[PAGID] XLA Cord Blood

[Mark Ballow]

I agree. Collect the cord blood for the reasons stated.

MB
-- 
Mark Ballow, MD
Chief, Division of Allergy and Immunology
Department of Pediatrics
State University of New York at Buffalo (SUNY Buffalo)
Women and Children's Hospital of Buffalo
219 Bryant St
Buffalo, NY 14222
716-878-7105 (office)
716-888-3841 (fax)
E-mail - mballow at upa.chob.edu; ballow at buffalo.edu
    
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From: "Sorensen, Ricardo" <RSoren at lsuhsc.edu>
Reply-To: <pagid at list.clinimmsoc.org>
Date: Wed, 20 Jun 2007 17:12:40 -0500
To: <pagid at list.clinimmsoc.org>
Conversation: XLA Cord Blood
Subject: [PAGID] XLA Cord Blood

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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