Age alone no longer should be considered a defining factor when determining whether an older patient with blood cancer is a candidate for stem cell transplantation. That’s the conclusion of the first study summarizing long-term outcomes from a series of prospective clinical trials of patients age 60 and over who were treated with the mini-transplant, a “kinder, gentler” form of allogeneic (donor cell) stem cell transplantation developed at Fred Hutchinson Cancer Research Center. The findings are published Nov. 2 in JAMA, The Journal of the American Medical Association.
“Age is no longer a barrier to allogeneic transplant,” said Mohamed Sorror, M.D., M.Sc., an assistant member of the Hutchinson Center’s Clinical Research Division and corresponding author of the paper.
Sorror and colleagues found that the five-year rates of overall and disease-progression-free survival among mini-transplant patients were 35 percent and 32 percent, respectively. Patients in three age groups – 60 to 64, 65 to 69 and 70 to 75 – had comparable survival rates, which suggested that age played a limited role in how patients tolerate the mini-transplant. Increased medical problems unrelated to cancer (comorbidities) and a higher degree of cancer aggressiveness were the two factors that affected survival among those older patients. For example, patients who had less-aggressive cancer and fewer comorbidities had a five-year survival rate of 69 percent, while patients with more aggressive cancer and a significant number of comorbidities had a survival rate of 23 percent, regardless of age.Although a long-term survival rate of one-third of patients may seem low, these patients all would have died of their diseases within a matter of months without a transplant. “The majority of patients were referred for a transplant after they had exhausted all forms of conventional therapy,” said Sorror, who works in the research group led by Rainer Storb, M.D., who developed the mini-transplant.
(…) Participation in this drive and thus registration with the National Marrow Donor Program consists of simple swabs of the cheeks using Q-tips for a DNA test. DNA information is entered into this lifesaving donor program database. If a potential donor is identified as a potential match for David or someone else in need, he/she will be contacted by the donor program to have a small amount of blood drawn for lab testing.
If that person is then confirmed as a match, he/she will be asked to provide stem cells through a simple donation procedure where blood is taken from one arm through a needle and run through a machine, which separates the stem cells from the blood, and returned into the other arm.
Myelodysplastic Syndromes (MDS) are a group of diseases that affect the bone marrow and blood. Some types of MDS are mild and easily managed, which other types are severe and life-threatening. Mild MDS can grow more severe over time. It can develop into a fast-growing, severe leukemia called acute myelogenous leukemia. Stem cell transplant is the only treatment that can cure MDS.
In this treatment, the patient receives high-dose chemotherapy and/or total body irradiation to kill the cells in the bone marrow (including the abnormal bone marrow cells). The patient would then receive new functioning blood-forming stem cells harvested from the donor (…)
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Scientists at the FIRC (Italian Foundation for Cancer Research) Institute of Molecular Oncology of the European Institute of Oncology in Milan have revealed how to eliminate cancer stem cells, the true reason for cancer’s incurability. Researchers led by Pier Giuseppe Pelicci, Director of the Department of Experimental Oncology of the European Institute of Oncology, and Professor of general pathology at the University of Milan, have discovered how cancer stem cells become immortal.
The same oncogenes that are responsible for triggering the process of tumor formation, also impede stem cells from growing old, and allow them to maintain their ability to form new tumor tissue. Basically, early cancer ‘mother’ cells replicate slower than other cells giving them time to repair damage making them virtually immortal. This discovery was published in Nature magazine.
“Current drugs”, a note from the oncologists that worked on the project explained, “are directed at later cancer cells, the ‘daughter cell’. This discovery paves the way for a phase of cures aimed at hitting original cancer stem cells or the mother cells”. New drugs with this function are already in the clinical testing phase on human beings: “In the next 5-10 years these drugs could become available for some types of tumors”. The study was performed in collaboration with the University of Milan.
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Mandi Schwartz ’11 completed a crucial step in her battle with leukemia Wednesday afternoon.
The women’s hockey player received a long-awaited stem cell transplant at about 3:30 p.m. local time at the inpatient transplant unit of the Seattle Cancer Care Alliance at the University of Washington Medical Center. The procedure took 32 minutes and there were no complications, said Dean Forbes, a spokesman for the cancer center.
Schwartz, a native of Saskatchewan, Canada has been in and out of chemotherapy for more than 20 months since first being diagnosed with acute myeloid leukemia in December 2008. After months of searching for an adequate bone marrow or stem cell donor, two “five-out-of-six” stem cell matches were located and Schwartz’s transplant was slated for Aug. 27, as she was declared in remission on June 9. But the timeline changed when Schwartz learned on Aug. 11 that her cancer had returned for a third time.
On Aug. 31, Schwartz entered remission once again after completing additional chemotherapy. She underwent a daily pair of hour-long radiation sessions between Sept. 15 and 17, and had another two days of chemotherapy on Sunday and Monday to prepare for the transplant.
Now, with the procedure completed at last, Schwartz will wait to see if the stem cells engraft. Forbes said it will take about three weeks to determine whether the transplant was successful. Schwartz will remain in the hospital during that stretch of time because her immune system is still weak.
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