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Introduction: Stem cell-based regenerative medicine has provided an excellent opportunity to investigate therapeutic strategies and innovative treatments for Alzheimer's disease (AD). However, there is an absence of visual overviews to assess the published literature systematically. Methods: In this review, the bibliometric approach was used to estimate the searched data on stem cell research in AD from 2004 to 2022, and we also utilized CiteSpace and VOSviewer software to evaluate the contributions and co-occurrence relationships of different countries/regions, institutes, journals, and authors as well as to discover research hot spots and encouraging future trends in this field. Results: From 2004 to 2022, a total of 3,428 publications were retrieved. The number of publications and citations on stem cell research in AD has increased dramatically in the last nearly 20 years, especially since 2016. North America and Asia were the top 2 highest output regions. The leading country in terms of publications and access to collaborative networks was the USA. Centrality analysis revealed that the UCL (0.05) was at the core of the network. The Journal of Alzheimer's Disease (n = 102, 2.98%) was the most productive academic journal. The analyses of keyword burst detection indicated that exosomes, risk factors, and drug delivery only had burst recently. Citations and co-citation achievements clarified that cluster #0 induced pluripotent stem cells, #2 mesenchymal stem cells, #3 microglia, and #6 adult hippocampal neurogenesis persisted to recent time. Conclusion: This bibliometric analysis provides a comprehensive guide for clinicians and scholars working in this field. These analysis and results hope to provide useful information and references for future understanding of the challenges behind translating underlying stem cell biology into novel clinical therapeutic potential in AD. [ABSTRACT FROM AUTHOR]

Background: Because of limitations of transportation imposed by the COVID-19 pandemic, current recommendation calls for cryopreservation of allogeneic stem cell transplants before patient conditioning. A single cell therapy laboratory was selected to function as the central cryopreservation hub for all European registry donor transplants intended for the Australian-Pacific region. We examined properties of these transplants to ascertain how quality is maintained.Methods: We analyzed 100 pandemic-related allogeneic mobilized blood-derived stem cell apheresis products generated at 30 collection sites throughout Europe, shipped to and cryopreserved at our center between April and November of 2020. Products were shipped in the cool, subsequently frozen with DMSO as cryoprotectant. Irrespective of origin, all products were frozen within the prescribed shelf-life of 72 h.Results: Prior to cryopreservation, viable stem cell and leukocyte count according to the collection site and our reference laboratory were highly concordant (r2 = 0.96 and 0.93, respectively) and viability was > 90% in all instances. Median nominal post-thaw recovery of viable CD34+ cells was 42%. Weakly associated with poorer CD34+ cell recovery was higher leukocyte concentration, but not time lag between apheresis or addition of cryopreservant, respectively, and start of freezing. The correlation between pre- and post-thaw CD34+ cell dose was high (r2 = 0.85), hence predictable. Neutrophil and platelet engraftment were prompt with no evidence of dose dependency within the range of administered cell doses (1.31-15.56 × 106 CD34+ cells/kg).Conclusions: General cryopreservation of allogeneic stem cell transplants is feasible. While more than half of the CD34+ cell content is lost, the remaining stem cells ensure timely engraftment. [ABSTRACT FROM AUTHOR]

The paper addresses the issues of admissibility of human embryo research and the legal protection to be recognized, in light of the growing importance that scientific research has been gaining in the clinical and biomedical fields of embryonic stem cells for therapeutic purposes. As for human embryo experimentation, particularly on cryopreserved supernumerary embryos, European legislation varies, since the European Court has granted member States a wide margin of appreciation. Some countries, including Italy, have strict legislation protecting embryos from the fertilisation stage, whereas others have taken permissive approaches, allowing experimentation until 14 days after fertilisation. Science, however, has shown that the 14-day limit can be moved. The author finds it necessary to achieve broad international consensus and shared regulations. Lawmakers, however, need to balance respect for the principle of life, represented by the embryo, against scientific needs, in order to devise sound regulations safeguarding both apparently conflicting fundamental values. [ABSTRACT FROM AUTHOR]

To date, four cases illustrate that stem cell transplantation (SCT) remains an option for cure of HIV in only few cases. Long-term follow-up data on viral shedding of reservoirs are still needed. So far, interruption of ART is the only way to validate long-term HIV remission. [ABSTRACT FROM AUTHOR]

Background and Aims: To review the regenerative technologies used in bone regeneration: bone grafts, barrier membranes, bioactive factors and cell therapies. Material and Methods: Four background review publications served to elaborate this consensus report. Results and Conclusions: Biomaterials used as bone grafts must meet specific requirements: biocompatibility, porosity, osteoconductivity, osteoinductivity, surface properties, biodegradability, mechanical properties, angiogenicity, handling and manufacturing processes. Currently used biomaterials have demonstrated advantages and limitations based on the fulfilment of these requirements. Similarly, membranes for guided bone regeneration (GBR) must fulfil specific properties and potential biological mechanisms to improve their clinical applicability. Pre‐clinical and clinical studies have evaluated the added effect of bone morphogenetic proteins (mainly BMP‐2) and autologous platelet concentrates (APCs) when used as bioactive agents to enhance bone regeneration. Three main approaches using cell therapies to enhance bone regeneration have been evaluated: (a) "minimally manipulated" whole tissue fractions; (b) ex vivo expanded "uncommitted" stem/progenitor cells; and (c) ex vivo expanded "committed" bone‐/periosteum‐derived cells. Based on the evidence from clinical trials, transplantation of cells, most commonly whole bone marrow aspirates (BMA) or bone marrow aspirate concentrations (BMAC), in combination with biomaterial scaffolds has demonstrated an additional effect in sinus augmentation and horizontal ridge augmentation, and comparable bone regeneration to autogenous bone in alveolar cleft repair. [ABSTRACT FROM AUTHOR]

