Archive for the ‘Bone Marrow Stem Cells’ Category
New Allo-HCT Approach Boosts Immune Response, Survival – Targeted Oncology
While ex vivo CD34-selected allogeneic hematopoietic stem cell transplants (HCTs) are promising treatments for patients with hematologic and myeloid malignancies, they can be limited by delayed immune recovery and increased risk of death not caused by relapse.
A late-breaking abstract presented at the 2024 Transplantation and Cellular Therapy Tandem Meetings investigated a new approach to allogeneic HCT. Investigators of the phase 2 PRAISE-IR study (NCT04872595) explored using a model-based approach to determine the optimal dose of antithymocyte globulin (ATG), which is used to prevent graft-vs-host disease after transplant. Previous studies suggested high ATG exposure might contribute to nonrelapse mortality.
According to Michael Scordo, MD, the model successfully achieved a low posttransplant ATG exposure, and immune reconstitution by day 100 was achieved in 69% of patients, meeting the studys primary end point. Further, the 2-year rates of nonrelapse mortality and relapse were 9% and 13%, respectively, and relapse-free survival and overall survival rates were high at 78% and 86%, respectively.
These findings suggest that using a model to determine the ATG dose for ex vivo CD34-selected allogeneic HCT can lead to improved immune reconstitution and excellent survival outcomes. This approach may help reduce nonrelapse mortality previously observed in other trials and improve the safety and effectiveness of this type of transplant.
In an interview with Targeted OncologyTM, Scordo, bone marrow transplant specialist and cellular therapist at Memorial Sloan Kettering Cancer Center in New York, New York, discussed the findings from this study and their implications for the allogeneic HCT treatment landscape.
Targeted Oncology: What was the rationale or inspiration for the study you presented at the Tandem Meetings?
Scordo: Ex vivo CD34-selected [allogeneic] transplant is one of the many methods of reducing graft-vs-host disease. It uses a myeloablative conditioning platform and integrates ATG, antithymocyte globulin, into that platform to help reduce the risk of rejection. This has been well studied over the years, but 1 of the downsides of this approach is the delayed immune recovery, particularly the T-cell immune recovery that occurs after [allogeneic] transplant with this approach. What we did based on a recent publication that we have from last year was we used a different dosing of ATG to ensure that the T-cell immune recovery after [allogeneic] transplant using ex vivo CD34 selection would be improved.
What are some of the unmet needs in this space?
There are many methods to reduce graft-vs-host disease after transplant CD34 selection. Many of the other methods including posttransplant cyclophosphamide [PTCy], which has now become a standard of care, are out there and should be used in the appropriate setting. In matched donor transplants, ex vivo CD34 selection is one of the methods of being able to use an ablative or intensive conditioning regimen with very low rates of particularly chronic graft-vs-host disease. We saw this as an opportunity to improve on this platform significantly, using a novel approach but a simple approach.
What were the goals of this study?
The primary end point of the study was the ability to improve the CD34 T-cell immune recovery by day 100 after transplant. This was a sort of a validated predictor in other studies. We had key secondary end points that included nonrelapse mortality, relapse rates, progression-free, and overall survival. With the primary end point, we exceeded that end point. With our trial, about 70% of our 56 patients achieved this appropriate immune recovery by day 100, which was significantly higher than our historical numbers had shown.
What were some of the other findings?
Aside from achieving the primary end point, we saw very low rates of nonrelapse mortality at 2 years, estimated at 8%, which is much lower than some of the previously published data using this platform in the last couple of years. [We also saw] low relapse rates [of] about 12% at 2 years and very favorable progression-free and overall survival, which was 80% and 87%, respectively, at 2 years.
What are some of the takeaways?
I look at this as a simple but novel approach to improving on a platform. We have existing platforms that work well, but we can improve them doing well. To community oncologists, I would say that for patients with myeloid malignancies, there are many different types of transplants that can be done safely and effectively. The appropriate choice of a platform really depends on many factors. We can improve on all these platforms individually, including PTCy. [For] ex vivo CD34 selection, I look at this as a method of just improving on what we have already shown to be an effective platform, being able to use dose-intensive chemotherapy or total body radiation to achieve maximal disease control but making the platform safe and tolerable.
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New Allo-HCT Approach Boosts Immune Response, Survival - Targeted Oncology
New immunotherapy could make blood more ‘youthful,’ mouse study hints – Livescience.com
Scientists reversed some signs of immune aging in mice with a new treatment that could one day potentially be used in humans.
The new immunotherapy works by disrupting a natural process by which the immune system becomes biased towards making one type of cell as it ages.
The mouse study is an "important" proof-of-concept, but it's currently difficult to gauge the significance of the findings, Dr. Janko . Nikolich-Zugich, a professor of immunobiology at the University of Arizona who was not involved in the research, told Live Science in an email. More work is needed to see how well the therapy shifts the immune system into a more youthful, effective state.
All blood cells, including immune cells and the red blood cells that carry oxygen around the body, start life as hematopoietic stem cells (HSC) in the blood and bone marrow, the spongy tissue found within certain bones. HSCs fall into two main categories: those destined to become so-called myeloid cells and those that will develop into lymphoid cells.
