Test-tube baby born to save ill sister

WASHINGTON (Reuters) -- A Colorado couple used genetic tests to create a test-tube baby that would have the exact type of cells desperately needed to save their 6-year-old daughter, the Washington Post reported on Tuesday.

The newspaper said it was the first time a couple was known to have screened their embryos before implanting one in the mother's womb for the purpose of saving the life of a sibling.

The baby, named Adam, was born in Denver, Colorado, Aug. 29. Doctors collected cells from his umbilical cord, a painless procedure, and on Sept. 26 infused them into his sister Molly's circulatory system, according to the 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, Minnesota, hospital and within about a week doctors should know whether the procedure was successful, the Post 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, the Post said, quoting doctors and ethicists.

"We knew we were running out of time," Charles Strom, director of medical genetics at Illinois Masonic Medical Center, where the genetic testing was done, told the paper.

Now, he said, the girl has an 85 percent to 90 percent 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 anemia, an inherited disorder that causes a massive failure of bone marrow cell production.

Children with the disease suffer from anemia, bleeding disorders and severe immune system problems and generally die from leukemia 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 Post 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 percent 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 fertilization 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 vitro fertilization 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 time benefited 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 to transfer 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 his umbilical cord. Research has shown 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, Minnesota, which specializes in bone marrow replacements for children with Fanconi anemia.

"Molly was holding Adam in her lap" while the cells dripped through a plastic tube into the girl's chest, Nash told the Post. "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, told the Post 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.

Copyright 2000 Reuters. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Illinois Masonic Medical Center
Fairview Health Services

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