Background and Aims: To describe the biology of alveolar bone regeneration. Material and Methods: Four comprehensive reviews were performed on (a) mesenchymal cells and differentiation factors leading to bone formation; (b) the critical interplay between bone resorbing and formative cells; (c) the role of osteoimmunology in the formation and maintenance of alveolar bone; and (d) the self‐regenerative capacity following bone injury or tooth extraction were prepared prior to the workshop. Results and Conclusions: This summary information adds to the fuller understanding of the alveolar bone regenerative response with implications to reconstructive procedures for patient oral rehabilitation. The group collectively formulated and addressed critical questions based on each of the reviews in this consensus report to advance the field. The report concludes with identified areas of future research. [ABSTRACT FROM AUTHOR]

Introduction: Mesenchymal stromal/stem cells (MSCs) derived from fat tissue are an encouraging tool for regenerative medicine. They share properties similar to the bone marrow-derived MSCs, but the amount of MSCs per gram of fat tissue is 500x higher. The fat tissue can easily be digested by collagenase, releasing a heterogeneous cell fraction called stromal vascular fraction (SVF) which contains a variable amount of stromal/stem cells. In Europe, cell products like the SVF derived from fat tissue are considered advanced therapy medicinal product (ATMPs). As a consequence, the manufacturing process has to be approved via GMP-compliant process validation. The problem of the process validation for SVF is the heterogeneity of this fraction. Methods: Here, we modified existing purification strategies by adding an additional plastic adherence incubation of maximal 20 hours after SVF isolation. The resulting cell fraction was characterized and compared to SVF as well as cultivated adipose-derived stromal/stem cells (ASCs) with respect to viability and cell yield, the expression of surface markers, differentiation potential and cytokine expression. Results: Short-term incubation significantly reduced the heterogeneity of the resulting cell fraction compared to SVF. The cells were able to differentiate into adipocytes, chondrocytes, and osteoblasts. More importantly, they expressed trophic proteins which have been previously associated with the beneficial effects of MSCs. Furthermore, GMP compliance of the production process described herein was acknowledged by the national regulatory agencies (DE_BB_01_GMP_2017_1018). Conclusion: Addition of a short purification-step after the SVF isolation is a cheap and fast strategy to isolate a homogeneous uncultivated GMP-compliant cell fraction of ASCs. [ABSTRACT FROM AUTHOR]

Background: Accomplishments in stem cell science and tissue engineering have resulted in a remarkable revolution in the context of future medicine. However, a general insight over the progress of stem cell research in Iran is still lacking. A better understanding of current needs in this field is required to design a better national roadmap. Methods: In this study, we defined the geographical regions based on the significance of their contribution to stem cell research; then, using the Scopus database, we retrieved reports from Iran and other countries concerning stem cell science and regenerative medicine published from 1994 until the end of 2016. Results: A significant number of citations belong to North America (6 554 029 citations equal to 49% of the total citations) and Europe (4 425 465 citations equal to 33% of the total citations) and the rest of citations were related to Asia (2 423 352 citations equal to 18% of the total citations). East Asian (2 168 472 citations equal to 76% of the total citations related to Asia) documents were cited more than those from the Middle East (ME) (494 141 citations equal to 17% of the total citations related to Asia) and North and Central Asia (196 382 citations equal to 7% of the total citations related to Asia). Iran as a country in the ME attracted 17% of the total citations related to the Asian countries winning the second position in this regard. The overview of total number of citations showed a sharp increase and upward trend in citation numbers for all the Iranian institutes from 2007 that resulted in the expansion of stem cell science in all major cities of Iran such as Shiraz (8%), Mashhad (5%), Isfahan (5%) and Ahvaz (5%). H-index of Tehran University of Medical Science, which has the highest total citations and document numbers, is the highest among all Iranian research institutes. Citation per paper of Royan Institute (RI) is the highest among the top 10 Iranian institutes, by 13 citations per paper. Conclusion: Stem cell research in Iran is rapidly developing. Since 2007, the number of published documents in major research institutes increased; thus, there is necessity for analysis of the status of publications in this field and choosing a better direction based on needs. Furthermore, it is necessary to expand and organize international collaborations to enrich our research and benefit from different team experiences. [ABSTRACT FROM AUTHOR]

Background: T cell-replete haploidentical stem cell transplantation (haplo-SCT) is a valid therapeutic option for adult patients with high-risk acute myeloid leukemia (AML) lacking an HLA-matched sibling or unrelated donor.Method: We retrospectively analyzed the outcomes of 912 AML patients ≥45 years of age who had undergone haplo-SCT with either myeloablative conditioning (MAC; n = 373) or reduced intensity conditioning (RIC; n = 539) regimens.Results: The median follow-up was 31.1 and 25.7 months for MAC and RIC, respectively. The incidence of relapse and nonrelapse mortality (NRM) were 25.1% versus 28.7% and 31.0% versus 30.3% for MAC and RIC, respectively; 2-year leukemia-free survival (LFS) was 43.9% for MAC versus 41.0% for RIC. In multivariate analysis, the use of MAC versus RIC was not associated with a difference in the outcomes. Results were confirmed in the propensity score-weighted analysis. Disease status and performance status at transplantation were associated with outcomes. Notably, the use of posttransplantation cyclophosphamide was associated with reduced acute graft-versus-host disease (aGVHD) stage III-IV, and NRM and increased overall survival, LFS, and GVHD-free, relapse-free survival. The use of mobilized peripheral blood stem cells was associated with an increased risk of stage II-IV aGVHD.Conclusion: No differences were found between MAC and RIC regimens for haplo-SCT in adults with AML who were ≥45 years of age. The type of GVHD prophylaxis, disease status, and performance status were the major predictors of transplantation outcome. These results may serve as the background for randomized study comparing RIC versus MAC for haplo-SCT in adults with AML. [ABSTRACT FROM AUTHOR]

