Clinical Policy Bulletin: Stem Cells for Bone Marrow Transplant

Aetna considers compatibility testing of prospective donors who are members of the immediate family (first-degree relatives, i.e., parents, siblings and children) and harvesting and short-term storage of peripheral stem cells or bone marrow from the identified donor medically necessary when an allogeneic bone marrow or peripheral stem cell transplant is authorized by Aetna.

Aetna considers umbilical cord blood stem cells an acceptable alternative to conventional bone marrow or peripheral stem cells for allogeneic transplant.

Aetna considers medically necessary the short-term storage of umbilical cord blood for a member with a malignancy undergoing treatment when there is a match. Note: The harvesting, freezing and/or storing umbilical cord blood of non-diseased persons for possible future use is not considered treatment of disease or injury. Such use is not related to the persons current medical care.

Notes:

When a covered family member of a newborn infant has a medically necessary indication for an allogeneic bone marrow transplant and wishes to use umbilical cord blood stem cells as an alternative, Aetna covers the testing of umbilical cord blood for compatibility for transplant under the potential recipients plan.

Performance of HLA typing and identification of a suitable donor does not, in and of itself, guarantee coverage of allogeneic bone marrow or peripheral stem cell transplantation. Medical necessity criteria and plan limitations and exclusions may apply.

See also the following CPBs related to bone marrow and peripheral stem cell transplantation:

According to the American Academy of Pediatrics (2007), cord blood transplantation has been shown to be curative in patients with a variety of serious diseases. Physicians should be familiar with the rationale for cord blood banking and with the types of cord blood banking programs available. Physicians consulted by prospective parents about cord blood banking can provide the following information:

Cord blood donation should be discouraged when cord blood stored in a bank is to be directed for later personal or family use, because most conditions that might be helped by cord blood stem cells already exist in the infant's cord blood (i.e., pre-malignant changes in stem cells). Physicians should be aware of the unsubstantiated claims of private cord blood banks made to future parents that promise to insure infants or family members against serious illnesses in the future by use of the stem cells contained in cord blood. Although not standard of care, directed cord blood banking should be encouraged when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) that could potentially benefit from cord blood transplantation.

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Stem Cells for Bone Marrow Transplant

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A Vietnamese girl adopted by a Swiss family underwent a stem cell transplant last Friday, months after she was diagnosed with acute lymphoblastic leukemia.

Joon Gremillet, 18, is under special care at the Geneva General Hospital with visits restricted to protect her from infections, given that her immune system drops close to zero, according to a post on the blog site Help Joon, which was opened to look for a matching donor by her adoptive father Patrick Gremillet, a senior program coordinator at the United Nations Development Program.

Patrick received Joon from a maternity hospital in Hai Phong in northern Vietnam and she has grown up with the family, traveling through Laos, Thailand, US, Austria and France.

Joon, who started her university studies last year in Geneva, was diagnosed with leukemia last May.

She was hospitalized immediately and received chemotherapy before the search began for a bone marrow donor that considerably increases chances of survival.

The father said a donor was a stressful issue as Joon was adopted and there was little chance of finding a matching donor in her current community.

He said there are also few Asians, and Vietnamese in particular, who are enrolled in the international stem cell donor registry.

Fortunately, a compatible donor was found in November, although details are being kept confidential.

Patrick said the donors stem cells were infused into his daughter in a process that lasted nearly two hours.

He said Joon will have to wait for between ten to 30 days before the transplanted cells begin to circulate in her bones and gradually resume production of bone marrow and blood cells. If things go well, she can regain immunity after three months.

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A miracle and a clarion call for more

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San Jose, California (PRWEB) January 02, 2014

Follow us on LinkedIn DNA Gene chips or DNA microarrays are small chips that are engrafted with DNA molecules. This advanced approach allows researchers to compare gene expressions in multiple cell types, identify active or switched-off genes, and compare various active genes under different settings. The growing focus on genetic testing and screening against a backdrop of increasing popularity of personalized medicine, is expected to drive demand for DNA gene chips. Growing popularity of preventive healthcare practices is also expected to help expand the use of DNA gene chips in preventative genetic diagnostics.

