Cord blood: A weapon against cerebral palsy?

In the treatment, the cord blood taken from Dallas' umbilical cord shortly after his birth was injected into his blood. The therapy is in this sense different from cord-blood-based therapies for cancers and genetic conditions, which rely on cord blood obtained from someone other than the patient -- either a child whose cord blood was donated to a public bank or a sibling.

Foreign blood is required for those conditions to avoid infusing patients with cells that may have the same defect that is causing disease. But to prevent the patient's immune system from rejecting the cells in the foreign blood, the procedure also requires chemotherapy to destroy the patient's immune system.

The risks of chemotherapy are too high to justify using someone else's cord blood until it is known whether the treatment will truly benefit children with cerebral palsy, says Dr. Joanne Kurtzberg, director of the Pediatric Blood and Marrow Transplant Program at Duke University Medical Center. For this reason, the trial is only treating patients who had their cord blood banked at the time of their birth.

To track progress, each child is evaluated by testing both their motor and cognitive skills over time. The results are then compared with the abilities doctors would have expected them to have based on their condition before the treatment.

Based on such evaluations, the treatment definitely appears to have benefited Dallas, Kurtzberg says.

But, she adds, "it's impossible to tell at this point" just how much progress he and others in the trial will make.

Kurtzberg says that of the children she has treated so far, only Dallas and one other child have made such dramatic improvements.

The others have had more modest results.

It is hard to tell, she adds, whether improvements were from the treatment, a "placebo effect" based on extra attention to the children and raised expectations of parents and physicians, or some other approach the parents were also trying.

Richardson-Heron stresses that it is important that families of children with cerebral palsy not get false hope from stories like Dallas'. The results of the cord-blood study so far "have great promise and are very exciting," she said, but until further research is done, "I would not call this a cure."

health@latimes.com

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