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MARROW page 46
blood withdrawn from the body,
and the remaining blood is re-
diation to wipe out their immune transfused into the patient. The
system and the diseased bone amount of marrow obtained with
marrow. Afterwards, they are this method can be seven to 10
given an infusion of marrow, times greater than from the
which contains stem cells, pre- bones.
In the new BMT protocol, the
cursors of all the cells in the
blood. In leukemia — a cancer- collected marrow is treated us-
like disease characterized by ing a method developed by Pro-
blood cell abnormalities — the fessor Reisner some 10 years ago
hope is that the transplanted to enable "bubble" children with
donor narrow will create a severe combined immunodefi-
healthy blood system in the pa- ciency diseases (SCID) to under-
tient, thus curing the disease. go BMT. The process — which
Marrow transplants from un- was also used in treating sever-
matched donors, however, have al victims of the nuclear accident
been problematic because despite at Chernobyl — involves the ap-
pretreatment, patients can main- plication of soybean-derived
tain some residual immunity lectin to the marrow in order to
that recognizes the incompatible eliminate certain white blood
marrow as "foreign" and rejects cells called T lymphocytes that
would otherwise attack the re-
it.
cipient's tissues, causing a se-
vere complication known as
graft-versus-host disease.
Prior to the transplanta-
tion, patients undergo a "con-
ditioning" regimen of drug
and radiation therapy as in
conventional BMT, but with
all of its aspects having been
"fine-tuned" and specifically
adapted to unmatched trans-
plants during several years of
animal studies at the Weiz-
mann and clinical studies in
Perugia.
Although the Reisner-
Martelli method has thus far
been tried only in people with
leukemia, in the future it may
be modified to treat non-
cancerous blood disorders,
such as sickle-cell anemia. At
present, the need to deliver
high doses of radiation prior
to BMT rules out the use of
this procedure for nonlethal
diseases. However, since ex-
Professor Yair Reisner
periments in mice suggest
that radiation "conditioning"
Professors Reisner and can be reduced thanks to the use
Martelli have now overcome this of the "megadose" marrow infu-
problem by means of "megados- sions, it is hoped that BMT may
es" of donor marrow, which had become a viable option for such
been shown in Professor Reis- disorders. Moreover, the mega-
ner's earlier animal studies to dose approach may also be used
reduce donor-recipient incom- in the future to facilitate organ
patibility. Such doses appear to transplantation, as successful
be effective because they give BMT performed prior to the pro-
donor cells an edge in their com- cedure induces tolerance towards
petition with recipient cells, thus transplanted organs. ❑
minimizing the risk of rejection.
However, the amount of mar-
row obtained via the usual
method — aspiration from the
Do you have an item for "Hot
spinal cord — is limited. There-
Shots"? "Hot Shots" is a period-
fore, to obtain megadoses of mar-
row cells the researchers
ic column recognizing medical
borrowed a technique used in au-
profesSionals for achievements in
tologous BMT, in which a patient
their field. Please send items to
receives a transplant of his or her
Ruth Littmann at The Jewish
own marrow. It consists of giv-
News, 27676 Franklin, Southfield,
ing the person hormonal drugs
MI 48034. A picture would be ap-
called cytokines, which increase
the number of stem cells in the
preciated. It can be color or black-
blood by mobilizing them from
and-white, but it must be in focus.
the bone marrow. These cells can
If you wish to have the picture re-
then be collected from peripher-
turned, you must enclose a self-
al blood by leukapheresis — a
addressed, stamped envelope.
procedure in which certain cells
are selectively removed from
lethal. In this treatment, patients
receive powerful drugs and ra-
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