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But Cryo-Cell's definition of "success" is surprisingly narrow: This means simply that the blood the company stored was thawed effectively and used.
Maass won't give an exact number of patients whose diseases have been cured by Cryo-Cell cord blood. And when asked whether any of the six children using autologous transfusions were cured by the blood transfusions, Maass says no.
"All of them are of course highly experimental and haven't been reduced to clinical participation," he says. "Did we cure diabetes with those two transplants? Not to my knowledge. Our job is to collect blood and make sure that after it's frozen, it's thawed out and administered. The only thing that we put on our website is whether the graft was viable when it was thawed."
In other words, whether they did any good once transplanted isn't Cryo-Cell's business.
On a recent Thursday afternoon, the spacious waiting room of Royal Palm OB/GYN in Coral Springs is packed with young families and expectant mothers. Toddlers doze and heavily pregnant women shift uncomfortably as crisp orderlies call out the names of patients. In the middle of the room, a basket of dog-eared pregnancy magazines is topped with a creamy-white brochure for Cryo-Cell International. On its cover, along with the liquid eyes of newborns, is the company's slogan: "Imagine. Believe. Expect. Miracles of Umbilical Cord Blood."
Plastic sleeves stuffed with Cryo-Cell brochures adorn other surfaces, including front and center at the checkout desk. It's clear that Royal Palm OB/GYN has followed Cryo-Cell's suggestion to "brand" itself a Cryo-Cell practice.
When Zafran appears, he is short, sprightly, and almost elfin, with boyish cheeks and a winning smile. He whisks into a quiet corner office, sits, and begins listing the virtues of cord blood.
"Leukemia, lymphoma, sickle cell anemia has been cured," he says. "The scientific community believes that there is significant value in umbilical cord blood for stem cells.
"The debate is who is going to store it and how you're going to store it. Is the government going to pay for this? There aren't many public banks. Right now, if you have a child and you want to donate to a public bank, there are very few."
Zafran explains that he's been involved with Cryo-Cell on a "consultant basis" for six to seven years. He came to believe in the promise of cord blood in the late 1990s, soon after his father's death from acute leukemia, when stem cell therapies were on his mind. After writing to Cryo-Cell's then-CEO, Daniel Richard, and visiting the company's facility, Cryo-Cell proposed a partnership Zafran would become a medical adviser. Zafran agreed. Since then, 300 to 400 families from Zafran's practice have stored cord blood at Cryo-Cell.
"I go each year to the American College of Obstetricians and Gynecologists' national meeting, partially for myself and partially as a spokesperson for the company," he says.
When asked if spokesperson is his official title at Cryo-Cell, Zafran looks pained.
"Well, I hate to call it that," he says. "I would say just a consultant."
Both he and Cryo-Cell didn't answer specific questions about compensation for his services. "I do get compensated... like a consultant fee," Zafran says. "I would say it's sort of a usual and customary kind of thing."
"That's company business," says Gerald Maass, the Cryo-Cell VP. "It's a traditional doctor consulting fee."
Though laws and ethics rules prohibit doctors from benefiting financially from the sale of a particular drug or procedure, companies routinely get around such strictures by giving gifts to doctor's offices, paying doctors handsome fees for attending "educational" seminars in exotic locales, and, as the New York Times has recently reported, buying just about every MD in the country a free lunch.
And because Cryo-Cell isn't a drug company, rules governing its relationships with physicians are even more porous.
"It's not illegal," says Arthur Caplan, a professor of bioethics at the University of Pennsylvania. Unlike a drug, banked cord blood isn't immediately used. "This is something you're storing for future use, so it's held to a laxer standard."
At the same time that Maass insists that Zafran's arrangement is common in the industry and aboveboard, he hints that his competitors don't have the same scruples, with some even offering doctors blatant kickbacks. Zafran and Cryo-Cell point out that Zafran is merely paid for his participation as a member of the company's Medical and Scientific Advisory Board, never for individual referrals.
And Zafran points out that when he does act as spokesman, he doesn't necessarily promote Cryo-Cell but cord blood banking in general. That was the case in 2001, when Cryo-Cell paid Zafran, along with Minnesota Viking Cris Carter, to co-chair the company's "Save the Stem Cells Campaign." Cryo-Cell flew Zafran to Minnesota to "increase public awareness about umbilical cord blood as a non-controversial, readily available source of stem cells," according to a press release. Zafran and Maass, however, seem reluctant to discuss the Save the Stem Cells campaign, saying that it wasn't successful.
New Times spoke to several doctors and ethicists who say that even indirect financial involvement in a private cord blood bank constitutes a conflict of interest. But even if these conflicts are unethical, they aren't illegal, so most doctors in private practice are policed only by themselves.