The trend report titled DNA Gene Chips announced by Global Industry Analysts Inc., is a focused research paper which provides cursory insights into the technology, its evolution, applications, and future prospects, in addition to providing coverage on corporate initiatives of key companies worldwide. The report also provides global market estimates and projections for DNA & Gene Chip (Microarray) in US dollars for years 2012 through 2017. Also covered are companies such as Affymetrix Inc., Agilent Technologies Inc., Illumina Inc., and Sequenom Inc., among others.

For more details about this trend report, please visit http://www.strategyr.com/TrendReport.asp?code=146088.

About Global Industry Analysts, Inc. Global Industry Analysts, Inc., (GIA) is a leading publisher of off-the-shelf market research. Founded in 1987, the company currently employs over 800 people worldwide. Annually, GIA publishes more than 1300 full-scale research reports and analyzes 40,000+ market and technology trends while monitoring more than 126,000 Companies worldwide. Serving over 9500 clients in 27 countries, GIA is recognized today, as one of the world's largest and reputed market research firms.

Global Industry Analysts, Inc. Telephone: 408-528-9966 Fax: 408-528-9977 Email: press(at)StrategyR(dot)com Web Site: http://www.StrategyR.com/

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PUBLIC RELEASE DATE:

2-Jan-2014

Contact: Vicki Cohn vcohn@liebertpub.com 914-740-2100 Mary Ann Liebert, Inc./Genetic Engineering News

New Rochelle, NY, January 2, 2014Minority women tend to be less aware of the increased risk of cardiovascular disease (CVD) they face by being overweight or obese. The results of a study that compared Hispanic and non-Hispanic white women based on their knowledge of heart disease risk factors and their perceptions of their own weight is published in Journal of Women's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Women's Health website at http://www.liebertpub.com/jwh.

Elsa-Grace Giardina, MD and coauthors, Columbia University Medical Center (New York, NY), report that although awareness of CVD and recognition that heart disease is the leading cause of death among women in the U.S has increased, knowledge of these risk factors still remains low among minority women, making prevention efforts more difficult. The authors compared how women estimate their weight and view their risk of heart disease and present their findings in the article "Cardiovascular Disease Knowledge and Weight Perception Among Hispanic and Non-Hispanic White Women."

"Based on these findings, prevention strategies need to target CVD knowledge and awareness among overweight and obese Hispanic women," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health.

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About the Journal

Journal of Women's Health, published monthly, is a core multidisciplinary journal dedicated to the diseases and conditions that hold greater risk for or are more prevalent among women, as well as diseases that present differently in women. The Journal covers the latest advances and clinical applications of new diagnostic procedures and therapeutic protocols for the prevention and management of women's healthcare issues. Complete tables of content and a sample issue may be viewed on the Journal of Women's Health website at http://www.liebertpub.com/jwh. Journal of Women's Health is the Official Journal of the Academy of Women's Health and the Society for Women's Health Research.

About the Academy

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Jan. 1, 2014 A novel breast-cancer therapy that partially reverses the cancerous state in cultured breast tumor cells and prevents cancer development in mice, could one day provide a new way to treat early stages of the disease without resorting to surgery, chemotherapy or radiation, a multi-institutional team led by researchers from the Wyss Institute of Biologically Inspired Engineering at Harvard University reported January 1 in Science Translational Medicine.

The therapy emerged from a sophisticated effort to reverse-engineer gene networks to identify genes that drive cancer. The same strategy could lead to many new therapies that disable cancer-causing genes no current drugs can stop, and it also can be used to find therapies for other diseases.

