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A baby was genetically engineered to provide bone marrow for his sick sister

She had a genetic disease that causes a lack of bone marrow and had to donate from a relative. The brother was chosen through in vitro fertilization because he matched. Hello to both

by Tamara Traubman

Parents from Colorado used in vitro fertilization and genetic testing to create a baby free of his sister's hereditary disease - who would also be genetically compatible for a bone marrow transplant in his sister. The girl, Molly, 6 years old, suffers from a hereditary disease called Panconi anemia. The only treatment that might help the girl is a bone marrow transplant, but the doctors were unable to find her a suitable donor.

The baby was born on August 29. His parents, Lisa and Jack Nash, named him Adam. The "Washington Post", which published the story yesterday, reported that the doctors extracted blood stem cells from a person's umbilical cord - the cells from which bone marrow cells develop - and injected them into Molly. The girl is currently hospitalized in a Minneapolis hospital, and in about a week her doctors will know if the treatment was successful.

Researchers were able to isolate human stem cells for the first time about two years ago, and the study of these cells is today considered one of the most promising fields in medicine. The various stem cells are the source cells from which the rest of the body's cells develop. They may be used in the future, for example, to replace damaged cells in the brains of Alzheimer's or Parkinson's patients, for patients with liver diseases, or for diabetics whose pancreatic cells do not produce insulin.

Some ethics experts said that planning a baby, as Lisa and Jack Nash did, could turn out to be a slippery slope, which would lead to situations where parents would give birth to a child, so that in the future they would have a suitable "tissue depot" for transplantation. "You can say that it quickly became a process similar to buying a new car, you decide which packaging and which accessories you want," said Jeffrey Kahn, director of the Center for Bioethics at the University of Minnesota, "I suspect that only because we still don't have the appropriate tests, parents still We don't ask for a fetus without a tendency to homosexuality, or tall children."

Lisa and Jack Nash emphasized that they did not give birth to Adam to provide cells for transplantation into their daughter. They said they had wanted another child for a long time, but because they each carry one normal copy and one defective copy of the gene associated with Fanconi's anemia, they have a 25% chance of having a child who will inherit two defective copies of the gene and develop the disease. The parents feared that with normal fertilization another child with the disease would indeed be born.
Doctors at the Masonic Hospital in Illinois offered them a process in which they extract eggs from the woman, fertilize them with sperm from the man, and test in the laboratory which embryos will not inherit the mutations. It should be emphasized that at this stage the doctors also checked whether one of the embryos without the mutations would be suitable as a donor for their daughter Molly.
After several cycles of fertilization, the doctors found a suitable embryo - this is the embryo that they implanted in the mother's womb.

Dr. Yuval Yaron, director of the prenatal diagnosis unit at the Ichilov Tel Aviv Medical Center, said he knows of a similar case in the US. According to Dr. Yaron, for a long time, parents in need of bone marrow donation give birth to additional children, without genetic diagnosis, so that they might get lucky and one of them will be found as a suitable donor.
According to Dr. Yaron, "In IVF and genetic diagnosis, it is necessary to choose which of the embryos to return to the uterus, because most of them have an excess. If a choice is already made of an embryo that appears to be free of disease, why should we prevent the parents from choosing an embryo that will also be a suitable donor for a sick brother or sister?"
{Appeared in Haaretz newspaper, 4/10/2000}

Below is the news as delivered yesterday by the news agencies:

A Colorado couple used genetic testing to create a test-tube baby with the exact type of cells needed to save their six-year-old daughter. This is what the Washington Post reported today (Tuesday).
The newspaper states that this is the first time that a couple maps the fetus even before it is implanted in the mother's womb in order to save a life.

Molly was born with Falconian anemia - an inherited deficiency that causes a complete failure of bone marrow cell formation. Children with this disease suffer from anemia, bleeding and serious problems with the immune system. They usually die of leukemia or other complications by the age of 7. The only effective treatment is to take a group of perfectly matched cells from a healthy brother or sister and replace the sick child's bone marrow cells.

The parents, Lisa and Jack Nash, wanted to have another child, but were afraid that he would also suffer from the same disease. A few years ago they heard about a new technique called preimplantation genetic diagnosis.
They tried four IVFs and the fourth time they were successful. Adam, the baby, was born in Denver on August 29. The doctors collected cells from his umbilical cord - a painless procedure - and on September 26 injected them into the bloodstream of his sister Molly. She is currently recovering in a Minneapolis hospital and within a week the doctors will know if the procedure was successful.

The procedure is both promising and ominous at the same time, especially regarding the future of childbirth according to scientific progress, at least for those who can afford to finance these procedures. "We knew we were running out of time," said Charles Storm, director of genetic medicine at Masonic Medical Center in Illinois. "Now the girl has between 85% and 90% of being free of the bone marrow disease, but the case also raises questions about the parents' ability to choose the characteristics of their children for any reason, whether practical or subject to their whims," ​​Storm added.

The news agencies - 3/10/2000 (14:20)

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