According to the judgement of the European Court of Justice in 2014, human parthenogenetic stem cells are excluded from the patenting prohibition of procedures based on hESC by the European Biopatent Directive, because human parthenotes are not human embryos. This article is based on the thesis that in light of the technological advances in the field of stem cell research, the attribution of the term 'human embryo' to certain entities on a descriptive level as well as the attribution of a normative protection status to certain entities based on the criterion of totipotency, are becoming increasingly unclear. The example of human parthenotes in particular demonstrates that totipotency is not at all a necessary condition for the attribution of the term 'human embryo'. Furthermore, the example of hiPSC and somatic cells particularly shows that totipotency is also not a sufficient condition for the attribution of a normative protection status to certain entities. Therefore, it is not a suitable criterion for distinguishing between human embryos worthy of protection and human non-embryos not worthy of protection. Consequently, this conclusion has repercussions for the patenting question. The strict delineation between an ethically problematic commercial use of human embryos and the concomitant patenting prohibition of hESC-based procedures and an ethically unproblematic commercial use of human non-embryos and the therefore either unrestrictedly permitted (cf. human parthenotes) or even unregulated (cf. hiPSC) patenting of procedures based on these alleged alternatives becomes increasingly blurred. [ABSTRACT FROM AUTHOR]

The understanding of disease biology and advances in cellular and molecular biology platforms have ushered in a new era of cell and gene based therapeutic products. The US-FDA refers to this category of products as Cellular and Gene Therapy Products (CGTPs), while the European Medicines Agency, Europe, refers to them as Advanced Therapy Medicinal Products (ATMPs). The research and development (R&D) and final commercialization of these products have thus picked up pace, especially in the last decade. This emerging scenario necessitates framing regulations and guidelines that take into consideration the unique biological nature of these products. Regulators and government agencies of different countries across the globe have come up with regulations and guidance documents to guide, monitor, and regulate the research and development in this field. India, given its powerful resources of skilled scientific manpower and infrastructure, is also contributing to development of these innovative therapeutic products. Keeping in line with the international counterparts, the Indian regulators and government agencies have developed regulations and guidelines for stakeholders. This chapter summarizes the regulatory landscape for research and development of CGTP in India. It provides an overview of the government agencies and committees overseeing this field and their roles that a stakeholder working in this field needs to have knowledge of. Furthermore, the chapter outlines the salient features of rules, regulations, and guidelines relevant to CGTP, the approval process, the current approved products in Indian market, and finally, the challenges and way forward for CGTP in India., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

In renal transplantation, live donor kidney grafts are associated with optimum success rates due to the shorter period of ischemia during the surgical procedure. The current shortage of donor organs for adult patients has caused a shift towards deceased donors, often with co-morbidity factors, whose organs are more sensitive to ischemia-reperfusion injury, which is unavoidable during transplantation. Donor management is pivotal to kidney graft survival through the control of the ischemia-reperfusion sequence, which is known to stimulate numerous deleterious or regenerative pathways. Although the key role of endothelial cells has been established, the complexity of the injury, associated with stimulation of different cell signaling pathways, such as unfolded protein response and cell death, prevents the definition of a unique therapeutic target. Preclinical transplant models in large animals are necessary to establish relationships and kinetics and have already contributed to the improvement of organ preservation. Therapeutic strategies using mesenchymal stem cells to induce allograft tolerance are promising advances in the treatment of the pediatric recipient in terms of reducing/withdrawing immunosuppressive therapy. In this review we focus on the different donor management strategies in kidney graft conditioning and on graft preservation consequences by highlighting the role of endothelial cells. We also propose strategies for preventing ischemia-reperfusion, such as cell therapy. [ABSTRACT FROM AUTHOR]

The development of new drugs using stem cells has become a clinic alternative for the treatment of different diseases such as Alzheimer's, diabetes and myocardial infarction. Similar to conventional medicines, stem cells as new medicinal products for cell therapy are subjected to current legislation concerning their manufacture process. Besides, their legality is determined by the Regulatory Agencies belonging to the Member State of the European Union in which they are being registered. With the evolution of therapy that uses cells as medicines, there is a need to develop the appropriate legislative and regulatory framework capable of ensuring their safety and effectiveness. However, few works have been published regarding the regulations that these products must comply through production and commercialization processes. The present work is focused on the description of key events during clinical development and cell production of stem cells as drugs. Such as the regulations, requirements and directives involved in the production of cell therapy medicinal products, from the clinical design stage to its commercialization in Europe. [ABSTRACT FROM AUTHOR]

Scarce information is available about the cost of mobilisation/collection of peripheral blood stem cells for patients undergoing autologous transplant for relapsed Lymphoma or Multiple Myeloma. This paper reports the consumption of resources and costs collected through a survey among Italian Centres who adhere to the GITMO and SIdEM scientific societies. General transplant information was extracted from the European Promise database. Resources used alongside the phases of mobilisation/collection were retrieved. Resources for each of the process phases were quantified and averaged across centres and a unit cost value was attributed, based on administrative data from 3 centres, tariffs and market values. 25/89 Centres (34% of 2009 Promise transplants) provided data according to their standard practice. The mean cost/patient of the process of cell mobilisation/collection was €6830±1802 for Multiple Myeloma and €7304±1542 for Lymphoma. The organisational path for PBSC mobilisation/collection appears complex and cumbersome, spread amongst different treatment settings, with many different healthcare professionals being involved and considerable amounts of time and resources being currently dedicated to the management of patients requiring autologous transplantation. [ABSTRACT FROM AUTHOR]

