Picking the Best Marrow

In many forms of leukemia, the blood-cell factory inside the victim's bone marrow produces too many white blood cells, of the wrong kind, and too fast. To get the marrow back on a proper production schedule, medical investigators have tried many ingenious, drastic and daring experiments. Now five Paris doctors believe they have found a possible answer in the blood and bone marrow of a patient's relatives.

The French physicians, led by Dr. Georges Mathe, got the idea from the emergency treatment improvised in 1958 for victims of a reactor accident in Yugoslavia--five nuclear scientists who got what would ordinarily have been a fatal overdose of radiation. Four were pulled through and are still doing well, thanks to injections of bone marrow. The radiation that almost killed the patients had made them able to accept other people's marrow cells, instead of rejecting them through nature's familiar "immune reaction."

Last spring, when some of the same doctors had a male patient of 26 dying of leukemia, they decided to give him marrow transplants. But whose marrow? His parents were still living; so were three brothers and a sister. Rather than trust their own judgment in picking which relative had the closest-matching marrow cells, the doctors left the choice to nature.

First they gave the patient a hefty dose of gamma rays--enough not only to knock out his bone marrow but to kill him, unless he soon got some more marrow. Within a week, they report in the British Medical Journal, they injected into his veins two quarts of a mixture of blood and bone marrow drawn from all six of his closest kin.

Then, although he was kept in an atmosphere as nearly germ-free as possible, the patient got sick. He developed a usually fatal form of tuberculosis: evidently some bacilli had been dormant in his body, and the radiation had destroyed his defenses against infection. Somehow, today's miracle drugs pulled him through, and his new marrow is still manufacturing new cells.

Which of his relatives saved him?

The Paris doctors are not sure, but from matching cells they think it was his youngest brother. Their shotgun attack with cells from six donors, they suggest, gave the patient's own system a chance to select the most suitable marrow.

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