"The findings open up the possibility of someday treating patients who have a genetic propensity for cancer, which could change people's lives and alleviate great anxiety," said Don Ingber, M.D., Ph.D., Wyss Institute Founding Director. "The idea would be start giving it early on and sustain treatment throughout life to prevent cancer development or progression." Ingber is also the Judah Folkman Professor of Vascular Biology at Boston Children's Hospital and Harvard Medical School, and Professor of Bioengineering at the Harvard School of Engineering and Applied Sciences.

Between breast self-exams, mammograms, MRIs, and genetic tests, more women than ever are undergoing early tests that reveal precancerous breast tissue. That early diagnosis could potentially save lives; however, few of those lesions go on to become tumors and doctors have no good way of predicting which ones will. As a result, many women currently undergo surgery, chemotherapy and radiation who might never develop the disease. What's more, some women with a high hereditary risk of breast cancer have chosen to undergo preemptive mastectomies.

A therapy that heals rather than kills cancerous tissue could potentially help all these patients, as well as men who develop the disease. But to date the only way to stop cancer cells has been to kill them. Unfortunately, the treatments that accomplish that, including surgery, chemotherapy, and radiation therapy, often damage healthy tissue, causing harsh side effects.

The Wyss Institute researchers thought they could do better by spotting new genes that drive breast cancer and developing targeted genetic therapies to block them. First they had to identify the culprit genes among the thousands that are active in a cell at any moment. Molecular biologists typically convict these culprits through guilt by association; for example, when looking for cancer-causing genes, they search for individual genes that become active as cancer develops. But because genes in cells work in complex networks, that approach has led to some false convictions, with innocent genes being fingered for crimes they did not commit.

To improve the odds of finding the real culprits, Ingber teamed up with Wyss Institute Core Faculty member Jim Collins, Ph.D., a systems biology expert who has developed a sophisticated mathematical and computational method to reverse-engineer bacterial gene networks. Collins is a Core Faculty member at the Wyss Institute for Biologically Inspired Engineering and the William F. Warren Distinguished Professor at Boston University, where he leads the Center of Synthetic Biology.

First, Hu Li, Ph.D. a former Wyss Institute postdoctoral fellow who is now an Assistant Professor of Systems Pharmacology at the Mayo Clinic, honed the computational network to work for the first time on the more complex gene networks of mice and humans. The refined method helped the scientists spot more than 100 genes that acted suspiciously just before milk-duct cells in the breast begin to overgrow. The team narrowed their list down to six genes that turn other genes on or off, and then narrowed it further to a single gene called HoxA1 that had the strongest statistical link to cancer.

The researchers wanted to know if blocking the HoxA1 gene could reverse cancer in lab-grown cells from mouse milk ducts. Amy Brock, Ph.D., a former Wyss Institute postdoctoral fellow who is now an Assistant Professor of Biomedical Engineering at the University of Texas, Austin, grew healthy mouse or human mammary-gland cells in a nutrient-rich, tissue-friendly gel. Healthy cells ensconced in the gel formed hollow spheres of cells akin to a normal milk duct. But cancerous cells, in contrast, packed together into solid, tumor-like spheres.

Brock treated cancerous cells with a short piece of RNA called a small interfering RNA (siRNA) that blocks only the HoxA1 gene. The cells reversed their march to malignancy, stopping their runaway growth and forming hollow balls as healthy cells do. What's more, they specialized as if they were growing in healthy tissue.

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The Neurorehabilitation Summit Returns to Mayo Clinic in 2014
The 2014 Neurorehabilitation Summit will be held May 19-20 in Rochester, MN. This conference will focus on the latest advances in the care and management of ...

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Regenocyte Adult Stem Cell Therapy -Howard Lindeman

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How to Pronounce Pluripotent
Learn how to say Pluripotent correctly with EmmaSaying #39;s "how do you pronounce" free tutorials. Definition of pluripotent (oxford dictionary): adjective Biol...

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Regenocyte Adult Stem Cell Therapy - Barbara McKean

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Current ratings for: Genetic brain development 'peaks before birth and in adolescence'

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Genetic expression behind the development of our brains is most active before birth, in the early months of pregnancy, and during our teenage years, scientists have found.

