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EDITORIALS: S J Proctor, A M Dickinson, T Parekh, and C Chapman Umbilical cord blood banks in the UK BMJ 2001; 323: 60-61 [Full text]

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True value of cord blood banks

Gareth Morgan   (1 August 2001)

Do not discard 99.99%of the human placental umbilical cord blood for the sake of stem cells only

Niranjan Bhattacharya   (6 October 2001)

True value of cord blood banks 1 August 2001
Gareth Morgan, clinical scientist MRC Laboratories, The Gambia Send response to journal: Re: True value of cord blood banks	To quote the patient with SCID from Dublin as the 'true value' of cord blood banks is misleading. Such patients both accept grafts more easily and are less at risk than all other categories of transplant recipients. The disorder is extremely rare, thus both in financial terms and as an indicator of the value of cord blood transplants to most recipients this is a poor example.
Do not discard 99.99%of the human placental umbilical cord blood for the sake of stem cells only 6 October 2001
Niranjan Bhattacharya, Surgeon and Superintendent Bijoygarh State Hospital, Calcutta,India Send response to journal: Re: Do not discard 99.99%of the human placental umbilical cord blood for the sake of stem cells only	To The Editor,BMJ, Dear Sir, Thank you very much for publishing a very interesting editorial by Drs.SJ Proctor,AM Dickinson,T Parekh and C Chapman in BMJ,2001;323:60-1(14 July).While the emphasis in this article is on stem cells, which constitute only 0.01% of the nucleated cells in the umbilical cord blood, the use of other cells which constitute 99.9% of the umbilical cord whole blood has not been mentioned.Our group of clinicians and researchers have been working in Calcutta on freshly collected placental cord whole blood transfusion,which is a rich source of fetal haemoglobin,growth factor and cytokine rich plasma as well as other nucleated cells,of which stem cells are an important constituent.We have been working on this project,which is funded by the Dept.of Science and Technology,Govt.of West Bengal,India, since 1st April 1999.Till date we have transfused 296 units of umbilical cord whole blood after following the standard blood transfusion protocol, and have not come across any adverse immunological or non-immunological reactions.The first 174 units of placental umbilical cord whole blood transfusion in 62 patients as a rich source of fetal haemoglobin supply was published in "Clinical and Experimental Obstetrics and Gynecology",vol.28,no.1,2001. We wish to point out some of our findings to you, which may give a better perspective on the uses of placental umbilical cord whole blood.(a) We have safely utilized placental umbilical cord whole blood in 108 human volunteers,so far, with different indications of standard blood transfusion;(b)we wish to reiterate the fact that fetal haemoglobin can carry more oxygen, which is an added advantage in critically ill patients admitted in ITU/ICCU/RCU.(c)We have also observed that on an average 100ml of placental blood can be collected from one term sized placenta and it has an oxygen carrying capacity of 30 to 50% more than standard adult blood.(d)Further,our observation is that in case of renal failure or severe anaemia,where adult blood transfusion in adequate amounts can risk the precipitation of heart failure,fetal haemoglobin rich cord blood transfusion may help clinicians to control the situation in a better way. Moreover, the number of geriatric patients is increasing all over the world.They may get(e)a fresh lease of life in case of varying degree of bone marrow's(?)senescence or functional failure through the transfusion of hypo-antigenic stem cell rich umbilical cord whole blood.(f)Terminal cancer patients too can have an extesion of life through this type of transfusion,utilizing nature's best available biological sieve,i.e., the placenta. And lastly,(g)we may get more information about fetal tissue- adult tisue interaction and gene switching mechanism as a result of this method of transfusion. Sincerely yours, Dr.NIRANJAN BHATTACHARYA,MBBS,MD,MS,FACS(Principal Investigator) Dr.TARASHANKAR BANDOPADHYAY,Ph.D. Dr.MAHUA BHATTACHARYA,MBBS,DA,DGO Dr.SANJUKTA BHATTACHARYA,Ph.D.