Placental umbilical cord whole blood transfusion to combat anemia in the background of tuberculosis and emaciation and its potential role as an immuno-adjuvant therapy for the under-resourced people of the world.
Tuberculosis causes approximately 1.5 billion latent infections, 8 million new clinical cases, and 3 million deaths annually, making it the most prevalent infectious disease in the world. Anemia and malnutrition are essential comorbidities with tuberculosis. Cord blood, because of its rich mix of fetal and adult hemoglobin, high platelet and WBC counts, and a plasma filled with cytokine and growth factors, as well as its hypo-antigenic nature and altered metabolic profile, has all the potential of a real and safe alternative to adult blood transfusion. We transfused 106 units (48 ml-148 ml mean 81 ml +/- 6.6 ml SD, median 82 ml, mean packed cell volume 49.4 +/- 3.1 SD, mean percent hemoglobin concentration 16.3 g/dl +/- 1.7 g/dl SD) of placental umbilical cord whole blood (from 1 April 1999 to 1st 2005) after lower uterine cesarean section from consenting mothers to 21 informed consenting patients with tuberculosis who had percent plasma hemoglobin of 8 g/dl or less. After collection, the blood was immediately transfused following the standard adult blood transfusion protocol. Each case was passed through the institutional ethical committee. The patients received 2-21 units of freshly collected placental umbilical cord blood without encountering any clinical, immunological or non-immunological reactions. Three days after completion of the placental umbilical cord blood transfusion, the peripheral blood hematopoietic stem cell (CD34) estimation revealed a rise from the pretransfusion base level (.09%), varying from 2.99% to 33%, which returned to base level in 66.66% at the three-month CD34 re-estimation, without provoking any clinical graft vs host reaction in any of the patients.
Bhattacharya
N
N
Bijoygarh State Hospital, Moore Avenue Specialist Polyclinic and B. P Poddar Hospital, New Alipore, Calcutta, India.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000628:therapy*; D018952:Antigens, CD34 / Q000378:metabolism; D001803:Blood Transfusion / Q000379:methods*; D002585:Cesarean Section; D003906:Developing Countries; D004614:Emaciation / Q000453:epidemiology; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D005434:Flow Cytometry; D006412:Hematopoietic Stem Cells / Q000378:metabolism; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010920:Placenta / Q000098:blood supply*; D011203:Poverty; D014376:Tuberculosis / Q000453:epidemiology; D014470:Umbilical Cord / Q000098:blood supply*
D018952:Antigens, CD34; D006454:Hemoglobins