Test-tube baby to the rescue of sister

The baby, named Adam, was born in Denver on August 29. Doctors collected cells from his umbilical cord, a painless procedure, and on September 26 infused them into his sister Molly’s circulatory system, according to the Washington Post report.

Molly suffered from an inherited bone marrow deficiency that is universally fatal without a transplant like the one she received from her newborn brother. She is recuperating in a Minneapolis hospital, and within about a week doctors should know whether the procedure was successful, the paper said.

The procedure is both a promising and worrisome harbinger of where scientific advances are taking human reproduction in the near future — at least for those who can afford to take that path, said doctors and ethicists.

"We knew we were running out of time," Charles Strom, Director of Medical Genetics at Illinois Masonic Medical Centre, where the genetic testing was done, told the paper.

Now, he said, the girl has an 85 per cent to 90 per cent chance of being largely free of the marrow disease.

But the case also raises questions about parents’ ability to choose the traits of their children, for whatever practical — or capricious — reason they may have.

The girl who received the cell transplant, Molly Nash of Englewood, Colorado, was born with fanconi anaemia, an inherited disorder that causes a massive failure of bone marrow cell production.

Children with the disease suffer from anaemia, bleeding disorders and severe immune system problems and generally die from leukaemia or other complications by the time they are 7.

The only effective treatment is to get a batch of healthy cells from a perfectly matched sibling to replace the ailing child’s faulty bone marrow cells.

The paper said Molly’s parents, Lisa and Jack Nash, had long wanted more children, but were afraid to conceive another for fear that any new baby would be affected by the disease. Each parent carries both a normal and a faulty version of the Fanconi gene, which meant they had a 25 per cent chance of having an affected child with each pregnancy.

But a few years ago they learned of a new technique under development called preimplantation genetic diagnosis.

Researchers harmlessly pluck a single cell from embryos that have been created by standard in vitro fertilisation and are developing in a laboratory dish. They test each of those cells for the presence of a disease gene, and then transfer to a woman’s uterus only those embryos whose cells test normal.

Lisa Nash told the Post that when she tried in vitrofertilisation for the first time a few years ago she turned to preimplantation genetic diagnosis primarily to select an embryo unaffected by Fanconi. She allowed researchers to test the embryos for compatibility with Molly’s cells, but the tests were not very good then, she said.

The couple went through this four Times, and each timebenefited from increasingly sophisticated cell typing tests. But none of the attempts resulted in a pregnancy.

Finally, in the fertility cycle initiated late last year,two of the couple’s 15 embryos tested as both free of the disease and having a perfect match for Molly, Strom said.

Only one of those two embryos was healthy enough totransfer to Lisa Nash’s womb. On Christmas Eve the couple learned that the embryo had implanted properly and that Lisa Nash was pregnant, according to the Post report.

After Adam was born, doctors saved blood cells from hisumbilical cord. Research has sown umbilical cord cells, like transplanted bone marrow cells, can go to a recipient’s bone marrow and repopulate the marrow space with healthy cells.

The transplant was performed last week at Fairview-University Hospital in Minneapolis, which specialises in bone marrow replacements for children with Fanconi anaemia.

"Molly was holding Adam in her lap" while the cells dripped through a plastic tube into the girl’s chest, Nash said. "It was the most awesome, monumental experience of our life, yet it was so simple. You’d think there’d be thunderbolts and lightning, but it was calm."

So far, doctors said, Molly is doing well.

University of Minnesota cord blood specialist John Wagner, who oversaw the transplant, said that there had been no complications, and Molly would soon be out of the high-risk period that follows such procedures. Doctors suppressed her immune system with the radiation and chemotherapy to increase the chances the cells would not be rejected.