Biomedical Engineering Reference
In-Depth Information
leprosy victims. This value returned to normal within three months in most cases
(80%) [Bhattacharya (39)].
Another study attempted to ascertain the fate of hematopoietic stem cells
(CD34) after placental umbilical cord whole blood transfusion, as assessed from
the peripheral blood CD34 level 72 hours after cord blood transfusion in sex- and
HLA-randomized patients and its prognostic implications.
In a small study of six cases of cancer patients, a patient with breast sarcoma
received the lowest amount of cord blood (six units), while another patient with
breast cancer received the largest amount (32 units). The youngest patient, a
16 - year - old boy suffering from non - Hodgkin ' s lymphoma, received eight units of
cord blood to combat anemia. Other patients received amounts varying from
7-15 units: a patient with metachronous lymph node metastasis received 15 units,
another patient suffering from breast cancer received 14 units, and one with lung
cancer received seven units. There was no transfusion-related clinical immuno-
logical or nonimmunological reaction. Studies of CD34 levels showed an initial
rise followed by a fall in two cases, two cases registered very little effect on the
CD34 level, that is, no change from the baseline, and one case demonstrated a
very slow rise from the baseline. However, one case showed a frequent steep rise
up to 99% and a sustained high CD34 level. This patient is alive with clinical
remission of the disease [Bhattacharya (40)]. These reports of ABO matched
HLA randomized transfusion with varying degrees of transplant impact on the
host raises serious questions about the requirement of myeloablation [Riordan
et al. (41) ].
19.9 CONCLUSION
There are about 100 million births per year globally. In India alone there are more
than 20 million births, which implies production of that many placentas. These are
normally thrown away. However, one of the products of the placenta is cord
blood, which has immense potential.
Hematopietic stem cells from cord blood are now harvested in many labora-
tories all over the world and stored in cord blood banks, but they constitute only
.01% of the nucleated cells of the cord blood. The rest, that is 99.99% of the
blood, which is wasted, is rich in fetal hemoglobin, growth factors and cytokine-
fi lled plasma. Moreover, in the womb, the fetus benefi ts from the mother's in-built
defenses against diseases and the placental environment is basically infection free
in the case of a healthy newborn.
To combat the emergency requirement of blood in natural or man-made
disaster management, both civil and military, these precious hypo-immune fetal
cells with an altered metabolic profi le are a gift of nature, entrapped inside the
placenta. Moreover, placental cord blood itself could be a readily available source
of blood not only in the under-resourced countries of the world, but also in
case of any genuine requirement for a blood substitute anywhere in the world,
especially at times of crisis.
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