A STEM CELL BANK WOULD HELP

Bone marrow transplants, the introduction of stem cells into the body to produce new blood cells, are used in the treatment of a number of diseases, among them leukaemia, lymphoma, aplastic anemia, beta-thalassemia, congenital metabolic disorders and diseases of the immune system (among them HIV-infection and systemic lupus).

Azerbaijan's citizens, who need treatment for these diseases requiring bone marrow transplants, have to go abroad and spend massive amounts of money on operations. But doctors in Azerbaijan are also starting to do bone marrow transplants after undergoing the appropriate training in Turkey, Belarus and other countries. There can be no doubt that a country like Azerbaijan should have acquired state-of-the-art technology and know-how for public health care long ago.

A public stem cell bank 

From a medical point of view, a bone marrow transplant is an extremely complicated procedure, involving several stages. But it has to be preceded by a search for a suitable bone marrow donor.  The set of studies determining whether the donor and recipient for whom the stem cells are intended is highly significant. The recipient himself may act as his own donor, having had his own stem cells harvested during a period of remission (a time when the illness subsides and the analyses' results are normal), after the requisite processing of the cells; or cells taken from an identical twin, where one exists, or a family member may also be used. The required maximum compatibility is not usually very high among relatives, no more than 25 per cent in brothers and even less in other relatives. So, it is common practice to try and find a donor at a special stem cell bank.

So, the setting up of a similar facility in Azerbaijan would play a very important and invaluable part in treating patients who need bone marrow transplants. Then there would be no need for patients to seek expensive treatment abroad. The head of the Leukaemia Sufferers Association, Mehriban Bagirova, told Regionplus that the main argument for setting up a stem cell bank was the country's population. Such a bank should be created where there is a large population.

Moreover, if we have our own stem cell bank, this would not only help the patients who have to go abroad for treatment, subjecting themselves to unaffordable expense, but would also make it easier to find a suitable donor. What is more, if the bone marrow transplant operation were carried out in this country, there would be no need to spend large sums of money on purchasing the necessary materials abroad. 

Where do we get stem cells from? Thousands of babies are born in Azerbaijan every day. The umbilical cord, which is cut off, contains blood rich in blood-producing stem cells. The gynaecologist and Candidate of Medical Sciences Lala Imanova told us that it is possible to store the blood from the umbilical cord, provided that the necessary preparations have been made beforehand, that instruments and vessels have been sterilised ready and trained staff are on hand. This blood needs to be stored at extremely low temperatures and in the future it can be used for the actual donor from whom it was harvested or for close relatives. It may also be suitable for use by others who need it, but with less likelihood of compatibility. 

This blood from the umbilical cord can be kept for 15 years. Moreover, it is highly unlikely that it will be needed by the child from whom it was taken; this only occurs in one in 1,400 cases (which is fortunate for a healthy child, naturally). It is more likely that a close relative might need it. The stem cell bank could also benefit from voluntary donations [of bone marrow]. Anyone who wishes to can become a stem cell donor. It is not customary to donate stem cells in our country, since there is nowhere for them to be stored. Therefore those needing bone marrow transplants can only hope that there is a compatible donor among their close relatives.

The sooner the better 

Naturally it is a complicated and expensive process to set up a stem cell bank. But this process would definitely recuperate its costs within a few years, not to mention the benefit it would bring to people. M. Bagirova told us that, if this were to be done, people would come to Azerbaijan for treatment from countries near and far. So, in Belarus, which boasts an extremely well known clinic in its capital Minsk, the state provides the country's citizens with treatment and stem cell transplants free of charge, but foreigners going there for treatment pay large sums for operations. This allows some of the expenditure on the free treatment to be recuperated. We could do the same in Azerbaijan.

Most other countries have special stem cell banks. That makes it easier to find a suitable donor and boosts patients' chances of recovery. For example, Israel has a large stem cell bank. Along with Germany and Turkey, Israel is a major centre for treatment, especially of oncological diseases, and patients' survival rates in that country are very high.

In Azerbaijan the stem cell bank issue continues not only to be an open one, but has not even been raised to a legislative level. The Ministry of Health told Regionplus that the use of stem cells is not permitted in Azerbaijan, because there is no law regulating it.