Rocha Vanderson, Wagner John E, et al (For the Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources)
Graft-versus-Host Disease in Children who have received a Cord Blood or Bone Marrow Transplant from an HLA-Identical Sibling.
New Engl. Jr of Medicine 342(25), June 22, 2000.
After destruction of bone marrow, transplantation of bone marrow becomes necessary. Transplantation of bone marrow is done and very often donor bone marrow takes over the hematological and immunological functions giving what is known as graft-versus-host rejection. Even the most accurate HLA matching of the donor’s blood or bone marrow has not given good results. The best results have now been obtained by transplanting cord blood into the host bone marrow space.
The HLA cord blood from a sibling (brother or sister) contributes stem cell, which forms a new bone marrow of the recipient and prevents the graft versus host rejection.
AK Stewart, AC Schuh (Department of Medical Oncology, Princess Margaret Hospital and Department of Medicine, University of Toronto, Ontario, Canada.
White cells 2: Impact of understanding the molecular basis of haematological malignant disorders on clinical practice.
The Lancet 2000; 22 April, 355:p.1447-53
– The molecular basis of many leukaemias is now known, allowing precise diagnosis.
– Treatment of chronic myeloid leukaemia is now possible by targeting of the BCR-ABL tyrosine Kinase.
– The underlying molecular abnormalities in acute leukaemias allow the outlook for individual patients to be assessed at
diagnosis and therapy tailored accordingly.
Analysis of VH genes in B-cell malignant disorders allows these to be placed in the hierarchy of B-cell development and may provide prognostically valuable information.
Recombinant Human Erythropoietin Therapy for Treatment of Anemia of Prematurity in very Low Birth Weight Infants: A Randomised, Doble- blind, Placebo - Contolled Trial
J Perinatol 18: 173- 177, 1998
Despite several clinical trials uncertainty still exists about the routine use of erythropoitin (EPO) in the treatment of anemia of prematurity. It is also not clear whether all low birthweight infants would benefit.
The present study is randomised , double- blind, placebo controlled trial to evaluate the safety and efficacy of Recombinant human erythropoitin (rHuEpo) in very low birth weight infants with anemia of prematurity.
It was observed that rHuEpo given twice a week decreased significantly the need for erythrocyte transfusion in very low birth weight infants. However, this therapy was associated with significant decline in serum ferritin levels. Therefore there is a need to determine the dose of iron supplementation in these patients.
Salima Hacein-Bey-Abina, Francoise Le Deist, et al
Sustained Correction of X-Linked Severe Combined Immunodeficiency by Ex Vivo Gene Therapy
New Eng J Med. Vol.346, April 18, 2002, pg.1185-93
X-linked severe combined immunodeficiency due to a mutation in the gene encoding the common g (gc) chain is a lethal condition that can be cured by allogeneic stem-cell transplantation. The authors investigated whether infusion of autologous hematopoietic stem cells that had been transduced in vitro with the gc gene can restore the immune system in patients with severe combined immunodeficiency.
CD34+ bone marrow cells from five boys with X-linked severe combined immunodeficiency were transduced ex vivo with the use of a defective retroviral vector. Integration and expression of the gc transgene and development of lymphocyte subgroups and their functions were sequentially analyzed over a period of up to 2.5 years after gene transfer.
No adverse effects resulted from the procedure. Ex vivo gene therapy with gc can safely correct the immune deficiency of patients with X-linked severe combined immunodeficiency.