness after the procedure, but is still having problems eating and drinking. Muscle contractions continue but at lower frequency and severity, doctors said.
The hospital will examine him three months later, then six months and then 12 months to assess the success of the approach. He will receive a couple more transplants if needed, besides physical therapy, doctors said in a Phu Nu newspaper report.
The boy’s family, residents of nearby Thanh Hoa Province, said he suffered high fever, blood contamination plus seizures and diarrhea when he was ten months old for reasons they have never understood to date.
He has since suffered body contractions, difficulties in breathing and has not been able to sit or crawl. He also failed to show appropriate development signs like toddling or babbling.
He was admitted to the hospital March 10 with fever, bronchitis and uncontrolled muscle movement in legs and arms.
Dr Nguyen Thanh Liem, director of the hospital and a world renowned pediatrics surgeon who conducted the transplant, said the process is to derive stem cells from the bone marrow and inject them back into the marrow so as to develop new neurological cells that will replace damaged cells or reactivate them in case they are not dead yet.
He said older patients can use stem cells from their adipose tissues.
Liem said the transplant costs around VND120-150 million (US$5,700-7,114), five to six times lower than in other countries.
He told Phu Nu that international researches have suggested the successful chance of stem cell transplant in treating cerebral palsy at 60-70 percent. The approach has been found to be most effective in recovering one’s mobility, followed by language and cognitive skills.
The method aims to fix neurological tissue damage and thus treats the causes instead of the symptoms of the condition, the doctor said.
He said stem cell transplant is only recommended for cerebral palsy patients in average or severe conditions, not for those with mild conditions or those suffering from epilepsy as well.
He explained that the method stimulates neurological cells to fix themselves and thus can ignite one’s epilepsy sessions.
The treatment is less effective on patients who can maintain proper mobility. Its effects are clearer in younger patients, especially those below five years old as their language and cognitive skills can be seen improving significantly afterward, the doctor said.
He said his hospital is readying for performing the first stem cell transplant on an autistic patient, which has been done in India and China, with the latter announcing 70 percent success. The United States has also used stem cell transplant to treat autism but has not publicized the results.
Vietnam has been using stem cell transplant to treat blood cancer, marrow tumors and other marrow disorders, and even cosmetic procedures.
Back to basics
Prof Truong Dinh Kiet, former vice principal of Ho Chi Minh City Medicine University, said at a conference on March 31 that stem cell treatment will take medical treatment to a new level, but cautioned Vietnam is poorly prepared for mainstreaming it, a Tuoi Tre newspaper report said.
“Stem cells are present in any part, any organ of the body. They only account for 1 percent of the cells but they decide the survival of the other 99 percent.”
He said the main role of stem cell scientists is to facilitate them in fulfilling their special functions, including helping other cells survive.
In Vietnam, around 260 people in 32 facilities including nine universities and institutes, 20 hospitals and three private companies are currently researching stem cell applications. But few studies have been published in international journals.
Studies on plants and animal stem cells are also limited and studies on human embryo stem cells are almost untouched, Kiet said at the conference held by the Health Ministry, Vietnam Medicine Association and the World Health Organization.
He said Vietnamese scientists lack four basics in doing stem cell treatment studies: they have no orientation or strategic plans, no instructions or standards to follow, no connection or network, and no consistent database to rely on.
Referring to the database challenge, he said international information on stem cells increases by the hour and in vast diversity, and this includes contradictory data and analyses.
Without a clear mind in handling the information, Vietnamese scientists can end up adopting perspectives or taking decisions that are either too optimistic or too skeptical, he said.
Medical schools in the country also lack proper stem cell training for future doctors, he added.
Apart from technical knowledge, the absence of relevant laws and codes of ethics are stumbling blocks for medical practitioners and government managers, he said.

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