The past decades witnessed the slow evolution of Europe's heterogeneous stem cell (SC) policy and substantial scientific advances in the field. Parallel to these developments, professional organizations have grown in influence. With the recently revised International Society for Stem Cell Research's Guidelines as a backdrop, we address the evolution of SC policies in 46 European countries and discuss how they fare against evolving ethical standards, societal views, and scientific advances. We identify areas of convergence, divergence, and the suitability of extant governance mechanisms to meet their stewardship roles. Europe represents a rich case study as it encompasses a wide range of policy approaches present worldwide. Comparative studies provide an opportunity to promote insight into national frameworks and to foster international harmonization.

Background: The perspectives of researchers and patients regarding roles and responsibilities in stem cell research are rarely studied, but these could offer insights about responsible research conduct. Method: We have conducted a qualitative study consisting of focus groups with both early- (n = 7) and late-career stem cell researchers (n = 11) that are primarily based in Europe, and with Dutch patients with chronic lower back pain (n = 9). These focus groups have been analyzed thematically. Results: Four themes were identified: 1) roles and responsibilities in the laboratory, 2) responsibilities of and toward patients and the public, 3) the role of regulation and 4) structural hurdles for responsibility. Discussion: The results suggest that responsible research conduct could be improved by addressing grant application procedures, publication pressure and by providing support of dissemination activities for researchers. Conclusion: Responsibility in stem cell research could be enhanced by embracing open science initiatives and targeted training.

According to the published report on current practice of hematopoietic SCT in Europe, high-dose therapy (HDT) with autologous stem cell support is a standard of care in paediatric patients with high risk (HR) or relapsed Ewing′s sarcoma (ES). Randomized trials, however, have not confirmed the value of this procedure yet. In this retrospective analysis we intended to evaluate the role of HDT as a consolidation therapy in first remission of ES. A total of 102 patients were included in the analysis and divided according to the following risk factors: metastatic disease at presentation, feasibility of surgery and histological response after induction. Forty-one patients were classified as standard risk (SR) patients, while the remaining 61 children, with at least one risk factor, were classified as HR patients. HR group patients were non-randomized and qualified according to the decision of the local clinician to give a conventional consolidation (CC) or to perform high-dose chemotherapy and radiotherapy in selected patients. Twenty-six children were given CC while 35 patients were treated with HDT. The HDT consisted of oral BU 4 mg/kg p.o. in divided doses daily for 4 days (total dose 16 mg/kg) followed by melphalan 140 mg/m2 i.v. on day −2. Probability of relapse-free survival (RFS) in median observation time was significantly worse in HR patients who were given CC therapy as compared with children with HR features receiving high-dose chemotherapy (0.27 vs 0.66 (P=0.008); OS 0.31 vs 0.71 (P=0.007), respectively). Patients from the SR group had a probability of RFS of 0.72 and OS of 0.75, and the difference between SR and HR patients after HDT was NS (P=0.37). Our observation confirms that the consolidation of the first-line treatment with BU and melphalan improves the outcome in ES patients with HR features. [ABSTRACT FROM AUTHOR]

BACKGROUND: Plerixafor with granulocyte-colony-stimulating factor (G-CSF) has been shown to enhance stem cell mobilization in patients with multiple myeloma and lymphoma with previous mobilization failure. In this European named patient program we report the experience in insufficiently mobilizing patients diagnosed with nonhematologic diseases. STUDY DESIGN AND METHODS: Thirty-three patients with germ cell tumor (n = 11), Ewing sarcoma (n = 6), Wiscott-Aldrich disease (n = 5), neuroblastoma (n = 4), and other nonhematologic diseases (n = 7) were included in the study. Plerixafor was limited to patients with previous or current stem cell mobilization failure and given after 4 days of G-CSF (n = 21) or after chemotherapy and G-CSF (n = 12) in patients who mobilized poorly. RESULTS: Overall, 28 (85%) patients succeeded in collecting at least 2 × 106/kg body weight (b.w.) CD34+ cells (median, 5.0 × 106/kg b.w. CD34+ cells; range, 2.0 × 106-29.5 × 106/kg b.w. CD34+ cells), and five (15%) patients collected a median of 1.5 × 106/kg b.w. CD34+ cells (range, 0.9 × 106-1.8 × 106/kg b.w. CD34+ cells). Nineteen patients proceeded to transplantation. The median dose of CD34+ cells infused was 3.3 × 106/kg b.w. (range, 2.3 × 106-6.7 × 106/kg b.w. CD34+ cells). The median numbers of days to neutrophil and platelet engraftment were 11 (range, 9-12) and 15 (range, 10-25) days, respectively. CONCLUSION: These data emphasize the role of plerixafor in combination with G-CSF or chemotherapy and G-CSF as an effective mobilization regimen with the potential of successful stem cell collection. Accordingly, plerixafor seems to be safe and effective in patients with nonhematologic diseases. Larger prospective studies are warranted to further assess its use in these patients. [ABSTRACT FROM AUTHOR]

