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Partial-match cell transplants for kids with resistant leukemia

Children with most resistant leukemia can be treated with a superior method of blood stem cell transplantations, when regular treatment fails, as showed by the clinicians at the St. Jude Children's Research Hospital. //

The St. Jude technique allows blood stem cells to come from parents or unmatched adult siblings; and it avoids the aggressive, toxic treatments that usually must accompany the transplant. This allows the majority of patients with leukemia or non-cancerous blood disorders to receive a transplant, according to Gregory Hale, M.D., St. Jude Bone Marrow Transplantation Division interim chief. A report on this work appears in the prepublication edition of the British Journal of Haematology.

A clinical trial of this technique demonstrated that it accelerated recovery of the immune system in recipients and shortened the duration of immune deficiency during the early post-transplant period, reducing the risk of infections. The immune system recovery included not only T and B lymphocytes, the major cells genetically programmed to attack specific targets, but also natural killer cells, a critical first-response army of cells that acts as a quick-strike force against a wide variety of targets.

"The overall success of this procedure suggests it holds promise for children who are likely to fail standard treatment for leukemia because they have treatment-resistant disease and no matched donor," Hale said.

The key to the St. Jude strategy--reduced intensity conditioning regimen (RICR)--is that it avoids the total-body irradiation routinely used to kill the recipient's own stem cells to make way for the transplantation. RICR also avoids the use of anti-thymocyte globulin (ATG), a drug commonly used to suppress the remaining immune system of recipients in order to reduce the chance they will reject the transplanted blood stem cells. ATG often delays rebuilding of the immune system in transplant recipients and can lead to a vir
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