There is a quieter intervening "movement" in the three-part "symphony" of human brain development, but one that is more sensitive to environmental factors, say the researchers publishing in the journal Neuron.

The initial surge of brain-developing genetic expression takes place during the first two-thirds of our gestation in the uterus, says the team led from the Yale School of Medicine in New Haven, CT.

The middle intermission then lasts from the final trimester of pregnancy until adolescence, at which point the genetic activity surges again for the final phase of our brain's development.

These two most active spurts relevant to human brain power, found to sandwich the childhood years, involve the development of the cerebral neocortex:

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Genetic brain development 'peaks before birth and in adolescence'

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"Genetics", Gregor Mendel

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Q: I have been hearing a lot about stem cell injections and was wondering if this would help my painful, arthritic knee?

There is a lot of exciting research and great interest in tissue engineering and regenerative medicine. However, there is also a lot of hype and misinformation out there. Tissue engineering is defined as the application of biological, chemical and engineering principles toward the repair, restoration, or regeneration of living tissues using biomaterials, cells, and factors, alone or in combination.1

The goal of tissue engineering is to regenerate damaged tissue. Tissue Engineering has three primary goals: Harvesting and isolating mesenchymal stem cells (MSCs), providing a scaffold onto which these cells are seeded so that their growth is organized and structured in an effort to duplicate a given tissue that is damaged, and assisting and promoting the growth of these MSCs with growth factors that cause the MSCs to ultimately become the tissue of interest.

There are two types of stem cells: embryonic stem cells, which are derived from fetuses and postnatal stem cells derived from adults. Embryonic stem cells have the ability to proliferate indefinitely in a test tube and the ability to produce all tissue types such as bone, cartilage or muscle. However, in the clinical setting they can cause an immune response in the recipient and can also cause tumors to grow. Furthermore, there are significant ethical concerns with harvesting embryonic stem cells as they are derived from human embryos. Currently in the U.S., the only research that can be performed on embryonic stem cells is that using stem cell lines that were in existence before 2009.

Adult stem cells have the advantage of not having these ethical concerns as they are harvested from the patient. Moreover, there is no immunogenic response as they come from you and also do not cause tumors to develop. However, they do not develop into various tissues as easily as embryonic stem cells do. Adult stem cells can be harvested from a variety of tissues: fat, blood, bone marrow, muscle and other tissue types. The number of stem cells seems to correlate with how much blood flow there is to a given tissue.

MSCs derived from fat or adipose tissue have been primarily used by proponents of regenerative medicine as adipose tissue is easily harvested and has a reasonable concentration of MSCs compared to other sources. Bone cells actually have more potential to differentiate into multiple cell types than fat cells, but harvesting cells from bone is more painful and invasive than harvesting fatty tissue, which most of us would be happy to donate. Anyone who has had a bone marrow biopsy can attest to the pain involved.

Patients who see me in the office with knee pain or knee arthritis often ask me if they would benefit from a stem cell injection. Currently, there is no good evidence in the orthopedic literature to recommend this. Insurance companies do not pay for this procedure, as again, there is no good evidence showing it to be efficacious. Thus, patients have to pay thousands of dollars out of pocket for this procedure. Given the lack of evidence to support it and the cost and possible risks, I do not recommend it. When injecting stem cells harvested from fatty tissue into an arthritic knee for example, these cells are not directed to grow cartilage nor are they directed to grow cartilage in the areas where your knee lacks it. Instead, these stem cells could equally differentiate into fat, bone, scar tissue or cartilage. In turn, you could grown bone on your own remaining cartilage, you could grow scar tissue on your ligaments, etc.

Tissue engineering is an evolving field with many possible exciting applications whose day will come, but unfortunately its clinical applications continue to be quite limited at the current time.

1 Laurencin CT, Ambrosio AM, Borden MD, Cooper JA Jr.: Tissue engineering: Orthopedic applications. Annu Rev Biomed Eng 1999; 1:19-46.

