Rapid Responses to:

EDITORIALS: Diana N J Lockwood and Bhushan Kumar Treatment of leprosy BMJ 2004; 328: 1447-1448 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

A preliminary Study report on Placental Umbilical cord blood transfusion in victims of anemia with Leprosy in Underresourced regions of the World

Niranjan Bhattacharya DSc, MBBS, MD, MS, FACS(USA), Mukherjee K.L,Chettri, M.K.,Bhattacharya S,Samanta B, Nandi, R,Biswas Tuli, Sen Gargi, Chatterjee Moloy,Pal Subrato,Banerjee T, Bhattacharya M,Maity C.R,Sharma Ardhendu, Joarder Siddhartha   (22 June 2004)

A preliminary Study report on Placental Umbilical cord blood transfusion in victims of anemia with Leprosy in Underresourced regions of the World 22 June 2004
Niranjan Bhattacharya DSc, MBBS, MD, MS, FACS(USA), Surgeon and Superintendent Bijoygarh State Hospital,Calcutta 700032, India, Mukherjee K.L,Chettri, M.K.,Bhattacharya S,Samanta B, Nandi, R,Biswas Tuli, Sen Gargi, Chatterjee Moloy,Pal Subrato,Banerjee T, Bhattacharya M,Maity C.R,Sharma Ardhendu, Joarder Siddhartha Send response to journal: Re: A preliminary Study report on Placental Umbilical cord blood transfusion in victims of anemia with Leprosy in Underresourced regions of the World	Thank you very much for publishing an interesting article on the treatment of Leprosy by Dr Diana.N.G.Lockhood and Prof Bhusan Kumar(BMJ 2004;328:1447-1448. 19th June).Leprosy is almost exclusively a disease of the developing world with 80percent of its victims reside in India,China,Indonesia, Myanmar,Brazil, Nigeria etc.The disease is practically absent in USA(Less than 200 cases detected from outsiders per year.)Poverty,rural background and its impact on socioeconomic,educational and nutritional background is very important for the long incubation and transmission of the disease.We are a group of investigators from Calcutta India) working on the problem of anemia (7 Gm or less Hemoglobin) among the Leprosy victims undergoing treatment.Varying degree of anemia is very much prevalent in patients of Leprosy which could be due to background malnutrition,coexistent diseases like helminthiasis or drug impact on the immune system,( including the bone marrow) , poor red cell survival,and rarely Glucose –6- phosphate dehydrogenase deficiency (Dapsone therapy). We have treated so far 12 cases (10 male+ 2 female ,Age 12-76 yrs,mean 46.4 yrs with S.D 12 yrs ,4 case pausi and 8 case multibacillary type ,clinical spectrum widely varying from tuberculoid to Lepromatous type and one patient presented with autoamputation of the leg and infested with maggots. In the present series we collected placental umbilical cord whole blood after LUCS from consenting mothers and transfused these placental umbilical cord whole blood (Vol 56-136 ml mean 81ml and 12 ml S.D) to leprosy victim with anemia within 3 days of collection and keeping this in a refrigerator .We followed the standard safe transfusion protocol as per WHO guideline and transfused 2units to 7 units of placental blood to each patient (Total 44 units of placental blood transfusion) without encountering any immunological to non immunological reactions so far.All the patients irrespective of their background tolerated the procedure well and there was a sense of wellbeing in each case.We are a group of researchers from Calcutta working on the problem of umbilical cord whole blood transfusion as an emergency alternative of adult whole blood transfusion from paediatric to geriatric age group in different indications since 1st April 1999 and received a research grant from the Dept of Science and Technology of the Govt of West Bengal, India and published our reports from time to time(1-11).We are of the opinion that the growth factor and