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| Last Updated ( Wednesday, 20 February 2008 ) | ||||
Patients get equal survival benefit, even with less-than-perfect match, study finds
By Ed Edelson
HealthDay Reporter
FRIDAY, June 8 (HealthDay News) -- Transplanted blood cells from umbilical cords appear to give better results than the bone marrow transplants that have been standard for leukemia patients, a new study finds.
"From my point of view, it now demonstrates that cord blood can be considered a first-line therapy and not an afterthought," said lead researcher Dr. John E. Wagner, director of the bone marrow transplant program at the University of Minnesota.
His team published its findings in the June 9 issue of The Lancet.
One way to treat various leukemias is to wipe out the old blood cell system and replace it with a new one via transplant. This study of 785 children under 16 who got such transplants found essentially equal five-year survival rates for the 503 patients who underwent transplantation with umbilical cord blood and the 282 who got bone marrow transplants.
That held true even when the transplanted blood cord cells did not match the immunological system of the recipients, a mismatch that can lead to severe side effects or rejection of the transplant, Wagner said.
"With bone marrow, you have to match eight antigens," he said. "In cord blood, you need to look at only six, and only need four matches."
Indeed, five-year survival was identical for recipients of perfectly matched bone marrow and cord blood recipients with two mismatches, Wagner said. That matching flexibility could expand the field considerably, because right now bone marrow matches cannot be found for half of all leukemia patients who need transplants, he said.
"With cord blood you can find a match for most patients, where with marrow you cannot," Wagner said. "The take-home message is that when cord blood is so promising, it should have an impact on public policy."
And yet the system for extracting and storing cord blood cells still has many gaps, he said. For example, "there is no [cord] banking effort" in Wagner's home city of Minneapolis, he said.
Cord blood transplants, originally done only in children, now are performed routinely for adults with leukemia, Wagner added. "Of the 8,000 transplants done to date, half have been in adults," he said. "Our next study will be to look at the outcome in adults."
Other studies also are needed, Wagner said, including those that compare the cost of the two types of transplant. "There is no economic analysis comparing bone marrow and cord blood transplants," he said. "We also need to look at the quality of life."
The federal government is financing a major effort to expand cord blood banking, said Dr. Pablo Rubinstein, director of the New York Blood Bank, the first in this country to store cord blood. The center, which participated in this study, started cord blood banking back in 1993 and now collects 8,000 units a year. It currently has an inventory of 40,000 units. The New York Blood Bank has provided material for more than 2,500 transplants, Rubinstein said.
The system being financed by the federal government "will have a national point of access, where all transplant physicians can go to fulfill their needs," he said.
There also is commercial activity, with some for-profit organizations urging parents to pay to store cord blood from their children's births, Rubinstein said. However, such storage "is extremely unlikely to be useful," he said, since if a child is found to have a blood problem, physicians would hesitate to use cells that might well be the source of that problem.
More information
Find out more about cord blood storage at the National Marrow Donor program.
SOURCES: John E. Wagner, M.D., director, bone marrow transplant program, University of Minnesota, Minneapolis; Pablo Rubinstein, M.D., director, New York Blood Center, June 8, 2007, The Lancet
Copyright © 2007 ScoutNews, LLC. All rights reserved.
On a hot summer day, it would be a good idea to start the day with liquids. Juice or tea is almost standard breakfast fare, but a bowl of fresh fruits will also be a good help. If still hungry, one can go for breakfast or puffed rice. It is light, easy to digest and filling, especially with some finely chopped cucumbers thrown in.
According to Ayurveda, lunch is supposed to be the heaviest meal of the day because the body’s digestive capabilities are at its highest at that hour of the day. For lunch, one can try curried parsnips and carrots, unleavened bread of whole wheat or rye, or rice cakes and a tossed salad of lettuce and sprouts, with simple oil and vinegar or lemon juice dressing. In the evening, fresh bitter berries or any fresh fruit with cool mint tea would be a good idea.
Dinner can be time for Asparagus soufflé and rice, accompanied by summer squash with parsley and dill. The salad can also be replaced by bean sprouts, tossed with some lemon juice.
Before we have the recipes of the main dishes, here are some pointers.
A generous sprinkling of coriander (usually found in the Chinese produce section of supermarkets) as Chinese parsley, is very cooling on the food. Also, addition of fennel seeds makes digestibility of any food that much easier and cooler. Many dieticians consider cumin also cooling, but for many people, they are not.
Curried Parsnips and Carrots:
You need 6 medium sized parsnips, and 3 medium carrots, washed and diced...
For the seasoning, 2 tablespoons sunflower oil (even ghee would be fine), one teaspoon mustard seeds and half teaspoon turmeric powder, with a pinch of asafetida.