Dr. Rick Cunningham is a Knee and Shoulder Sports Medicine Specialist with Vail-Summit Orthopaedics. He is a Physician for the US Ski Team and Chief of Surgery at Vail Valley Medical Center. Do you have a sports medicine question youd like him to answer in this column? Visit his website at http://www.vailknee.com to submit your topic idea. For more information about Vail-Summit Orthopaedics, visit http://www.vsortho.com.

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stem cell therapy treatment for spinal muscular atrophy by dr alok sharma, mumbai, india
improvement seen in just 3 months after stem cell therapy treatment for spinal muscular atrophy by dr alok sharma, mumbai, india. Stem Cell Therapy done date...

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stem cell therapy treatment for beckers muscular dystrophy by dr alok sharma, mumbai, india
[gujarati] improvement seen in just 5 days after stem cell therapy treatment for beckers muscular dystrophy by dr alok sharma, mumbai, india. Stem Cell Thera...

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5 Genetic Discoveries in 2013
2013 was a big year in the world of gene research. We #39;re learning incredible things about why we are the way we are. Guest host Cristen Conger of Stuff Mom N...

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Current ratings for: Gene found that 'protects against neurodegenerative diseases'

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Scientists from the University of Queensland in Australia say they have discovered that a gene called mec-17 has the ability to protect against adult-onset progressive nerve degeneration. This is according to a study published in the journal Cell Reports.

The research team, led by Dr. Brent Neumann of the Queensland Brain Institute (QBI) at the University of Queensland, say their discovery may one day lead to a cure for a number of neurodegenerative diseases, such as motor neuron disease, Parkinson's disease, Huntington's disease and Alzheimer's disease.

To reach their findings, the investigators analyzed a small roundworm called Caenorhabditis elegans. They note that the roundworm is a genetic model commonly used to better understand neurobiology at a basic level.

From this, they discovered that mec-17 - a gene found among many species - protects axons, also known as nerve fibers. These are parts of the nerve cells, or neurons, that are responsible for conducting impulses between the cells.

The gene protects the axon by sustaining its cytoskeletal structure, say the investigators. This is made of proteins that maintain a nerve cell's shape, support and movement.

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Gene found that 'protects against neurodegenerative diseases'

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George Church introduction at HMS Genetics
Harvard Medical School Genetics Leadership Summit 2013 Fall Meeting.

By: Reese Jones

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Tent-op 2 - Canadian Connoisseur Genetics. Fireberry OG Kush, Bio Diesel
Here is going into week 5 ( day 33 of flower) and my new clones for next round at 3.5 weeks into veg from being 2 inches tall.

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Minecraft FTB Horizons - Advanced Genetics - S3E14
I #39;m a geneticist! http://feed-the-beast.com/ Installation - https://www.youtube.com/watch?v=TjPKkgZI2H0 Minecraft: https://minecraft.net/ Minecraft.net forum...

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DNA Genetics / Big Buddha TrueCanna Genetics / Greenhouse Seeds Seminar PART 3 Cannabis Cup 2013
http://andrew.pyrah.net Thanks for watching! COMMENT and LIKE if you enjoyed the video and SUBSCRIBE to see my new videos as they are released. This video is...

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DNA Genetics / Big Buddha TrueCanna Genetics / Greenhouse Seeds Seminar PART 3 Cannabis Cup 2013 - Video

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DEKALB Genetics Dealer Recruiting Informational Video
An informational video supplied to perspective DEKALB Genetic #39;s seed dealers.

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Amid somewhat of a renaissance in drug development for orphan diseases, another gene therapy company announced funding today for a potential treatment for a rare neurodegenerative condition called Friedreichs ataxia (FRDA).

Agilis Biotherapeutics said its raised $8 million and will work with synthetic biology company Intrexon Corp. to develop gene therapies and genetically modified cell therapies for FRDA. Whereas current treatments focus on minimizing symptoms of the disease, the partners expect their drugs to be able to target the underlying disease mechanisms.