cytokine filled cord blood collected from the placenta of the consenting mother after the birth of the healthy newborn, aseptically,has all the potentialities for an effective therapeutic adjuvant for the Leprosy victims with anemia in the underprevilaged world.The cord blood is protected from infection in the natures finest biological sieve.ie,placenta.and contains 60-80 percent fetal hemoglobin (Which can carry 60 percent more hemoglobin than the adult hemoglobin),high WBC,Platelet content ,hypoantigenic in nature and has an altered metabolic profile.It also has the potentialities(?), which we are studying at present, to convert TH2 responses(Lepromatous) to TH1 response(Tuberculoid) due to its rich cytokine and growth factor content which has a role(?) in gene switching. REFERENCES: 1) Bhattacharya N, Mukherjee KL, Chettri MK, Banerjee T, Mani U, Bhattacharya S, “A Study Report of 174 Units of Placental Umbilical Cord Whole Blood Transfusion in 62 Patients as a Rich Source of Fetal Hemoglobin Supply in Different Indications of Blood Transfusion”, Clinical and Experimental Obstetrics and Gynecology, vol.28, no.1, 2001 : 47-52. 2)Bhattacharya N, Bandopadhyay T, Bhattacharya M, Bhattacharya S, “Do Not Discard 99.99% of the Human Placental Umbilical Cord Blood for the Sake of Stem Cells Only”, http://bmj.com/cgi/eletters/323/7304/60#16874, 5 Oct 2001 3) Bhattacharya N, Bandyopadhyay T, Bhattacharya M, Bhattacharya S, “Immunization and Fetal Cell /Tissue Transplant : A new strategy for geriatric treatment 6th April 2002, http://bmj.com/cgi/eletters/323/7320/1025/b#21055, 5 Apr 2002 4)Bhattacharya N et al, “Umbilical Cord Whole Blood Transfusion : A Suggested Strategy to Combat Blood Scarcity in Ireland”, http://bmj.com/cgi/eletters/324/7330/134/c#19096, 27 Jan 2002 5)Bhattacharya N, Chhetri MK, Mukherjee KL, Ghosh AB, Samanta BK, Mitra R, Bhattacharya M, Bhattacharya S, Bandyopadhyay T, “Can human fetal cortical brain tissue Transplant (upto 20 weeks) sustain its metabolic and oxygen requirements in a heterotrophic site outside brain ? A study of 12 volunteers with parkensons disease, Clinical and Experimental Obstetrics and Gynaecology, Vol-29, No. 4, 2002 6)Bhattacharya N, Chhetri MK, Mukherjee KL, Das SP, Mukherjee A, Bhattacharya M, Bhattacharya S, “Human Fetal adnenal transplant : A possible role in relieving intractable pain in advanced rheumatoid Arthritis, Clinical and Experimental Obstetrics & Gynaecology, vol. 29, No. 3, 2002 . 7)Bhattacharya N, Mukherjee KL, Chettri MK, Banerjee T, Bhattacharya S, Ghosh AB, Bhattacharya M, “ A Unique Experience with Human Pre-immune (12 weeks) and Hypo-immune (16 weeks) Fetal Thymus Transplant in a Vascular Subcutaneous Axillary Fold in Patients with Advanced Cancer: A Report of Two Cases”, European Journal of Gynecological Oncology, vol.22, no. 4, 2001 : 273-7. 8)Bhattacharya N, “Fetal Tissue/ Organ Transplant in HLA Randomized Adult’s Vascular Subcutaneous Axillary Fold: A Preliminary Report of 14 Patients”, Clinical and Experimental Obstetrics and Gynrcology, 2001; 28(4); 233-239. 9) Bhattacharya N et al,”The safe use of Placental umbilical cord whole blood transfusionin patients suffering with anemia and Thalassemia in underresourced regions of the world”http://bmj.com/cgi/eletters/321/7269/1117#62372, 9 Jun 2004. 10) Bhattacharya N et al,”Umbilical cord whole blood transfusion in HiV patients with anemia and emaciation” http://bmj.com/cgi/eletters/327/7414/562-a#59738, 17 May 2004 11) Bhattacharya N et al,”Utilization of a genuine blood substitute: A suggestion to the Medical faternity in Iraqi Hospital” http://bmj.com/cgi/eletters/326/7391/675#30850, 30 Mar 2003 Competing interests: None declared Competing interests: None declared