Keep a cup of water and about half a cup of plain yogurt ready.
For the spices, keep ready half teaspoon sea salt, a quarter teaspoon cinnamon, half a teaspoon curry powder and one teaspoon coriander powder.
If you have the taste for coconut, about one tablespoon of shredded garlic and about the same quantity of copped coriander leaves can be used as garnish.
Heat oil in a pan and add the black mustard seeds and asafetida. When the seeds start popping, add turmeric powder and a quarter cup of water, parsnips and carrots. Mix well and cover. Let it cook on slow heat for about 15 minutes or until the vegetables are tender. Then add yogurt, some water and all the other spices. Cook over low heat for another 5 minutes. Garnish with coriander, and if you wish, coconut. This makes a tasty dish to be had with bread, rice or unleavened bread.
For a summer dinner, the main dish will be Asparagus Soufflé
For this dish you need one cup of milk (preferably soy milk or goat), three tablespoons unclarified butter and three tablespoons of whole wheat or barley flour. Keep ready four egg yolks and a pinch of cream of tartar also. These will be required to make the sauce.
Also keep ready about one cup of cooked asparagus and yolk of one egg.
For the seasoning, the spices required are half a teaspoon of sea salt, a quarter teaspoon of ground pepper.
The asparagus needs to be washed, chopped into inch long pieces and steamed for about 8 minutes.
Melt the fat in a skillet and slowly stir in the flour. Then add the milk, gradually stir it in. This is basically the same method as a regular white sauce. As t cooks, the sauce will thicken. Just as it boils, add the cooked asparagus and let it thicken a bit more. Reduce the heat and stir in the egg yolk. Them add the salt and pepper, and mix well. Remove from heat and cool.
In the meanwhile, beat together he egg whites with cream of tartar in a clean bowl (preferably metal). When the whites are stiff, fold gently into the asparagus sauce and pour into a deep baking dish. Sprinkle the top with crushed paprika and bake at 325 degrees for about 45 minutes.
Serve with rice or whole wheat bread.
The other dishes in the summer menu are basically tossed together salads with vinegar and oil or lime juice dressing and are really self explanatory. Sticking to this kind of a menu can help take care of a lot of heat related problems which the human body may suffer.
By Kanika Goswami
Published: 4/27/2004
Fruits and green vegetables are so important for a healthy diet. Your child should know why fruits score over packaged foods. You need to include fresh fruits during breakfast times or slip one in the lunchbox. Make it interesting by having fresh fruit juices or even fruit salads to break the monotony.
Children are not aware about many things that are very important for their growth. As parents, you must ensure your child has plenty of water and fluids during the day. Fluids should include fresh juices. Make sure your child carries a bottle of fresh juices to school.
Kids should know the importance of exercise at an early age itself. Teach kids few basic exercises that can be done at home. An exercise routine that incorporates walking or swimming can help children to manage these activities on a daily basis. As they grow up, these routines will naturally form a part of their life.
Kids should also be aware of hygiene-related issues. Youngsters should learn things such as the need to wash hands before and after meals. For young kids, you can simply use a singsong routine to get them into the process. Children will then surely make this a part of their routine once they understand the importance of personal hygiene.
Dental care should begin at an early age. Brushing teeth twice daily is needed to keep teeth looking healthy and clean. You can promise to read a bedtime story for a kid that does not really enjoy a brushing routine. Make it seem enjoyable rather than making the child feel punished.
As your child grows older, you can help your kid maintain a chart on foods to be avoided on a regular basis. It’s important the child knows that indulgence in foods high in sugar is fine once in a while. It should not be done on an everyday basis. Avoid being too stern if your kid wants to enjoy foods such as French fries and ice cream. Simply teach your child how to be smart and consume such foods only occasionally.
Your child may require a daily dose of vitamins if the diet does not include the required amount. Make sure you check with your doctor about the vitamin intake to give the right amount of doses. There are many vitamin tablets packed in attractive containers. Generally, kids believe they eat candy instead of medicines due to the innovatively packed products that are available these days. There can also be alternative ways to include food items in the diet, which are a rich source of vitamins. Your doctor would be the best judge to decide upon the diet plan.
Parents also need to make sure their children get the appropriate amount of sleep. The child needs a healthy balance of activities and play. Sometimes, children take a long time to fall asleep. You can read a bedtime story or simply speak to the child softly. This will help the child to fall asleep naturally. This health tip will help children to stay in good health and remain active during the day.
Children need plenty of love and care right from their early years. Along with loads of love, these health tips will help to keep your kid fit and smiling throughout the day!
By Kashmira Lad
Published: 12/30/2008
