Italians celebrate success of treatment no longer legal in Italy
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《英国医生杂志》
A 5 year old child with Cooley抯 anaemia has been successfully treated in Italy using cord blood stem cells from his new born twin brothers.
The case has been controversial in Italy because the parents initially went to Turkey to have in vitro fertilisation; preimplantation diagnosis of the fetus to ensure that the baby would not have his or her brother抯 condition; and tissue typing to ensure a good match for the transplant. Italy has a restrictive law on assisted reproduction (3 January, p 9 and 5 June, p 1334), and the initial procedure which the parents chose to have in Turkey (because they are Turkish) is no longer legal in Italy.
The couple had a procedure similar to that approved earlier this month by the United Kingdom抯 Human Fertilisation and Embryology Authority for use by Julie and Joe Fletcher from Moira, County Down, to help their son Joshua (11 September, News extra, p 592).
The cord blood stem cell transplant was done by Professor Franco Locatelli, paediatrician and oncohaematologist from the San Matteo University Hospital in Pavia, Italy. The announcement was made in Milan last week by his team together with the team from the cell research facility of Policlinic Hospital of the University of Milan, which replicated 60 times the stem cells from one of the cords, which contained too few of them.
"One month after the transplant, the child is healthy and shows no sign of graft versus host disease," said Professor Locatelli, who is waiting for a longer follow up before submitting the study for publication.
At the press conference where the announcement was made, Health Minister Professor Girolamo Sirchia welcomed the success of the treatment.
"Until now, the only clinically relevant results have been obtained with adult stem cells," Professor Sirchia said. In his career as a haematologist at the University of Milan, he helped create the Milano Cord Blood Bank in 1993 and, as a minister inaugurated in 2001, the cell research facility where the work was done. "This transplant was historical because for the first time it opens the way to the treatment of the adult," he said.
But his words caused angry reactions when it was found out that the parents had travelled to Turkey for their initial treatment, and that such treatment would no longer be legal in Italy.
A spokesman for the Health Ministry insisted, however, that in vitro fertilisation and embryo selection was not essential to the treatment. " with embryo selection is not a fundamental requisite for this scientific result, which can be obtained, even though with lower probabilities, with donors born from natural fertilisation," he said. The spokesman did not mention that any child born by natural methods—without the use of in vitro fertilisation and genetic preimplantation diagnosis so that their blood might be used to help a sibling with an inherited disorder—was at increased risk of the genetic disease itself.
"This information was not made public because it was irrelevant from the clinical point of view, and we wanted to respect the privacy of the family. Not even Minister Sirchia was informed," said Professor Locatelli. "The couple arrived in our centre when the pregnancy was underway."
But the debate on the controversial law "in defence of the embryos" is so heated in Italy that Professor Sirchia himself recently said abortion was for him similar to homicide. Another member of the government, Carlo Giovanardi, recently compared those against the law to the Nazis.(Milan Fabio Turone)
The case has been controversial in Italy because the parents initially went to Turkey to have in vitro fertilisation; preimplantation diagnosis of the fetus to ensure that the baby would not have his or her brother抯 condition; and tissue typing to ensure a good match for the transplant. Italy has a restrictive law on assisted reproduction (3 January, p 9 and 5 June, p 1334), and the initial procedure which the parents chose to have in Turkey (because they are Turkish) is no longer legal in Italy.
The couple had a procedure similar to that approved earlier this month by the United Kingdom抯 Human Fertilisation and Embryology Authority for use by Julie and Joe Fletcher from Moira, County Down, to help their son Joshua (11 September, News extra, p 592).
The cord blood stem cell transplant was done by Professor Franco Locatelli, paediatrician and oncohaematologist from the San Matteo University Hospital in Pavia, Italy. The announcement was made in Milan last week by his team together with the team from the cell research facility of Policlinic Hospital of the University of Milan, which replicated 60 times the stem cells from one of the cords, which contained too few of them.
"One month after the transplant, the child is healthy and shows no sign of graft versus host disease," said Professor Locatelli, who is waiting for a longer follow up before submitting the study for publication.
At the press conference where the announcement was made, Health Minister Professor Girolamo Sirchia welcomed the success of the treatment.
"Until now, the only clinically relevant results have been obtained with adult stem cells," Professor Sirchia said. In his career as a haematologist at the University of Milan, he helped create the Milano Cord Blood Bank in 1993 and, as a minister inaugurated in 2001, the cell research facility where the work was done. "This transplant was historical because for the first time it opens the way to the treatment of the adult," he said.
But his words caused angry reactions when it was found out that the parents had travelled to Turkey for their initial treatment, and that such treatment would no longer be legal in Italy.
A spokesman for the Health Ministry insisted, however, that in vitro fertilisation and embryo selection was not essential to the treatment. " with embryo selection is not a fundamental requisite for this scientific result, which can be obtained, even though with lower probabilities, with donors born from natural fertilisation," he said. The spokesman did not mention that any child born by natural methods—without the use of in vitro fertilisation and genetic preimplantation diagnosis so that their blood might be used to help a sibling with an inherited disorder—was at increased risk of the genetic disease itself.
"This information was not made public because it was irrelevant from the clinical point of view, and we wanted to respect the privacy of the family. Not even Minister Sirchia was informed," said Professor Locatelli. "The couple arrived in our centre when the pregnancy was underway."
But the debate on the controversial law "in defence of the embryos" is so heated in Italy that Professor Sirchia himself recently said abortion was for him similar to homicide. Another member of the government, Carlo Giovanardi, recently compared those against the law to the Nazis.(Milan Fabio Turone)