“Latest Stem Cells News”

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.

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A particular type of stem cell transplantation using the patient’s own cells led to short-term freedom from insulin injections in 20 of 23 patients newly diagnosed with type 1 diabetes participating in an experimental protocol in Brazil.

One patient even managed to go four years without needing outside sources of insulin, although the average was 31 months, said the authors of a report in the April 15 issue of the Journal of the American Medical Association, a themed issue on diabetes.

The patients also kept their blood sugar under control, which is key to preventing complications from diabetes. And, the authors stated, increased C-peptide levels indicated that the pancreas’ beta cells were alive and well.

“We were trying to preserve islet beta cell mass, that is, the cells that produce insulin, by stopping the immune system attack on these cells,” said senior study author Dr. Richard Burt, of Northwestern University Feinberg School of Medicine in Chicago. “Why new onset? Because we wanted to make sure there were still some islets there. We don’t believe stem cells form islet cells, but if the islet cells are still there, there might be regeneration if we stop the attack soon enough.”

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