The effectiveness of the novel hematopoietic stem cell mobilizing agent plerixafor was evaluated in nationwide compassionate use programs in 13 European countries. A total of 580 poor mobilizers with non-Hodgkin's lymphoma (NHL), Hodgkin's lymphoma (HL) and multiple myeloma (MM) were enrolled. All patients received plerixafor plus granulocyte CSF with or without chemotherapy. Overall, the collection yield was significantly higher in MM patients (>2.0 × 106 CD34+ cells/kg: 81.6%; >5.0 × 106 CD34+ cells/kg: 32.0%) than in NHL patients (>2.0 × 106 CD34+ cells/kg: 64.8%; >5.0 × 106 CD34+ cells/kg: 12.6%; P<0.0001) and also significantly higher in HL patients (>2.0 × 106 CD34+ cells/kg: 81.5%; >5.0 × 106 CD34+ cells/kg: 22.2%) than in NHL patients (P=0.013). In a subgroup analysis, there were no significant differences in mobilization success comparing patients with diffuse large B-cell lymphoma, follicular lymphoma and mantle cell lymphoma. Our data emphasize the role of plerixafor in poor mobilizers, but further strategies to improve the apheresis yield especially in patients with NHL are required. [ABSTRACT FROM AUTHOR]

Abstract: Cellular therapy is a novel form of medical or surgical treatment using cells in place of or in addition to traditional chemical drugs. The preparation of cellular products – called advanced therapy medicinal products – ATMP in Europe, requires compliance with good manufacturing practices (GMP). Based on long-term experience in blood component manufacturing, product traceability and hemovigilance, selected blood services may represent ideal settings for the development and experimental use of ATMP. International harmonization of the protocols and procedures for the preparation of ATMP is of paramount importance to facilitate the development of multicenter clinical trials with adequate sample size, which are urgently needed to determine the clinical efficacy of ATMP. This article describes European regulations on cellular therapy and summarizes the activities of the ‘Franco Calori’ Cell Factory, a GMP unit belonging to the department of regenerative medicine of a large public university hospital, which acquired a certification for the GMP production of ATMP in 2007 and developed nine experimental clinical protocols during 2003–2011. [Copyright &y& Elsevier]

The article discusses the Court of Justice of the European Union (CJEU) decision in BrĂstle v. Greenpeace which was related to the patentability of stem cells in Europe. It describes the decision of the court that human embryos used for scientific research are excluded from patentability and if the technical teaching requires the destruction or use of human embryos then it is also unpatentable. It analyses the court's decision and reflects its implications.

Six hundred and twenty-four centers from 43 countries reported a total of 31 322 hematopoietic SCT (HSCT) to this 2009 European Group for Blood and Marrow Transplantation (EBMT) survey with 28 033 first transplants (41% allogeneic, 59% autologous). The main indications were leukemias (31%; 92% allogeneic), lymphomas (58%; 12% allogeneic), solid tumors (5%; 6% allogeneic) and non-malignant disorders (6%; 88% allogeneic). There were more unrelated than HLA-identical sibling donors (51 vs 43%) for allogeneic HSCT; the proportion of peripheral blood as stem cell source was 99% for autologous and 71% for allogeneic HSCT. Allogeneic and autologous HSCT continued to increase by about 1000 HSCT per year since 2004. Patterns of increase were distinct and different. In a trend analysis, allogeneic HSCT increased in all World Bank Categories (P=0.01, two sided; all categories), autologous HSCT increased in middle- (P=0.01, two sided) and low-income (P=0.01, two sided) countries. EBMT practice guidelines appeared to have an impact on trend, with a clear increase in absolute numbers within the categories 'standard' and 'clinical option' for both allogeneic and autologous HSCT (P=0.01, two sided; for both allogeneic and autologous HSCT) and a clear decrease in autologous HSCT for the 'developmental' and 'generally not recommended' indications (P=0.01, two sided). These data illustrate the status and trends of HST in Europe. [ABSTRACT FROM AUTHOR]

The article presents abstracts on topics related to osteoporosis which are presented during the European Congress on Osteoporosis and Osteoarthritis including the effectiveness of different molecular weight of hyaluronic acids in treating patients with knee osteoarthritis, conservative treatment of osteoarthritis for orthopedic outpatients, and the different presentations of osteomalacia.

In 1997, the Joint Accreditation Committee ISCT & EBMT (JACIE) was created. The following year, it approved the first edition of standards for haemopoietic progenitor cell collection, processing and transplantation. The purpose of the standards is to ensure a minimal level of quality, alertness and homogeneity in the implementation of autologous and allogeneic haemopoietic stem cell transplantation (HSCT) programme in onco-hematology. The acquisition of accreditation is based upon the system of examination by trained medical professionals according to countries endorsements with the national regulation obligations applicable to HSCT. In 2008, the fourth edition has been launched. The range of application of the standards comprises both donors and recipients, and all phases of collection, processing, storage and administration of haemopoietic progenitor cells. Among the accredited processing facilities, a few have been integrated JACIE standards into their existing management quality system which is inspected by national health authority. In France, the comparison between JACIE standards and the good manufacturing practices of cellular therapy product reveals some common points and some differences to apply. [ABSTRACT FROM AUTHOR]

To overview banks, repositories and registries of stem cell lines in Europe excluding bone marrow and cord blood banks; to concisely discuss the most important scientific, regulatory and ethical aspects of stem cell banking in a manner understandable to a layperson, but remain detailed enough not to compromise thoroughness of information. Review of scientific publications, laws and ethical guidelines in this field up through September 2008; hearing the opinions of key persons working in stem cell banking. The article discusses the procedure of stem cell banking and related safety issues and reviews the regulation of stem cell banking at the regional (European) and the national level. Stem cell banking can help meet scientific and certain ethical imperatives, but is complicated in the context of heterogeneous laws, guidelines, and ethical standards. In the pluralistic European society with cultural diversity leading to heterogeneous laws, harmonisation of international guidelines and national laws regulating stem cell banking is needed, as well as mapping of implementation at the national level. [ABSTRACT FROM AUTHOR]

