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Alert Number 244

With a Little Help from a Million or So of Your Friends

Date: August 12, 2007

Some of you have written to me about the potential benefit of storing cord blood from your children or grand-children in private banks, for your potential use down the road. I strongly urge you to consider donating the cord blood to the public banks instead — it is much more likely to be of help to you. Here is how the math works.

You have a set of HLA markers, half from your father and half from your mother. Unless your family has a long tradition of marrying first cousins etc and you are very closely related to your husband, chances are zero that you will have any HLA markers in common with your spouse. There are literally thousands and thousands of variations of HLA markers, and it is very unlikely that you and your husband (or wife) share any of them.

Now, when your child is born, the cord blood from your child would have half the markers from you, and the other half from your husband. In other words, it is guaranteed that your child’s cord blood would match you exactly half way down the line. This is called a “haplo” match, and your kid will have exactly 3 out of 6 HLA markers that researchers look for from you, the other three from your husband. (If the match is not even 3 out of 6 for your husband, he may have grounds for asking you some tough questions lady ). Unfortunately, a 3/6 match is not good enough for a cord blood transplant. Bottom line, present guidelines are that your child’s cord blood cannot be used as suitable material for your CLL transplant.

The probabilities get even more remote, when you consider your grand-kids cord blood as a good match for your use. This is because now we are throwing into the mix the HLA markers of your son-in-law or daughter in-law. Exactly half the time the grandkid’s cord would be a haplo match (exactly 3 out of 6, and therefore not good enough), the other half the time it will not match you at all, it will be 0 out of 6.

You are absolutely right that any one random stranger will also not match you any better than your own kid or grandkid, most likely he/she will not match you at all.

But now think about a million absolute strangers donating their baby’s cord blood to the public bank. There is a very small probability that any one of them will be a good match, but if you have a million possible small chances of matching, it is next to a certainty that you will get lucky at some point, and at least one of the million cord blood units will be a perfect match for you. If you are the gambling type, think of getting a royal flush in poker. Chances are next to zero you will be so lucky, in any one deal. But if you play millions of hands dealt randomly, chances are excellent that some time in all those poker hands you will come up a winner and get that perfect royal flush.

This is why it is so important to increase the number of people donating to the public cord blood banks. The larger the number of cord blood units stored in the banks, the higher the chance that any one looking for a well matched cord will find one. You can read more about donating cord blood to the public banks by clicking on the link below, it will take you to the National cord blood donor program.

National Cord Blood Donation Program

Then there is the question of the cord being saved for potential use down the road of the very baby whose birth made it possible. I would like you to think about this a bit more. Many genetic diseases are being cured by cord blood transplants. But genetic diseases are, by definition, something wrong at the genetic level, very often something we inherit in our very genes. Would it worry you that whatever is wrong and needs fixing may wrong in the cord blood as well? Why use this “autologous” cord blood, when you have the chance of using a perfectly matched “allogeneic” cord blood from a perfectly healthy and generous donor in the public blood banks? I give you this point to ponder: autologous stem cell transplants in CLL are not able to cure the disease. Allogeneic transplants are the only therapy with potential for a full cure. Think of it as a case of throwing out the immune system bums not doing its job of controlling your CLL, instead getting in a whole new crew that has not been contaminated by the corruption of the prior administration.

The same logic goes, to a lesser degree, for saving the baby’s cord blood to be of possible help to a sibling down the road. Remember by comments about “nepotism”. Recent data from places like the Hutch suggest matched unrelated donor (MUD) transplants are getting better results than transplants from siblings, possibly because the new graft from a total stranger is less likely to get cozy with the cancer cells, get corrupted by their family similarity.

Be well; please become a part of the solution.

Chaya
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