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Pioneering Umbilical Cord Blood Transplant Looks Promising, Researcher Says

September 27, 1993

NEW YORK (AP) _ When it came time to replace the bone marrow of 3-year-old Derick Pritchard, whose own marrow was destroyed by chemotherapy and radiation for his leukemia, doctors used an unusual source.

They injected him last month with blood from the umbilical cord and placenta of an unrelated newborn. The blood cells have now replaced his marrow, a researcher said, boosting hopes for developing an alternative to some marrow transplants.

It will take a couple years to know if Derick’s leukemia is in long-term remission, but for now ″the fact that this cord blood could make his bone marrow grow is really very important,″ said Dr. Joanne Kurtzberg of Duke University Medical Center in Durham, N.C.

Derick remains hospitalized, but may be allowed to become an outpatient in a week or two.

Before the blood transplant on Aug. 24, Air Force Staff Sgt. Steven Pritchard and his wife, Susan, had been told that their son would be the first person to get umbilical cord blood from an unrelated donor.

″We didn’t care about that,″ Pritchard said Monday in a telephone interview from the medical center. ″All we cared about was this was the last chance for our son.

″He’s a fighter, he wants to fight it, so we’ll fight with him,″ added Pritchard, who is based at Randolph Air Force Base near San Antonio.

Transplants of cord blood, which is collected after birth and actually comes mostly from the placenta, had been done before. Derick’s is significant because the blood came not from a newborn sibling, but from a specialized blood bank.

His transplant appears to be the first in the world to use blood from an unrelated donor and follow standard procedures of Western medicine, said Dr. John Wagner of the University of Minnesota, who keeps an international registry of cord blood transplants.

Reports of similar procedures in China are still sketchy, he said.

Sibling blood generally is used to improve the chances for a good match. But if donations from unrelated newborns can work too, cord blood banks may prove useful when patients have no suitable relative to donate the blood or marrow. And that is most of the time.

Such patients now can get marrow transplants from unrelated donors, but suitable donors aren’t always available. Besides, cord blood could be more easily obtained than marrow and delivered more quickly when the need arises, some scientists say.

In Derick’s case, ″there really was no time to look for a marrow donor because he was in relapse,″ Kurtzberg said.

Bone marrow transplants are usually performed on cancer patients whose own marrow is destroyed by chemotherapy and radiation treatments.

Dr. Craig Howe, chief executive officer of the National Marrow Donor Program, which seeks unrelated marrow donors, said the idea of cord blood banks has sparked enthusiasm in the transplant community. But he said many questions about their potential have yet to be answered.

For example, he said, frozen storage of cord blood is expensive, and it is not yet clear whether a unit of cord blood will be enough to rebuild an adult’s marrow.

Blood for Derick was found at the New York Blood Center’s Lindsley F. Kimball Research Institute, which is storing almost 1,000 units of cord blood, said project director Dr. Pablo Rubinstein.

The cord blood project, funded by the National Heart, Lung and Blood Institute, is now seeking matches for about 200 other patients, he said.

The institute’s cord blood bank is the only one of any substantial size in the nation that has been recognized by transplant centers, Wagner said.

Cord blood transplants provide stem cells, which give rise to the various types of cells found in marrow. The marrow supplies blood cells for the body.

Derick received about 20 teaspoons of the blood over about 15 minutes.

Once cord blood is injected, the stem cells take up residence in the bone in just a few minutes. They take about a month to start producing cells for the blood.

A second patient at Duke was transplanted with cord blood from an unrelated donor two weeks ago, Kurtzberg said.