Navigation Links
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 us-related lymphoma. The standard treatment, called myeloablative conditioning regimen (MCR) uses total body irradiation, ATG and other drugs to eradicate the patient's own blood stem cells and suppress the remaining immune system to prevent rejection of the transplanted blood stem cells.

The underlying technique that permitted the team to eliminate total body irradiation and ATG was the use of haploidentical hematopoietic stem cell transplantation (HaploHSCT) for children, which was previously pioneered by St. Jude investigators. Before this technique, only matched transplants from a genetic twin or from a matched, unrelated donor could be used, since unmatched donations led to unacceptably high rates of severe graft-versus-host disease (GVHD).

However, the St. Jude technique treats partially matched donor blood stem cells to remove the aggressive immune system cells called T lymphocytes that normally cause GVHD. GVHD occurs when donor immune cells respond to the recipient as foreign and launch an attack on the body.

An additional advantage of this new treatment is that donor immune cells are likely to attack the leukemic cells remaining in the recipient, a reaction called a graft-versus-tumor response, according to the researchers.

During a 12-month follow-up after transplantation, the St. Jude team compared the results of its modified transplantation technique with results from a group of patients with refractory blood cancers who were treated with MCR. The investigators reported that following RICR in 22 children, 91 percent achieved full donor chimerism; that is, the recipients "adopted" the transplanted stem cells and built a blood system that was identical to that of the donor. In the MCR group that received the more aggressive therapy, 92 percent achieved full donor chimerism.

Also, although 12 patients in the RICR group and two in the MCR group experienced acute GVHD, and five in the RICR group developed chr onic GVHD, none of the patients had died at the end of the first year as a result of GVHD. Acute GVHD arises within 100 days of transplant, while chronic GVHD arises after the third month. v The team also reported that these patients had a rapid recovery of immune system cells during the first four months after transplantation, compared to patients who had undergone the more toxic, standard treatment to prepare them for transplantation. This rapid recovery of the immune system reduced occurrence of viral infection, the researchers reported.

"Many viruses exist in the body in an inactive state, even after a person clears an initial infection," Hale explained. "A healthy immune system keeps those viruses in check, but after a transplant, the patient's immune system is rebuilding and not capable of mounting a strong defense. That leaves the patient vulnerable to developing hepatitis, gastroenteritis, encephalitis or other diseases that can be fatal."

Viral infections can also cause graft failure or prolong the need for transfusions to supplement red blood cells or platelets, he added. Viral infections can further weaken the immune system of transplant recipients, leaving them vulnerable to fungal infections. Moreover, the drugs used to treat those viral infections and reactivation of old infections can cause low blood counts and kidney damage.

Source-Eurekalert
GYT
'"/>




Related medicine news :

1. Parasite infections linked to organ transplants
2. Cell transplants used to fend off Parkinsons symptoms
3. Bone marrow transplants for limbs
4. Cell transplants for stroke
5. More risks connected with live-donor liver transplants
6. Baltimore doctors perform three simultaneous kidney transplants
7. Skin cancer linked to usage of Drug Azathioprine in organ transplants
8. Innovative solution to help reduce the waiting times for kidney transplants
9. Islet cell transplants for Type 1 Diabetes
10. Flaws Reported in overview of US organ transplants
11. African HIV strains more resistant to anti HIV drugs
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:5/26/2016)... ... May 26, 2016 , ... Intalere, the healthcare ... suppliers for its inaugural Member Conference at the Paris Hotel in Las Vegas, ... operational health of America’s healthcare providers. , The conference was highlighted by the ...
(Date:5/26/2016)... (PRWEB) , ... May 26, 2016 , ... ... one that has a significant negative impact on long-term patient survival, reports a ... The results, published online this week in the Journal of Thoracic and Cardiovascular ...
(Date:5/26/2016)... ... May 26, 2016 , ... An April Gallup survey found rising health care ... of Sun Health Senior Living (SHSL) may not share those same worries ... prescription copays for the year, while holding the line on increasing their contributions, including ...
(Date:5/26/2016)... ... , ... The Lung Institute has partnered with the Gulfcoast North ... 6 at their clinic in downtown Tampa. The class is complimentary for the public. ... created a free downloadable 4 Week Smoking Cessation Guide for those who ...
(Date:5/26/2016)... ... May 26, 2016 , ... Eugene Batelli, D.P.M., ... with his wonderful accolades and stellar patient reviews, Dr. Batelli continues to be ... Dr. Eugene Batelli is a highly trained Podiatric Surgeon who specializes in treating ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... 25, 2016 ReportsnReports.com adds ... report that provides an overview on therapeutic pipeline ... various stages, therapeutics assessment by drug target, mechanism ... molecule type, along with latest updates, and featured ... players involved in the therapeutic development for Chronic ...
(Date:5/24/2016)... Cirujanos holandeses han puesto en ... médicos a compartir sus mejores prácticas por el mundo ... médicos de Europa, África, Asia ... aplicación, que combina la transmisión en vivo con mensajería ... Educación   "Imagine un médico de Medicines ...
(Date:5/24/2016)...   , Study met ... and superiority in , Excellent plus ... of the ascending colon   , ... B.V. today announced new positive data from the phase III MORA ... standard 2 litre PEG with ascorbate. The study met both primary ...
Breaking Medicine Technology: