Transplantation
The particularly powerful ? and very scarce ? flexible forms of stem cells needed for medical research and treatment may now be both plentiful and simple to produce, with a new technology developed at the U.S. Department of Energy's Argonne National Laboratory ? and the source is as close as your own bloodstream. These flexible stem cells, able to morph into a variety of cell types, are called "pluripotent," and before this Argonne research, they have been found only in fetal tissue, which is limited, and in bone marrow, which is difficult to collect. Pluripotent stem cells are important because they can generate all types of tissues found in the body, and the Argonne-developed technology can produce them from adult blood cells.
As a result of a blood type mismatch that occurred during the Feb. 7, 2003 heart-lung transplant for Jesica Santillan, Duke University Hospital has implemented additional safeguards that will improve the safety of the organ transplantation process.
"Every effort is being made to save Jesica's life," said William Fulkerson, M.D., CEO of Duke Hospital. "Our primary concern has always been for Jesica and her family. This was a tragic error, and we accept responsibility for our part. This is an especially sad situation since we intended this operation to save the life of a girl whose prognosis was grave. Jesica continues to remain at the top of the national organ donation list.
Eds: Jesica Santillan received a new heart transplant that was reportedly functioning unaided Thursday afternoon.
Rapamycin, a drug approved for use in kidney transplant patients to prevent organ rejection, could also benefit patients with lupus and other autoimmune diseases as well as patients with blood cancers, such as acute myeloid leukemia, reports a team of researchers from the University of Pittsburgh and Justus-Liebig University in Giessen, Germany. Their conclusions, outlined in a paper to be published in the journal Blood and currently posted on the journal's Web site (www.bloodjournal.org), were based on two key discoveries about rapamycin's mechanisms.
Exposing rats to low levels of carbon monoxide (CO) prior to aorta transplantation prevents arteriosclerosis associated with chronic organ rejection and can also suppress stenosis after balloon-angioplasty-induced carotid artery injury, according to a study published in the Feb. 1 edition of Nature Medicine. The article is published online today.
"These findings demonstrate a significant protective role for CO in vascular injury and support its use as a therapeutic agent," according to study author Leo Otterbein, Ph.D., research assistant professor, University of Pittsburgh School of Medicine, division of pulmonary and critical care medicine.
Nearly one-third of patients with advanced multiple myeloma who had failed current standard therapy of chemotherapy or stem cell transplantation responded to thalidomide for a median duration of nearly one year in a Mayo Clinic study of the effects of thalidomide on myeloma. The findings are reported in the January issue of Mayo Clinic Proceedings.
Many studies in the last three years have determined that thalidomide is effective in the treatment of multiple myeloma, following the initial report by researchers at the University of Arkansas. However, information is limited on how long thalidomide therapy works and on survival rates with such therapy.
Transplanted hearts stayed healthier in patients who took a cholesterol-lowering drug, according to an eight-year study reported in today's rapid access issue of Circulation: Journal of the American Heart Association. After eight years, the survival rate for patients who received early simvastatin treatment was 88.6 percent compared to 59.5 percent of patients who didn't start simvastatin treatment until four years after transplant, says the study's lead author. The team also studied the effects of simvastatin on the development of coronary artery thickening called transplant vasculopathy, which is a major long term complication of heart transplantation. Early simvastatin treatment cut in half the incidence of vessel thickening as measured by angiography, which probably explained the improved survival rate.
The Stanford University School of Medicine announced on Dec. 10 plans to form an Institute for Cancer/Stem Cell Biology and Medicine. This multidisciplinary institute will study both stem cell biology and cancer biology, and will attempt to apply knowledge learned from stem cell biology to new treatments for cancer.
Q: Is Stanford planning on cloning human embryos?
A: No. The new institute will study adult stem cell lines generated from individuals with specific diseases such as cancer or neurodegenerative disorders. The institute will also investigate two different ways of generating new embryonic stem cell lines ? initially in mice. This may be extended to human cell lines if the techniques prove useful.
An international team of researchers has used a gene test to identify certain patients with adult T-cell acute lymphoblastic leukemia (ALL) who can be successfully treated with chemotherapy alone and should not be subjected to the rigors of bone marrow transplants. The researchers found that these patients survived for at least three years after being treated with intensive chemotherapy. It was previously known that only slightly over half of the patients with this disease could be cured with chemotherapy. Adult ALL patients often undergo transplants in an effort to beat back the stubborn disease. Until now there was no way to identify those who have a more favorable outlook and shouldn't undergo risky bone marrow transplantation.
The longer patients on dialysis wait for a kidney transplant once they develop end-stage renal disease, the worse they fare, researchers have confirmed. The findings reinforce the benefit of transplantation over dialysis for these patients and highlight the importance of placing them on the transplant list as early in the course of their disease as possible, researchers say.
Bone marrow cells implanted into blood-starved legs formed new blood vessels, increased blood flow and prevented amputation in people with peripheral artery disease, researchers have reported. "This is the first multicenter and double-blind clinical study to prove the clinical efficacy of growing new blood vessels using bone marrow cell transplantation,? says the study's lead author Hiroya Masaki M.D., Ph.D. He hopes that transplanting bone marrow cells will establish a new therapy for peripheral artery disease (PAD).
Cancer researchers in San Diego have developed a 3-step process in which human leukemia cells and neighboring immune-system T cells are manipulated together in the laboratory to create a powerful and specific cancer-killing cocktail. "For reasons that are not yet entirely clear, leukemia cells fail to trigger immune responses," said the study's senior author, Edward D. Ball, M.D., of the Rebecca and John Moores UCSD Cancer Center. "We have developed a method in which we induce the leukemia cell to change its behavior and stimulate the immune system. At the same time, we persuade the immune system to wake up and attack only the leukemia cells." The details of this approach, known as adoptive immunotherapy or cellular therapy, are reported in the October issue of the journal Biology of Blood and Marrow Transplantation.
