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Published online 17 February 2009 | Nature | doi:10.1038/457941a
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Tumours spark stem-cell review
Russian treatment linked to cancerous growths.
A report claiming that unregulated transplants of human fetal neural stem cells led to tumours in a boy's brain and spinal cord is being hotly discussed by stem-cell researchers. Although the procedure took place well outside the scientific mainstream, it underscores the need for caution as clinical trials involving stem-cell transplantation move forward.
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Well, iPSCs researchers should read this news very carefully and re-assess their hope for using iPSCs for regenerative medicine or therapeutic cloning.
A "fail-safe" means of protection against tumor formation or other aberrant behavior in transplanted stem cells entails the insertion into these cells, pre-transplant, of suicide genes that can later be called upon to destroy the cells if they misbehave in vivo. These include the herpes simplex thymidine kinase (HSV-tk) gene, which sensitizes cells to ganciclovir, and a cytosine deaminase gene that sensitizes to fluorocytosine. The HSV-tk system has already proved clinically useful in ablating life-threatening graft-vs-host reactions mediated by lymphocytes allografted into patients with hematopoietic malignancies.
This is not an issue with therapeutic potential but with quality control and patient selection. Basically, what you expect when you go to a snake oil salesman with an immunosuppressed patient. Trying to make any extrapolation to current reviewed and approved stem cell protocols would be the equivalent of trying to judge approved cancer protocols based on the failure of laetrile clinics.