Abstract: Legislation in individual member states of the European Union on human embryonic stem cell (hESC) research is as divergent as the different cultural, ethical, and religious views on the issue. On the occasion of the public launch of the European Human Embryonic Stem Cell Registry (hESCreg: www.hescreg.eu), a two-day symposium was held on 18 and 19 January 2008 in Berlin to offer participants an overview of state-of-the-art hESC research and legislation throughout Europe and in selected regions of the world. Thirty leading scientists from Europe as well as from the United States, Japan, and Australia reported on a range of aspects related to research on hESC and reviewed the key elements of the newly established hESCreg database of hESC lines. In this article we summarize and complete the information on the current status of international hESC regulation. [Copyright &y& Elsevier]

From the first success in cultivation of cells in vitro, it became clear that developing cell and/or tissue specific cultures would open a myriad of new opportunities for medical research. Expertise in various in vitro models has been developing over decades, so nowadays we benefit from highly specific in vitro systems imitating every organ of the human body. Moreover, obtaining sufficient number of standardized cells allows for cell transplantation approach with the goal of improving the regeneration of injured/disease affected tissue. However, different cell types bring different needs and place various types of hurdles on the path of regenerative neurology and regenerative cardiology. In this review, written by European experts gathered in Cost European action dedicated to neurology and cardiology-Bioneca, we present the experience acquired by working on two rather different organs: the brain and the heart. When taken into account that diseases of these two organs, mostly ischemic in their nature (stroke and heart infarction), bring by far the largest burden of the medical systems around Europe, it is not surprising that in vitro models of nervous and heart muscle tissue were in the focus of biomedical research in the last decades. In this review we describe and discuss hurdles which still impair further progress of regenerative neurology and cardiology and we detect those ones which are common to both fields and some, which are field-specific. With the goal to elucidate strategies which might be shared between regenerative neurology and cardiology we discuss methodological solutions which can help each of the fields to accelerate their development. [ABSTRACT FROM AUTHOR]

Appropriate regulation of stem cell-based products is essential to ensure public safety and trust while minimising unnecessary barriers to product development, but presents numerous challenges. Weaknesses of existing legal frameworks include variation between jurisdictions and poor fit between product categories and new technologies. The new European Regulation on advanced therapy medicinal products is an important attempt to provide a consolidated regulatory framework for novel products. Others can learn from issues encountered in its development, including definition of product categories, ethical concerns, and the application of regulations to small-scale production. Several aspects of the Regulation will be useful models, but some larger questions remain unresolved. As reform efforts move forward, harmonisation and sharing of expertise will be vital to effective regulation. [Copyright &y& Elsevier]

The article discusses the patenting of stem cells in the U.S. and Europe. It is stated the patent applications made by the Wisconsin Alumni Research Foundation (WARF) in the U.S. and by the European Patent Office (EPO) were questioned due to its effect on human health. It mentions that the patent system of WARF shows a reasonably level in the field of technology for its comprehensive criteria for the grant of monopoly rights of exploitation in the area of stem cell technology. On the other hand, the patent system of EPO shows poor quality in attaining the required standards in patenting and assessing inventions.

Abstract: The success of treatment for acute myocardial infarction and chronic myocardial ischemia has improved general medical care in Europe, resulting in an increasing population of patients with chronic and congestive heart failure. By applying currently available therapeutic options the quality of life and lifespan of these patients have both increased. However, amongst patients––predominantly the elderly––who remain symptomatic despite intensive medical treatment, autologous bone marrow-derived mononuclear cells may trigger attempts to repopulate lost tissues directly as a novel therapeutic option. In this concised paper the current understanding of stem cell therapy and early clinical experiences are discussed and related to the application of stem cells in elderly patients with myocardial ischemia. [Copyright &y& Elsevier]

Wink R. Gatekeepers and proximity in science-driven sectors in Europe and Asia: the case of human embryonic stem cell research, Regional Studies. The production of new knowledge cannot only rely on regional innovation systems but needs also creative inputs and diversity by interactions with actors in other regions. Science-based sectors such as stem cell research with its narrow linkage of basic research from different scientific disciplines, a diversified set of applications and potential commercial products for different markets depend particularly on institutions to enhance interactions between actors in different regions to improve efficiency of knowledge production. Gatekeepers serve to provide interface nodes between regional innovation systems by different forms of proximity. The paper analyses political approaches to support gatekeepers in stem cell science in three European and three Asian countries and their impact on the organization of knowledge production... [ABSTRACT FROM AUTHOR]

Background: Autologous, and in some cases allogeneic, hemopoietic stem cells (HSC) are stored for varying periods of time prior to infusion. For periods of greater than 48 h, storage requires cryopreservation. It is essential to optimize cell storage and ensure the quality of the product for subsequent reinfusion. Methods: A number of important variables may affect the subsequent quality of infused HSC and therapeutic cells (TC). This review discusses these and also reviews the regulatory framework that now aims to ensure the quality of stem cells and TC for transplantation. Results: Important variables included cell concentration, temperature, interval from collection to cryopreservation, manipulations performed. They also included rate of freezing and whether controlled-rate freezing was employed. Parameters studied were type of cryoprotectant utilized [dimethyl sulphoxide (DMSO) is most commonly used, sometimes in combination with hydroxyethyl starch (HES)]; and storage conditions. It is also important to assess the quality of stored stem cells. Measurements employed included the total cell count (TNC), mononuclear cell count (MNC), CD34+ cells and colony-forming units . granulocyte macrophage (CFU-GM). Of these, TNC and CD34+ are the most useful. However, the best measure of the quality of stored stem cells is their subsequent engraftment. The quality systems used in stem cell laboratories are described in the guidance of the Joint Accreditation Committee of ISCT (Europe) and the EBMT (JACIE) and the EU Directive on Tissues and Cells plus its supporting commission directives. Inspections of facilities are carried out by the appropriate national agencies and JACIE. Conclusion: For high-quality storage of HSC and TC, processing facilities should use validated procedures that take into account critical variables. The quality of all products must be assessed before and after storage. [ABSTRACT FROM AUTHOR]

