The beneficence of neonatal hematopoiesis

Article Abstract:

As early as the first few weeks after conception the yolk sac of the human embryo begins to manufacture red blood cells. These cells are produced by a small population of highly specialized hematopoietic stem cells. Slowly, the production of red blood cells moves first to the liver and then to other organs of the fetus including the spleen, lymph nodes and kidney, as well as the marrow spaces of bones. The total volume of hematopoietic or blood-forming tissue at birth is nearly equivalent to the volume that is found in an adult. Conceptually the body appears to grow around this supply. Research has shown that the blood of late fetuses and newborn infants contains a small but significant quantity of hematopoietic stem cells in addition to normal circulating blood cells. This fact has been exploited recently when blood was taken from the umbilical cord and placenta of a normal newborn infant, frozen for later use, and used to seed the marrow of a sibling with a genetically caused aplastic anemia. The procedure was carried out using conventional bone marrow transplant techniques and brought a successful result with minor complications. This study shows that human material that is usually discarded can, in selective cases, be used for transplantation. Although successful in this case, the general value of this technique is probably restricted, and the report is probably more important for showing the degree to which bone-forming cells can be saved using cryopreservation (freezing) techniques.

Fetus, Placenta, Umbilical cord, editorial

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Analysis of 462 transplantations from unrelated donors facilitated by the National Marrow Donor Program

Article Abstract:

A bone marrow transplant from an unrelated donor can prolong the survival of patients with leukemia and other disorders affecting the bone marrow. Data were collected from the National Marrow Donor Program on 462 patients treated with bone marrow donated by an unrelated donor between Dec 1987 and Nov 1990. Most had some type of leukemia. Over 90% of the patients' grafts began functioning within 100 days of transplantation. Almost two-thirds suffered from mild to severe graft-versus-host-disease (GVHD), which occurs when the transplanted bone marrow attacks the recipient's tissues. After an average of 1 1/2 years, 20% to 40% of the leukemia patients were still alive. Almost 30% of the patients with aplastic anemia were still alive. By Sep 1991, 66% of the patients had died, most from infection or GVHD. Only 14% died from a recurrence of their disease.

Care and treatment, Leukemia

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Clonal hematopoiesis demonstrated by x-linked DNA polymorphisms after allogeneic bone marrow transplantation

Article Abstract:

Transplantation of bone marrow that is different from the marrow it replaces can successfully replace the old marrow and produce blood cells. All the patients in the investigation were being treated for leukemia or lymphoma. After transplantation, some of the blood of ten out of twelve patients showed traces of having been produced by the transplanted marrow. One of the other two patients had few or no blood cells produced by the transplanted marrow, while the other had most of his blood cells produced by the transplanted marrow. The second patient's blood remained in this condition for nine months.

Physiological aspects, DNA, Hemoglobins, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Hemoglobin polymorphisms, Homografts

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