No Barriers to Stem Cell Transplantation for Older Patients with Blood Cancers

Age no longer should be a barrier to stem cell transplantation for older patients with blood cancersAge 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.

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Patients’ own stem cells may protect against toxins of chemotherapy

Chemotherapy saves lives, but it also kills healthy tissue like bone marrow. According to a new study involving three patients with glioblastoma, a deadly cancer of the brain, stem cells from cancer patients’ own blood may protect their bone marrow from the toxic effects of treatment.

Glioblastomas often carry an active form of a gene called MGMT, which is a DNA repair enzyme that protects the cancer cells against chemotherapy. To overcome that protective effect, doctors use benzylguanine, a drug that blocks MGMT – but that drug also makes bone marrow and blood cells vulnerable. For this study, scientists at Fred Hutchinson Cancer Research Center in Washington took a different approach by transplanting gene-modified stem cells into study participants.

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United Spinal Association Reports Positive Results of Stem Cell Transplantation to Treat Multiple Sclerosis

Study May be Key to Unlocking a Cure

An article published in the Summer 2009 edition of Multiple Sclerosis Quarterly Report, a joint publication of United Spinal Association (www.UnitedSpinal.org) and the North American Research Committee on Multiple Sclerosis (NARCOMS), highlights the positive initial results of patients who have improving neurologic function after receiving a stem cell transplant, despite no longer taking any MS medications.

The results are reported in a National Institutes of Health (NIH)-sponsored study called HALT-MS to confirm whether high-dose immunosuppression followed by autologous stem cell transplantation will prevent MS attacks in patients who are not responding to available treatment options and ultimately protect against the degeneration of nerve fibers.

The article, written by George H. Kraft, MD, MS, director of the Western MS Center in Seattle, Washington, and colleagues, reveals the promising outcomes of the first three patients entered into the HALT-MS Study, including a 27-year-old woman with an 8-year history of relapsing MS who was treated with five different MS drugs, but continued to have relapses.

The study involves wiping out the patient’s immune system through high-dose chemotherapy or other means, such as radiation, to destroy most blood cells and bone marrow. Blood “stem cells” with the capacity to generate new blood and immune cells are then transplanted into the patient. These stem cells can either be the patient’s own or those from a matched donor. Once the cells are transplanted, they repopulate the bone marrow and restart building all the cell types found in the blood, a process called “engraftment”. After transplantation, the patient would effectively have a “new” immune system that would not attack nerves in the brain and spinal cord as seen in MS.

Currently, there are approximately 400 patients with MS worldwide who have been treated with stem cell transplantation. Research demonstrates that patients with highly active forms of relapsing-remitting MS have responded best to treatment.

The Halt-MS Study is taking place at four centers in the US: The Fred Hutchinson Cancer Research Center/University of Washington Western MS Center; Ohio State University; Baylor College of Medicine; and M.D. Anderson Cancer Center, and is currently open to participants with severe relapsing forms of MS. For more information, visit HALT-MS Website

from PR newswire

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Hutchinson cancer center gets 16.7mln USD for stem cells research

Two scientists at the Fred Hutchinson Cancer Research Center in Seattle have been awarded $16.7 million for stem cell research projects.
Dr. Irwin Bernstein and Beverly Torok-Storb received the federal funding from the National Heart, Lung and Blood Institute. Their award is part of a $170 million effort divided among 18 scientific teams.

Torok-Storb will work with Dr. Mortimer Poncz of Children’s Hospital of Philadelphia to develop molecular and cell-based therapies for a range of blood diseases, using an $8.2 million grant.
Bernstein will work with Edward Morrisey of the University of Pennsylvania to study how biochemical reactions inside cells affect cell development, using an $8.5 million grant.

from http://seattle.bizjournals.com/seattle/stories/2009/10/05/daily41.html

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Stem cell shield may protect body from chemotherapy side effects

Washington State University researchers provided computer analyses for a new gene therapy study published in Science Translational Medicine.

The study – conducted by the Fred Hutchinson Cancer Research Center in Seattle and published May 9 – found stem cell gene therapy could protect blood cells from damage by chemotherapy in patients suffering from glioblastoma (malignant brain tumors), thereby extending life expectancy.

The WSU laboratory of co-author Grant D. Trobridge, assistant professor of pharmaceutical sciences, developed bioinformatics software that aided the Fred Hutchinson researchers in evaluating the safety of the procedure. The approach was to remove blood stem cells, add a gene that shields them from chemotherapy used to treat the brain tumor, and then reintroduce these protected stem cells.

Trobridge noted the co-lead authors of the Fred Hutchinson study both received their Ph.D.s at WSU – Jennifer Adair in 2005 and Brian Beard in 2003 – in the School of Molecular Biosciences. Both now work at Fred Hutchinson in the laboratory of Hans-Peter Kiem, who was senior author on the paper.

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