A R10 000-plus, 21-year insurance policy, with odds of 100 000 to one against a payout, may not seem a good bet — yet 3 000 South African parents have taken the gamble.
That’s the number of people who have chosen to store stem cells from their child’s umbilical cord in case he or she needs them for medical treatment over the next two decades.
Three companies, Lazaron, Cryoclinic and Netcells, now offer stem-cell storage in South Africa, and all three say that they are at least breaking even — despite the pool of people able to pay up to R14 500 per baby being small.
Stem cells are “primitive” cells which, depending on type, can develop into different kinds of body cells. They can be injected into the blood or an organ where they can grow to replace damaged tissue.
But private stem-cell storage banks are controversial, and are banned in some countries. Researchers, doctors and regulators have expressed concern about selling a service that has little chance of being used. The odds of needing stem cells are put at between one in 450 to one in 100 000.
Steven Purcell, medical director of Cryoclinic, the first stem-cell storage facility in South Africa, says that his company’s services should be regarded as a luxury, as stem-cell storage is very expensive and there is little chance the cells will be used.
Purcell said that if parents were concerned about the cost of the procedure, they should not have it done. But for those who can afford it, stem-cell storage offered an insurance policy for the child and, possibly, for siblings.
In the general population the odds of finding someone with matching stem cells is thought to be one in 100 000, while 25% of siblings have matching tissue types.
Other doctors, such as National Blood Transfusion Service consultant Robert Crookes, argue that the creation of a public stem-cell storage bank, which would make the cells available to whoever needs them most, would have several benefits, including being more equitable.
Parents would agree to donate the umbilical stem cells anonymously and free of charge, with the cells made available on the international registry. Genetic markers, rather than race or nationality, would determine who gets a transplant. A public bank would still charge for stem cells, but only to cover costs, as there would be no shareholders. However, the costs of typing, testing and storing samples would be considerable.
Among researchers looking at the development of a public stem-cell bank is Michael Pepper, medical director of the private cord-cell storage bank, Netcells. Pepper argues that any public bank should be complemented by private storage banks, to facilitate skills and technology transfer and allow people to buy the insurance of private stem-cell storage if they wish.
He said that if stem-cell therapy is needed, the cost of donor cells can be astronomical — and that using patients’ own cells reduces the need for anti-rejection drugs.
Cord stem cells, like those collected from bone marrow or peripheral blood of older children and adults, are conventionally used to treat cases of bone-marrow failure, such as that caused by chemotherapy for leukaemia.
Lazeron has stored several hundred batches of cord stem cells in its laboratory in the Cape in the year it has been offering the service. Lazeron’s cord-storage medical director, Braam Ackermann, said many clients were from families with a history of blood cancer.
Researchers are also looking at using stem cells for other conditions, including heart disease and diabetes. One argument for storing cord stem cells is the possibility that new uses could be found for them in the future. It is usually better to use one’s own stored cells than those of a donor.
If stem-cell technology takes off, as many believe it will, it will be a hugely profitable business.
Netcells, majority-owned by Netcare, couriers about 50 samples a month to storage in the United Kingdom. But the company plans to invest heavily in developing its own laboratory and storage facilities.
Potentially, patients would store their stem cells in Netcells facilities, undergo stem-cell treatment by Netcare medical workers and researchers, while using Netcare-linked hospital and laboratory facilities.
Similarly Lazeron has close ties with stem-cell research at the University of Stellenbosch.