An Institutional Review Board needs to be set up in India as per international guidelines to look into bio-safety, clinical and ethical standards that are required in stem cell preparation and therapy institutions, according to Dr. S P Thyagarajan, renowned herbal scientist and vice chancellor of the Madras University.

Addressing a gathering in Chennai last week during the inauguration of India's first umbilical cord blood bank and research centre, Lifecell, he said such an Institutional Review Board would also assist in preventing legal and ethical issues related to stem cell banking.

He noted that internationally stem cell therapy has attracted utmost attention of scientists, medical experts as well as human rights activists. Hence, the ethical issues connected with stem cell therapy has also to be carefully considered, since it involves use of human embryonic and fetal tissues. The sources of the stem cells are classified under three categories: uncontroversial sources, controversial sources and sources that should not be controversial.

Umbilical cords and cord blood are the uncontroversial sources and these are currently desired in many cases. Even though adult stem cells from donors is also non controversial, they are not clinically effective. The controversial sources are: aborted fetuses, frozen 'spare embryos' and cloned human embryos and that should not be controversial are those by which we can obtain stem cells through tissue and cell culture technology, he explained.

He noted that stem cell therapy is emerging as a cent percent efficacious alternative for the various types of transplantations like organ and tissue replacements. The major immunological advantage is that it would be 100 per cent accepted by the recipient, since immunological system of the recipient would accept these cells, which are pre-embryonic, and pluripotent cells. Hence, there may not be any rejection and transplantation related side effects or complications. That is why it is now effectively used in about 70 diseases, both malignant and non-malignant diseases, including hybrid leukaemia, sickle cell anaemia etc.

One of the recently published successful story of stem cell transplantation is in the study on 'multiple myeloma' published in the journal, 'Cancer Control (April 2004) issue from Duke University Medical center, Northern California, USA. MM is a type of blood cancer involving B-lymphocytes. In USA every year 14000 new patients of MM are diagnosed and their survival is only for five years, and treatment is through chemotherapy. Currently, they have shown complete response in up to 67 per cent of the cases through allergenic stem cell therapy. When successfully established, stem cell therapy would also be utilized for gene therapy in several incurable genetic disorders, said S P Thyagarajan.