Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: Drs Fasth and Wahlstrom point out
that stem cell therapy may not be an option for ALL or AML, given the effectiveness
of chemotherapy. However, given the sizeable proportion of treatment failures
that Fasth and Wahlstrom note, we believe that the option of stem cell therapy
should still be available for patients for whom chemotherapy is not effective,
particularly if the parents plan to have another child anyway. ALL and AML
are still in the list of conditions for which cord blood transplantation has
been performed for many years. We agree with Dr Wagner and colleagues that
preimplantation HLA typing for inherited forms of DBA should be combined with
preimplantation genetic diagnosis (PGD) of DBA. However, as we mentioned in
our article, all known mutations causing DBA were excluded in our cases by
detailed mutation testing in parents and affected children, and this was also
confirmed by the ongoing follow up studies of the HLA-matched children born
after preimplantation HLA typing.
Kuliev A, Rechitsky S, Verlinsky Y. Preimplantation Testing to Produce an HLA-Matched Donor Infant—Reply. JAMA. 2004;292(7):803. doi:10.1001/jama.292.7.804-a
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