Dutch patients are warned against stem cell treatmentBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7552.1232-d (Published 25 May 2006) Cite this as: BMJ 2006;332:1232
Patients in the Netherlands have been warned against having controversial stem cell treatment for conditions such as multiple sclerosis and spinal chord injuries.
The Dutch Health Care Inspectorate issued the warning before the end of an investigation into two private clinics that offer such treatment because of “media attention.” The clinics are the Preventive Medicine Clinic in Rotterdam and Cells4Health, based near Zutphen.
These clinics claim to have had successful results with the techniques, for which the Health Care Inspectorate says there is “no scientific proof.” Such treatment is banned in the United Kingdom but not in the Netherlands.
The investigation follows complaints from leading Dutch neurologists. The Association For Neurology has denied the “worldwide impression” that Dutch neurologists are treating with stem cells patients who have “multiple sclerosis, stroke, amyotrophic lateral sclerosis, or other diseases of the nervous system.” Years of research are necessary before such “stem cell therapy” could be recommended, it says.
The inspectorate has written to all relevant patient groups warning of the “unknown consequences” of stem cell treatment and the “certain risks” involved (http://www.igz.nl/).
The acting inspector general, Nico Oudendijk, said, “I thoroughly understand that many patients find themselves in unbearable, hopeless situations, but it is important, especially for them, that I express my concern about this type of treatment, for which there is no scientific proof and which is often very costly. The safety of these treatments has not been sufficiently studied, yet what does seem clear is that they are highly profitable for certain businesses.”
A spokesman for the Preventive Medicine Clinic says that it injects cord blood stem cells in a method designed to “target cells in a manner specific to an individual's condition.” Its medical director, Dr Robert Trossèl, a long standing advocate of alternative medicine, says he has treated 120 patients, mostly British, in the past year, half of whom had multiple sclerosis.
He claims 10% are now “walking out of a wheelchair” while another 80% have had “a proven significant clinical benefit.” The treatment costs about £12 500 (€18 400; $23 400).
A spokesman for Cells4Health said that its “autologous stem cell preparation” has the possibility of differentiating between nerve cells and thus regenerating spinal cord lesions. It has treated 150 patients in the past year, charging between £3800 and £10 900.
Dr Rogier Hintzen, the head of the Erasmus Medical Centre's multiple sclerosis centre in Rotterdam, said that the two clinics' methods were obscure, but, in general, he had ethical, economic, and medical objections to private clinics offering stem cell therapy. “It is not clear how they treat patients.” He said he thought their treatment was inadequately controlled. He added that it is not certain that there are no side effects, such as tumours or infections, nor should patients pay to take part in medical research.
“Holland is like a banana republic. Compared with other countries there is an absence of laws. The government should have an obligation to protect the weak.”
Cells4health's director, Cees Kleinbloesem, declined to comment. Preventive Medicine Clinic's manager, Niels Van Gent, said, “The treatment is not officially recognised. It is in a test phase. But the treatment is very safe and it is being carefully investigated.”
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