FRDA is caused by a genetic defect that results in limited production of frataxin, a protein thought to help assemble clusters of iron and sulfur molecules in cells that are necessary for the function of many other proteins. When cells are deficient of frataxin, they may not function properly, causing damage to the nervous system and problems with movement. Most people with the disease become wheelchair-bound within two decades of diagnosis, and many die early due to weakened heart muscles.

The goal for Agilis and Intrexon is to use Intrexons gene switch technology to develop drugs that will repair the defective gene and enable increased production of the frataxin protein. Under the options of the deal, Agilis and Intrexon could add another rare genetic disease to the collaboration.

Ahead of the pair in developing new treatments for the rare disease are ViroPharma, which is in Phase 1 development of a small molecule drug for FA, and Edison Phamaceuticals, which is conducting a Phase 2 study of its drug.

[Image credit: LendingMemo.com]

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Spinal cord injury C5-C6(incomplete) bed mobility 29nov14
Have tried to document the progress made by one of our clients, who had a C5-C6 incomplete spinal cord injury at Punar Thiran. this is part of a series i am planning to post. look our for...

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Four year old Hannah Day has spent most of her young life in and out of hospital.

She has Leukemia and its the second time in as many years that she is battling cancer.

She underwent 15 months of chemotherapy for a tumour in her stomach, but weeks later was diagnosed with Leukemia. Hannahs family says her only hope for survival is a stem-cell transplant, but neither her sister nor her parents are a perfect match, so theyre hoping a donor will be found. They set up a web page called Angels for Hannah to try and find a donor.

A stem-cell transplant is her last chance.

To become a stem-cell donor you can fill out a questionnaire online if youre between the ages of 17 and 35, and youll be sent a kit in the mail. A swab of your cheeks will reveal if youre a suitable donor. Once identified as a match, donors will undergo one of two procedures. Stem cells can be harvested from bone marrow under general anesthetic, or throughperipheral blood stem cell donation.

The donor does not experience pain during either procedure.

Our age criteria is 17 to 35 to register, saysMary Lynn Pride from Canadian Blood Services. So were really looking to those young people to step forward to provide an opportunity to help patients like Hannah who are in need. Were also asking young men to step forward because we do have a particular need for young men to register as they have been deemed as the optimal donor patients in need of transplant.

Pride says generally men produce a higher volume of stem cells for donation but also post-transplant there is better recovery for patients with a male donor over a female donor.

We do know that younger donors provide better post-transplant recovery for patients as well as the longevity of ensuring that they are on the registry longer to support patients in need, she says.

Canada currently has 326,000 people who are already registered as potential stem-cell donors. Hannah is one of 750 Canadians who are currently awaiting a stem-cell transplant.

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Back to basicsCaveman workout is the choice for functional training.

Swim, bike and runtriathlon became even more popular in 2013.

It was the year stem cell therapy became a household name.

Although the science has been around for half a century in Europe, it was not until the Asian Institute of Longevity Medicine (AILM) opened its doors to Filipinos in 2009 that stem cell therapy took off in the country.

Today, AILMs German-based partner, Tissue and Cell Banking (Ticeba), headed by its founder and managing director Dr. Christoph Ganss, is one of the countrys most sought-after stem cell therapy consultants.

If you think that, because of its exceedingly high price tag, stem cell therapy would catch on only among the well-heeled, think again. Entrepreneurial Pinoys saw the potential moneymaker in the name, and soon peddlers began brandishing everything from stem cell water to stem cell fertility kits.

Another top hit of 2013 is juicing/detox. Now a multibillion-dollar industry in the United States, juicingwhile it has been practiced by many vegans and vegetarians in the Philippines since the early 2000sbecame big this year when the Australian documentary filmmaker and juicing advocate Joe Cross visited the country.

Today, there are three major competing organic juice brands on the market.

Organic produce

Vegan food the five-star way

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Stem cells, juicing, Piloxing, triathlon, workout apps–health and wellness on overdrive

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