[PAGID] XLA Cord Blood

[Sorensen, Ricardo]

Hi everybody,

 

Mary Ellen and I thought that the following exchange of ideas may be of
interest to you and elicit further comments and suggestions:

 

Hi Mary-Ellen,

 

I have an important question for you:

 

We have a little patient with XLA that is going to have a brother in
October (the parents were not interested in any form of ante-natal
testing).

 

We were preparing to arrange for a cord blood sample to check for B
cells when the question came up if we should not save the cord for
possible later use as stem cell source in case baby #2 is healthy AND
HLA compatible. I do know that transplantation is not available jet, but
I did not want to miss a possible opportunity to have a potentially
ideal healthy stem cell source in the future.

 

Should we even mention the possibility to save cord blood for the rather
small possibility of having a healthy, HLA matched brother for an even
less likely future use as a stem cell source?

 

I would appreciate your opinion about this issue.

 

Ricardo


Hi Ricardo,

 

I agree with you, I think it is a good idea to save the cord.  If the
new baby is an HLA match, he might be a donor in the future.  If the new
baby is affected, maybe the cord could be used for gene therapy.  We
have used the center in Oakland for cord blood for our families.

 

We usually have the family bring the new baby in by 6 weeks of age to
evaluate and we try to start gammaglobulin before 10 weeks of age.
About 10% of patients with sporadic XLA are hospitalized for infection
at less than 6 months of age so we push for early therapy.

 

Mary Ellen

 

PS. I think you are right - cord blood collection might be a topic that
elicited an interesting discussion.  Would you be willing to start it
(just like your note to me - I've got a mom who is going to deliver.
Should we use the cord for diagnosis or save it?).

	 

		 

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