Every once in awhile I survey the on-line stem cell clinic landscape and each time I do I come away a bit more puzzled than the last. Way back in 2005 when we began doing this work, there literally was no one else in the United States using stem cells for orthopedic injuries. Back then I envisioned a future rational physician explosion in stem cells, hopefully lead by strong professional societies who would enforce qualifications, certifications, and some sanity. I couldn’t have been more wrong.
The national round up as I saw it yesterday looks something like this:
1. We have folks in Florida teaching fat stem cell techniques to anyone who will pay them money. The course is taught by someone without an advanced degree and sponsored by a company that has several projects in front of FDA for cellular drugs. The company also performs live demos in the course and treats everything from macular degeneration to ALS to MS, treatments that are breaking the current laws around the production of illegal stem cell drugs. Yikes!
2. We have doctors in Houston and Arizona using “amniotic stem cell therapy” that contain no live stem cells or any other living stem cell for that matter. The folks in Houston are throwing in bone marrow, without a shred of scientific evidence that the amniotic material they also inject will help the bone marrow stem cells. This seems to be what I have called an “Insta-tute”. Here you can get all sorts of surgeries that have recently been shown to be ineffective without stem cells, but through the magic of stem cells these surgeries become effective?
3. We have guys in California using fat stem cells claiming to be performing IRB approved, patient self-funded, scientific studies and to the lay reader, you would be 100% convinced that they are involved in intense science. To anyone who knows a bit more, the studies are simply a marketing tactic. They could say that they’re just tracking treated patients in a registry, but somehow the guise of a scientific study seems sexier?
4. We have a physician in my own backyard who seems to have hired an NFL celebrity endorser who claims that the doctor, who began using an automated bedside centrifuge a few years back and who has no lab research capabilities, was the FIRST (to use stem cells) and is the best because he’s done the most work and research in this field. I certainly understand that the retried NFL guy wants to do his job well, but you would think the clinic would at least edit that part out?
5. A new scary trend at many clinics (including several of the ones above), is injecting bone marrow stem cells IV. While the fat stem cell clinics have done this for years (I had the chance to adjudicate at least one death due to the practice in Korea many years back), using bone marrow stem cells in this way has only been done by the most hard core nutty docs. The bone marrow focused clinics seem to be doing this not based on any known science (as based on existing studies 96-98.5% of the cells will get stuck in the lungs through a pulmonary first pass effect), but as a way to compete with the fat stem cells clinics. The issue is the death I discussed above, which seems to have occurred because of the stem cells aggregating (which they like to do). Small clots in processed bone marrow are common and sometimes can’t be 100% avoided, which have no impact when injected into a joint or tendon. But take that same small clot and float it through the blood stream IV where it will pick up platelets and become a bigger clot, and pulmonary embolism can happen, leading to a bad day for everyone.
The upshot? It’s wild out there. My dream of a rational, physician policed, stem cell filled future with strong professional organizations providing rational training by real experts never happened. Instead, we have loads of docs just doing whatever it takes to get eye balls without investing in the science or who even have read the existing science. Time to step down from the soapbox…