More U.S. Experts, Medical Supplies Flown to Moscow

Two more American bone marrow transplant experts and thousands of pounds of medical supplies and equipment have been flown to Moscow to assist Dr. Robert P. Gale, the UCLA physician who has been in Moscow treating victims of the Chernobyl nuclear accident.

Included in the shipment were sophisticated machines, including a cell separator and a cell counter, that can be used in the treatment of persons with bone marrow damage.

The shipment also contains chemicals that determine the extent of bone marrow damage and help match compatibility of potential donors and recipients.

The supplies were quickly assembled over the weekend by researchers and technicians at UCLA after they received a telephone call from Gale.

Bone marrow produces cells that are responsible for protecting against infections and bleeding problems, the chief causes of death in persons who have received excessive amounts of radiation.

Moscow Communist Party chief Boris N. Yeltsin said over the weekend that 154 Chernobyl victims remained in hospitals, of whom 20 to 25 were in serious condition, and that another 10 to 15 might be added to the “serious” list.

Two of the Americans who followed Gale to Moscow were his UCLA colleagues, Dr. Richard Champlin, chief of bone marrow transplant surgery, and Paul I. Terasaki, an international authority on tissue typing.

A third scientist, Dr. Yair Reisner, a visiting fellow from Israel at Memorial Sloan-Kettering Cancer Center in New York, left Monday to join the UCLA team.

“Gale is receiving the full cooperation from the Soviet doctors and the Ministry of Health,” said Armand Hammer, chairman of Occidental Petroleum Corp. He said he is underwriting the cost of shipping the medical equipment and supplies. The machines were made available by the manufacturers.

According to Hammer, the Soviets said they will reimburse him for the physicians’ travel and related expenses.

Damage Assessment Difficult

The U.S. team clearly has its work cut out. According to John Wells, associate professor of medicine at UCLA, determining the extent of bone marrow damage is not be easy because it is almost impossible to pinpoint the amount of radiation exposure suffered by the Chernobyl victims.

Another problem is that the physicians must quickly determine the patient’s tissue type and then find a donor with a suitable marrow match. Bone marrow transplants have the highest success rate if the donor and recipient are blood relatives, especially if they are twins.

In the case of the Chernobyl victims, if close relatives are not available, it may mean that unrelated donors will have to be used. This would mean that the chances of a successful transplant diminish significantly.

Since 1970, about 9,000 marrow transplants have been performed worldwide, primarily in the treatment of leukemia, aplastic anemia and other immune-deficiency diseases. All but 80 to 100 of them have involved closely related donors, and only a small handful has been performed on radiation accident victims, according to bone marrow experts.

Terasaki is a pioneer in the science of tissue typing and was one of the first scientists to identify various tissue types and to use them in ways that improved the success of the transplantation of other organs, especially kidneys.

Major Transplant Problem

Champlin is an authority on the prevention of a complication called graft-versus-host disease that is the major problem in marrow transplants using unrelated donors. In graft-versus-host disease, the donor marrow often destroys the recipient’s vital organs, causing death.

Gale also is a pioneer in bone marrow transplantation whose aggressive style has sometimes landed him in trouble.

Last December, the National Institutes of Health formally reprimanded Gale for conducting bone marrow experiments without the approval of a faculty committee responsible for protecting the rights of the patient. The experiments, conducted in 1978-79, involved terminal cancer patients--the kind of patient for whom marrow transplants are now the treatment of choice.

At the time of those experiments, the treatment was not yet accepted as the choice treatment.

Gale has been allowed since to continue his work, but the National Institutes of Health ruled that he must be closely monitored until March, 1988.

The medical assistance from the United States was initiated by Hammer last week when he approached the Soviet Embassy in Washington on behalf of the International Bone Marrow Transplant Registry. He extended an offer by registry scientists to help evaluate victims of the nuclear accident, and the Soviets responded Thursday by inviting Gale, who is chairman of the registry.

Poland may have received an early medical warning from the Soviets. Page. 18.