[Blood and blood diseases].
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From Feb. to Dec. 1985, 15 patients were treated with fetal liver cell transfusion (FLT). They were 10 cases with malignant tumors treated by chemotherapy (tumor group) and 5 with blood diseases (blood group). Under strict aseptic technique, 3 1/2-6 month old fetus was selected for preparing suspension of the fetal liver cells on the superclean table. The speed of FLT should be increased gradually from slow to rapid. There are 1.8 X 10(8)-4 X 10(12) fetal liver cells in a fetus of more than 5 months old, in which most are CFU-C. In the tumor group, after FLT, white blood cell, platelet and hemoglobin increased by 700-3,900/mm3, 5,000-116,000/mm3 and 0.5-2.0 gm/mm3 respectively. But in the blood group, they increased by 800-1,300/mm3, 14,000-84,000/mm3 and 0.4-11.0 gm/mm3. In most of the cases, these hematological indexes reached up to the highest in 2 weeks after FLT. It suggests that FLT can improve the peripheral blood picture obviously and stimulate bone marrow. Experiment confirms that there are considerable hematopoietic stem cells in the fetal liver, by which the functions of hematopoiesis and immunity are able to recover. It is more marked in the tumor group than in the blood group. FLT provides a favourable condition for high dose chemotherapy.
UNLABELLED: Genetic blood diseases are frequent in Bahrain as in all Middle Eastern countries. Previous neonatal screening in 1984-1985 showed that the birth prevalence of sickle cell disease (SCD) was 2.1%, of sickle cell trait 11% and of glucose-6-phosphate dehydrogenase (G6PD) deficiency 25%. The Ministry of Health recognized the importance of controlling these diseases. In 1984, the first genetic clinic was established, which started the educational campaigns. Information booklets were prepared and distributed widely in schools and clubs in an attempt to increase awareness about these diseases among students and the public. In 1991, the Bahrain Hereditary Anemia Society was formed. In 1992, the Minister of Health formed a national committee for the prevention of genetic diseases in Bahrain. Screening of all pregnant women began, followed by newborn testing if the mother was found to be a carrier. In 1993, a premarital counseling (PMC) service was organized and in 1998, a student-screening project began. At this stage, we want to update the national birth prevalence figure by screening Bahraini newborns for these genetic diseases. This will help to design prevention programs and to measure the effect of health education on the previous birth prevalence figure. SUBJECTS AND METHODS: A newborn screening study was conducted to determine the effects of this long-term campaign (16-18 years). Cord blood samples from 2,000 Bahraini newborns were tested for hemoglobinopathies and G6PD deficiency using HPLC. RESULTS: 18 newborns were found to have SCD. The new birth prevalence figure for SCD in Bahrain is 0.9%, which indicates a 60% decline in the birth prevalence rate. CONCLUSION: With the continuation of education, awareness campaigns, screening of carriers and PMC, we expect the number of affected children born to be reduced tremendously over the next few years.
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