Technique Cures Immune-Deficient Babies
Four infants who would have died because of severe immune deficiency have been basically cured with bone marrow transplants preceded by total irradiation of their bodies with X-rays, a University of California physician said Thursday.
Two of the infants had rejected marrow transplants before irradiation, and tests on the other two indicated that they would have rejected the transplants without the treatment, said Dr. Francine Halberg, assistant professor of radiation oncology at UC San Francisco.
In each of the cases, the transplants came from the parents of the babies, including the two that had previously been rejected.
The children were irradiated at the ages of 2 to 3 months before receiving the marrow transplants. The youngest is now 9 months old and the oldest is 6 1/2 years.
Infants born with severe combined immunodeficiency disease usually die before the age of 2 if marrow transplants fail.
“The bottom line is four babies with total immunodeficiency disease are alive today after total body irradiation and bone marrow transplants,” Halberg said.
Halberg said the children are progressing without brain damage or growth problems.
Before the total body irradiation, two of the infants had rejected marrow transplants from their parents. Halberg said the transplants did not take because of inadequate immunosuppression therapy.
The children then were readied for a second transplant with total body irradiation preceded by chemotherapy using antithymocyte globulin and cyclophosphamide.
The radiation is delivered in a single dose to the entire body by a three-dimensional X-ray beam. The brain, eyes and lungs are shielded from the radiation, which obliterates the marrow to make way for the marrow transplant.
“Irradiation in these doses essentially kills the bone marrow cells . . . and also renders more space for the transplant,” Halberg said.
After the irradiation and transplant, the patients are given gamma globulin for a year, until tests show total immune recovery.