As the recent experience of the European Patent Office graphically demonstrates, there is an inherent political tension between the individual ownership rights necessary for the operation of an international market in human embryonic stem cell science and the communal values of the many cultures in which such markets operate. This report examines the basis of the conflict between patenting and morality at national and international levels, the manifestation of those tensions in European patenting policy, and the contribution of bioethics to the attempt by European institutions to develop a governance response. [ABSTRACT FROM AUTHOR]

The article focuses on the European view regarding the patenting of human embryonic stem cell processes and products. The patent system concerning stem cells has been complicated by ethical exclusion clauses in the European Patent Convention and the European Biotechnology Directive. As a result, protracted delays in the processing of embryonic stem cell patents are observed.

This fifteenth annual European Group for Blood and Marrow Transplantation activity report lists the transplant activity in Europe in 2004 and documents the changes in indication over the past 15 years. In 2004, there were 22 216 first hematopoetic stem cells (HSCT), 7407 allogeneic (33%), 14 809 autologous (67%) and 4378 additional re- or multiple transplants reported from 592 centres in 38 European and five affiliated countries. Main indications were leukemias (7045 (32%; 78% allogeneic)); lymphomas (12 310 (55%; 94% autologous)); solid tumors (1759 (8%; 93% autologous)) and nonmalignant disorders (1015 (5%; 92% allogeneic)). In comparison, 145 teams from 20 countries performed 4234 HSCT (2137 allogeneic, 50%; 2097 autologous, 50%) in 1990. The overall increase was accompanied by major changes. Stem cell source changed from bone marrow to peripheral blood. More than one-third of allogeneic HSCT are now from unrelated donors. Reduced intensity conditioning is employed for one-third of allogeneic HSCT. Leukemias for allogeneic and lymphoproliferative disorders for autologous HSCT continue to increase. The decline in HSCT for chronic myeloid leukemia appears to level off for the first time since 1999. These data are informative for patient counselling and decision making for health care professionals.Bone Marrow Transplantation (2006) 37, 1069–1085. doi:10.1038/sj.bmt.1705377 [ABSTRACT FROM AUTHOR]

Biotechnology policy in the United States promotes the commercial development of genetically modified crops, yet adopts a precautionary approach when it comes to stem cells and cloning. In this article, the evolution of this bifurcated policy domain is traced. A detailed analysis of congressional hearings shows how distinctions between the products of biotechnology came to be reflected in the character of committees holding hearings, the attention to risks and benefits, and the pattern of interest-group activity in different biotechnology applications. It is argued that many of the differences that separate the United States and Europe in biotechnology reflect the way institutions reinforce past policy choices. [ABSTRACT FROM AUTHOR]

The patenting of embryonic stem cell-related inventions appears to be as controversial as the technology itself. The author outlines the state of play in Europe and the USA as well as other selected territories. While Europe has the broadest statutory exclusions to patenting of inventions which might be regarded as unethical, it appears that a smooth ride for applicants and patent holders is not guaranteed elsewhere. [ABSTRACT FROM AUTHOR]

Summary:This EBMT activity survey presents the status of hematopoietic stem cell transplantation (HSCT) in Europe 2003 and focuses on changes in stem cell source over the last decade. There were 21 028 first HSCT, 7091 allogeneic (34%), 13 937 autologous (66%) and 4179 additional re- or multiple transplants reported from 597 centers in 42 European countries in the year 2003. Main indications were leukemias (6613 (31%; 78% allogeneic)); lymphomas (11 571 (55%; 93% autologous)); solid tumors (1792 (9%; 92% autologous)) and nonmalignant disorders (898 (5%; 93% allogeneic)). In 1991, the vast majority of autologous and all allogeneic HSCT were still bone marrow (BM) transplants. Stem cell source changed rapidly to peripheral blood (PB) for autologous HSCT between 1992 and 1996. In 2003, 97% of autologous HSCT were PB derived. The change to PB for allogeneic HSCT followed 3 years later and occurred at a lower rate. In 2003, 65% of all allogeneic HSCT were PB derived. The change in stem cell source was not homogeneous. It was associated with donor type, main diagnosis, disease stage and it differed between European countries. In 2003, bone marrow remains a significant source of stem cells in some European countries for autologous HSCT and for nonmalignant disorders in allogeneic HSCT.Bone Marrow Transplantation (2005) 36, 575–590. doi:10.1038/sj.bmt.1705104; published online 8 August 2005 [ABSTRACT FROM AUTHOR]

Over the last years several European patents were opposed for protecting technology violating the morality requirement under Article 53(a) EPC. Attempts have been made by the Appeal Boards of the European Patent Office (EPO), as well as by amendments introduced into the Implementing Regulations of the European Patent Convention (EPC), to address this sensitive patentability requirement more precisely. The most recent hot topic coming up in this context is the patentability of stem cells. It is to be expected that this discussion will still go on in the field of biotechnological inventions for the next several years. [ABSTRACT FROM AUTHOR]

The many dimensions of the field of reproduction (clinical, scientific, social, ethical, legal) must be addressed by those with editorial responsibility for the major journals in the field. As the editorial team of the leading reproductive journal Human Reproduction, we have evolved processes that attempt to ensure a transparent but robust approach to complexities whose impact varies across international boundaries. [ABSTRACT FROM AUTHOR]

