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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
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.
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
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
Competing interests: No competing interests