Great Ormond Street stem cell freezing 'may have led to death'
A problem freezing stem cells may have contributed to the death of a 12-year-old girl, a coroner has ruled.
Cancer patient Sophie Ryan-Palmer died in 2013 after the frozen cells were used in a bone marrow transplant at Great Ormond Street Hospital.
Three other children also died, but a more successful grafting of the cells would not have prevented their deaths, the coroner said.
Eight children in total had problems after the treatment, the inquest heard.
Great Ormond Street Hospital said tests carried out before the transplants had found no problems.
The court heard the hospital had been freezing the stem cells using the same method for 10 years.
But in June 2013 concerns were first raised after Sophie, from Sunbury, Surrey, did not make progress after she had the treatment.
In July of that year, 13-month-old Ryan Loughran from Bournemouth died. Sophie died a week later on 17 July while four-year-old Katie Joyce, from Hertfordshire, died in October.
Five-year-old Muhanna al-Hayany, who had come from Kuwait for treatment, died in August 2014.
All were treated at the hospital at the same time, but the inquest heard they died at different times because of their differing illnesses.
The treatment was stopped in October.
Coroner Mary Hassell ruled that the treatment may have contributed to Sophie's death, however it was "unclear".
She said the other three children were so seriously ill that the stem cell treatment would not have changed the outcome.
The court heard that the hospital could not find the reason why the process was no longer working, but an expert from University College London found the stem cells were not maturing properly.
"We don't know why the method stopped working, and there's no widespread consensus," said Ms Hassell.
Sophie's mother Debbie Ryan said: "It's a lot of 'don't know, we don't know why', which to me is not good enough, not in this day and age.
"Great Ormond Street have been fantastic to save her over the years, I won't put them down for that, but unfortunately I feel that at the last hurdle they let her down badly."
A hospital statement said: "We understand that this has been an immensely distressing process for all of the families involved.
"These four young patients were extremely poorly children with complex conditions, and it is frustrating for everyone concerned, especially their families, for it still to be unclear exactly what caused the freezing problem and to what extent this might have contributed to one patient's eventual outcome."
It said it had now re-introduced freezing of cells using an alternative method which is being closely monitored.
The hospital now holds meetings every month - instead of every six months - to review the treatment.
It also said it would listen to the opinion of scientists as well as consultants.
The coroner added that she would be preparing a prevention of future deaths report for NHS England.
What are stem cells?
- Stem cells are very immature cells which are made by the bone marrow and can grow into the many different types of cell that are found in the body - from bone to blood or skin, for example.
- Doctors can take a sample of these cells and freeze them so they can be used as a treatment at a later date.
- Children with leukaemia may have this treatment after they have had chemotherapy - chemotherapy kills off healthy bone marrow cells as well as cancerous ones.
- Stem cell transplants are similar to bone marrow transplants, replenishing the cells that have been lost.
- The way that stem cells are frozen, stored and then defrosted for use is important because there is a chance that the cells can be damaged in the process.
Source: BBC Health