While many European countries are entering unknown legal terrain where the embryo in vitro is concerned, France can already look back on a long tradition of public discussion and legal codification of ways of dealing with in vitro embryos. In its comprehensive law of 1994, France had still rejected embryo research; however, due to the promising perspectives of stem cell research, the new law now pending implies a clear liberalization of the 1994 provisions. Both the French lawmakers and the National Ethics Commission have repeatedly argued that possible utilization of embryos for research purposes may seem legitimate from the moment that there is no more”parental project.”De facto, this concept implies that an embryo can be transformed into an object from the moment that the parents cease to desire it and that the value of protection is solely dependent on the will of third persons. At the same time, France is still speaking of guaranteeing respect for the“dignity of the embryo,”which would mean that an embryo must not be reduced to a thing and treated for purposes which are not his own. Therefore, the French solution is not a consistent and honest solution, and in its new legal provisions, France has involved herself in manifold contradictions. France has rejected the conception of pre-embryo, but is de facto following Britain’s model without making it explicit. [ABSTRACT FROM AUTHOR]

The article discusses some European ethics about stem cell research. Stem cell research is globally controversial. Debates are raging on this topic from North America to Europe, from Asia Minor to China and Japan. Stem cell research is nationally controversial. Like many other biomedical topics, stem cell research divides society. But the issue it raises of "consumptive embryo research," that is, of whether life may be destroyed for the purposes of research, even divides individual groups: politicians, philosophers, scientists, theologians, patients, and families. Even attempts to define European identity by means of the common root of Christianity have ultimately failed, due to the fact that various governments within Europe could not agree to the inclusion of a reference to the Christian roots of the European continent in a joint Constitution.

The article discusses the controversies surrounding the research in human embryonic stem cells in Europe. It mentions that human embryonic stem cells research offers a prospect of great medical benefits but requires research on human embryo and destroy the embryo from which they are taken. It mentions that questions were raised over the ontological and moral status of the embryo, its effect on the value of human dignity, and creating human embryos mainly for research.

Screening for galactomannan (GM) has been adopted by many European centers as part of the management plan for allogeneic stem cell transplant recipients. However, the temporal onset of GM antigenemia remains unknown. A series of allogeneic stem cell transplant recipients were monitored prospectively, and the relationship between antigenemia and other diagnostic triggers for initiation of antifungal therapy was analyzed. GM detection had a sensitivity of 94.4% anda specificity of 98.8%. Positive and negative predictive values were 94.4% and 98.8%, respectively. This statistical profile was better than that of other triggers, including unexplained fever, new pulmonary infiltrates, isolation of Aspergillus species, and abnormalities seen on computed tomography. Antigenemia preceded diagnosis on the basis of radiologic examination or Aspergillus isolation by 8 and 9 days in 80% and 88.8% of patients, respectively. Antigenemia preceded therapy in 83.3% of patients. Detection of GM was especially useful when patients were receiving steroid treatment or when coexisting conditions masked the diagnosis of invasive aspergillosis. Prospective screening for GM allows earlier diagnosis of aspergillosis than do conventional diagnostic criteria. [ABSTRACT FROM AUTHOR]

Editorial. Explores challenges for organ transplantation in Europe. Possible creation of cloned human embryos as sources for tissues to be used in transplants; Lack of consensus on what should be the framework of the status of embryos; Ethical issues associated with xenotransplantation; Animal welfare.

We provide a patent‐eligibility analysis of methods used in induced pluripotent stem cell (iPSC) theranostics, which links the discovery–diagnostics–therapeutics pipeline across a single platform. This article investigates recent statutory and judicial exclusions from patentability in the United States, compares them with exclusions in Europe, and highlights potential shortfalls of patent applications claiming the triad of disease modeling, cellular diagnostics, and personalized therapeutics with potential implications for patient care. Clinical Pharmacology & Therapeutics (2013); 93 4, 318–320. doi:10.1038/clpt.2013.11 [ABSTRACT FROM AUTHOR]

The article presents abstracts on stem cells research topics which include the ranking of values as a basis for ethical decision making in ethical controversies: the case of stem cell research, the import of embryonic stem cell lines, and ethics and legislations on stem cell research examples on European legislations on stem cell research.

We evaluated the number and characteristics of randomized controlled trials (RCTs) addressing hematopoietic stem cell transplantation (HSCT) for patients with hematological malignancies, comparing the productivity of US and Europe. A MEDLINE search was conducted to identify all published RCTs for the management of adult patients with hematological malignancies from January 1992 to December 2003. Eighty-three of the 306 trials identified included HSCT as one of the treatment arms. The US produced 25, Europe 54, and all other countries four. Four European countries, France, Italy, Germany, and UK (FIGU), produced 32 out of the 54 European studies. Significant differences emerged when focus of the study and accrual numbers were analyzed. Trials comparing HSCT to standard dose therapy represented 34.9% of the 83 trials and 59.4% of FIGU trials, but only 4% of US studies (P=0.001). US trials accrued a mean of 110.2 patients per study, as compared to 222.6 in FIGU studies (P=0.006) and 205.3 when all non-US countries are considered (P=0.01). Our conclusions are that US transplant RCT have focused on issues other than the comparison of HSCT to standard therapies. There is serious paucity of US trials defining the role of HSCT in the management of hematological malignancies. [ABSTRACT FROM AUTHOR]

Lists patents of different findings in biology in Europe, Germany and the U.S. as of 2001. Molecular Marker for Muscle Stem Cells; Endoluminant Prosthesis; Method for the Propagation of Hair.