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Blood test

National | National blood banks work to avoid waste, study touts adult marrow cells, and research questions mammography

Issue: "Paying the price," Feb. 9, 2002

IN SEARCH OF A NEW CIRCULATORY SYSTEM
Blood banks nationwide are preparing a contingency plan to make sure that enough blood is in circulation after a disaster -but without creating bad blood between themselves and potential donors. The plan is an attempt to prevent problems that followed the Sept. 11 attacks. The American Red Cross called for donations even though demand was low, and the group had to toss out 49,000 pints of excess blood. Under the new plan, blood banks and federal officials will cooperate on a task force that will kick into action during a catastrophe, coordinating supplies and emergency donation requests. Individual blood banks will work with the group on a voluntary basis. "The whole point is to establish this up front so if something happens, every blood center knows exactly what to do," said Karen Shoos Lipton of the American Association of Blood Banks, which will oversee the task force. Some disasters require a lot of blood while others need little-and knowing which is which can be difficult in the heat of a crisis. Blood banks also must test fresh donations, which means they can't deploy new blood to a disaster scene right away. The next task force is expected to prepare guidelines for blood needs by examining previous disasters. Adults only?
Adult bone marrow tissue may be coming to the rescue of embryonic life. A group of researchers has found that adult bone marrow cells, dubbed multipotent adult progenitor cells (MAPCs), can generate specialized cells that might become the building blocks of replacement body parts. This gives new hope that they can be used instead of embryonic stem cells in treating diseases. Catherine Verfaillie and her colleagues at the University of Minnesota's Stem Cell Institute experimented with bone marrow cells in test tubes and discovered that they can develop bone, cartilage, fat, and skeletal muscle cells, as well as those that resemble nerve and liver cells. The researchers also found that the adult stem cells can be used to repair tissue damaged by disease. Dr. Verfaillie said the discovery, published in the Journal of Clinical Investigation, might mean that adult cells have an advantage over embryonic cells. The techniques themselves may take years to perfect. "We're not anywhere close that we can fix everything," said Dr. Verfaillie. She said her findings do not mean embryonic work should stop, but the announcement raised political antennae. Sen. Sam Brownback (R-Kan.) said, "This latest finding is of enormous importance-it shows, once again, that we can find cures for the many diseases that plague humanity without destroying human embryos." Mass mammograms
Are 30 million mammograms a year in America too many? Doctors often promote the breast X-rays as lifesavers, especially for women over 40, but new research challenges this widely held belief. Two Danish researchers, Peter Gotzsche and Ole Olsen, examined studies from the 1970s and 1980s used to promote mammography and say they are so flawed that their conclusions cannot be supported. "There is no reliable evidence that screening decreases breast cancer mortality," they concluded in last October's issue of The Lancet. Since then, a scientific uproar has developed over the analysis. Now the National Cancer Institute is reviewing its guidelines after a group of advisers agreed with Drs. Gotzsche and Olsen. Officially, the NCI still recommends that women get screened. "That translates into, 'You should not make the decision lightly,'" panel member Donald Berry of Houston's M.D. Anderson Cancer Center explained. "It is something that a woman can reasonably choose not to do and not feel that she's harming her health." Many cancer specialists reject such skepticism. "The bulk of the evidence at this point continues to endorse mammography as a useful tool in potentially reducing one's risk," said Robert Young, president of the American Cancer Society. He said that screening can also mean the difference between breast-conserving surgery or a mastectomy.

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