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Welcome to the second part of a series on Hemato-oncology.
Question: Dr. Chiragbhai, we discussed about your work in stem cell transplant last time, and we decided to talk more about the procedure itself for our readers. Can you tell us what are Stem Cells?
Answer: Applications of stem cell technology is an exciting area of medicine, and currently a topic of hot debate at several fronts. It holds a great promise to ease or cure many ailments. Research is ongoing in severalareas.Stem cell or the “Basic Cell” is a simple concept, based on the fact that all humans are made from a single cell. This cell gives rise to all body tissues and organs. We all know that genetic material of all body cells is same, whether it is the embryonic cells or most differentiated heart muscle cells for example – all contain same 46 chromosomes, with some switches turned on and some turned off.

Precise controls for making various cell types from the same genetic material are not known. It is now known that even in adult body, there are cells which can differentiate into any type of cell, and hence potentially can recreate any tissue. These cells are known as Stem Cells. This is the premise of stem cell research. If we can find these cells and understand their controls, we can recreate and replace injured or lost tissue e.g. in heart attack, stroke/paralysis, diabetes, arthritis, liver or kidney damage, burns…

Que: That is very right. If all cells have same genetic material, we should be able to make any cell from any cell.
Ans: Well you are right in theory and to some extent this has been practically done as well e.g. scientists have turned skin fibroblasts or buccal mucosa cells into embryonic level stem cell by various methods, making them capable of differentiating into any tissue type.

However, it is not easy as it sounds e.g. when we inject stem cells into an area of damaged heart, whether they will grow into heart muscle cells or nerve cells or blood vessel wall cells and in what proportion, is currently not controllable. We do not know the dose of cells to be injected, frequency of injections required and what other supportive growth factors or other cells to be given with stem cells, who are the patients most likely to benefit, and other issues… Same applies to neurology, diabetes etc.

All of the above mentioned areas and many others are under active research, but none is confirmed beyond doubt and therefore still remain experimental, except in one area i.e. hematology and oncology.

Fortunately for Hematology-Oncology, above questions were more easily answered, and that too several years ago. Hence, it is an established treatmentfor many blood disorders, including benign and malignant. Of course, we are continuing to refine this to improve results further. Next time, we will talk about that with some case examples.
Dr. Chirag A. Shah; M.D. Oncology/Hematology (USA), 98243 12144, 98988 31496
Diplomate American Board of Oncology and Hematology. Ahmedabad.
Shyam Hem-Onc Clinic. 402 Galaxy, Near Nehrunagar Circle, Ahmedabad.