Thursday, February 21, 2008

Use Of Cord Blood To Cure Leukemia

Use Of Cord Blood To Cure Leukemia By Kerwin A Chang

A three-year-old leukemia victim was given a life-saving infusion of her own cord blood, marking the first time a child with this disease served as their own blood donor, American doctors said.

The little girl is now a thriving six-year-old -- a tribute, say her doctors, to the pioneering transplant that helped her recover from radical chemotherapy.

They also commended the foresight of her parents who decided to save some of her umbilical cord on the off chance it might be needed later.

"There's a good chance the procedure saved her life.

She is in remission and has an excellent chance of being cured," said Ammar Hayani, the pediatric oncologist who treated the youngster at Advocate Hope Children's Hospital in Oak Lawn, Ill.

In 2003, the little girl was diagnosed with the most common childhood cancer, acute lymphoblastic leukemia, and began long-term chemotherapy treatment.

She quickly went into remission, but 10 months later the cancer was back, and this time it had spread to her spine, a worrying development that signaled the leukemia was a particularly aggressive kind that would probably not respond well to treatment, Hayani said.

Her doctors responded with a more aggressive chemotherapy protocol and full-body radiation, and then looked around for ways to replace the blood system they had wiped out.

Ordinarily they would have had to choose between a blood or bone marrow transplant from a family member or unrelated donor, but in this case, the family members were not a match.

And rather than use material from an unrelated donor, with the corresponding risk of life-long complications, they opted to take the controversial and risky step of transplanting the girl's own cord blood, which had been frozen and stored at a private blood bank several years following her birth in 1999."We were in unchartered territory," said Hayani.

"We couldn't predict with any certainty whether the operation would be successful. We had no concrete data, but the parents felt very comfortable with it, so we went ahead.

"The procedure was not without risk, because even though the cord blood was screened to ensure it did not contain any cancerous cells, the screening techniques are not 100 percent accurate, Hayani explained.

Still, the child's parents weighed the risks and gambled that their daughter's own stem cells, contained in her cord blood, would benefit her more than stem cells harvested from the bone marrow or blood of strangers.

The results so far suggest they made the right call, said Hayani who reported on the girl's case in a paper that appears in the January issue of the journal Pediatrics.

"It's hard to argue with success. Relapse seems very unlikely at this point, and she has an excellent quality of life, much better than if she had taken stem cells from a donor