Myeloid cells include red blood cells and immune cells belonging to our broadly reactive first line of defense against pathogens, including cells called macrophages that trigger inflammation. Lymphoid cells include cells that develop a memory of germs, such as T and B cells.
Related: 'If you don't have inflammation, then you'll die': How scientists are reprogramming the body's natural superpower
As we age, the HSCs slated to become myeloid cells gradually increase in number and eventually outnumber the lymphoid stem cells. This means we can't respond to infections as well when we're older as when we're young, and we're more likely to experience chronic inflammation triggered by increasing levels of myeloid cells that trigger inflammation.
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In the new study, published Wednesday (March 27) in the journal Nature, scientists developed an antibody-based therapy that selectively targets and destroys the myeloid HSCs, thus restoring the balance of the two cell types and making the blood more "youthful." The antibodies latch onto the targeted cells and flag them to be destroyed by the immune system.
The authors injected the therapy into mice aged 18 to 24 months, or roughly the equivalent of being between 56 and 69 years old as a human.
They then extracted HSCs from the mice after treatment and analyzed them, revealing the rodents had a smaller percentage of the myeloid HSCs than untreated mice of the same age.
This effect lasted for two months. Compared with untreated mice, the treated mice also produced more naive T cells and mature B cells. These cells can go on to form memory cells, which are directly involved in the immune attack; in the case of the B cells, they can form antibody-producing plasma cells.
"Not only did we see a shift toward cells involved in adaptive immunity, but we also observed a dampening in the levels of inflammatory proteins in the treated animals," Dr. Jason Ross, lead study author and postdoctoral researcher at Stanford University, said in a statement. Specifically, the researchers saw that the levels of one proinflammatory protein fell in the treated mice. This protein, called IL-1beta, is mainly made by myeloid cells.
Eight weeks post-treatment, the researchers vaccinated the mice against a virus they'd never been exposed to before. The mice that had received the immunotherapy had more apt immune responses to vaccination than the untreated mice, producing more T cells against the germ.
"We believe that this study represents the first steps in applying this strategy in humans," Ross said. However, other experts have cautioned against jumping to conclusions.
Nikolich-Zugich noted that, although the researchers measured changes in the numbers of naive T cells in the mice, they didn't look at the function of the organ that makes them: the thymus. The team also saw reductions only in IL-1beta and not other inflammatory proteins. They also didn't test whether the mice's baseline immunity to new infections could be improved with this therapy, without vaccination, he said.
Furthermore, the study didn't consider potential long-term side effects of the treatment, such as anemia, or a deficiency in red blood cells, said Dr. Ilaria Bellantuono, a professor in musculoskeletal aging at the University of Sheffield in the U.K. who was not involved in the research.
Although an "interesting" study, more work is needed to understand whether it can bring "meaningful changes" in the immune system, Bellantuono told Live Science in an email, whether that of mice or humans.
Ever wonder why some people build muscle more easily than others or why freckles come out in the sun? Send us your questions about how the human body works to community@livescience.com with the subject line "Health Desk Q," and you may see your question answered on the website!
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New immunotherapy could make blood more 'youthful,' mouse study hints - Livescience.com
Geron Presentations at Upcoming EHA Annual Meeting to Report Updated Durability, Disease Modification and Favorable Patient Reported Outcomes (PRO) in…
BioRestorative Therapies Announces Completion of Patient Enrollment for Safety Run-In Component of its Phase 2 Clinical Study of BRTX-100 -…
BioRestorative Therapies Announces Completion of Patient Enrollment for Safety Run-In Component of its Phase 2 Clinical Study of BRTX-100 Marketscreener.com
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BrainStorm Cell Therapeutics Strengthens Leadership Team with Appointment of Kirk Taylor, M.D., as Executive Vice President and Chief Medical Officer…
BrainStorm Cell Therapeutics Strengthens Leadership Team with Appointment of Kirk Taylor, M.D., as Executive Vice President and Chief Medical Officer Marketscreener.com
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BioRestorative Therapies Announces Notice of Allowance by the European Patent Office for Patent Related to its ThermoStem Program – Marketscreener.com
BioRestorative Therapies Announces Notice of Allowance by the European Patent Office for Patent Related to its ThermoStem Program Marketscreener.com
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BioRestorative Therapies Announces Notice of Allowance by the European Patent Office for Patent Related to its ThermoStem Program - Marketscreener.com
Here are the 9 most common types of cancer – Interesting Engineering
Around 80% survive their cancer for one year or more, and almost 60% survive their cancer for five years or more.
Early-stage colon cancer can often be identified and treated with a colonoscopy. A colonoscopy employs a tiny camera mounted on a small, flexible tube to look for indications of colon cancer.
During a colonoscopy, small, early-stage malignancies may also be removed. Surgery is typically required for larger tumors. It is occasionally used with radiation, chemotherapy, targeted therapy, and/or immunotherapy. These therapies reduce tumor size and stop their spread.
Breast cancer can kill both men and women.
Cancerous cells in the lining of the breast's lobules or ducts are what cause breast cancer. While the vast majority of cases are found in women, men make up around 1% of all breast cancer cases. The process through which cells become cancerous and infiltrate other body tissues takes time.
Surgical treatments for breast cancer may include removal of the breast tissue and associated lymph glands (mastectomy) or lumpectomy.
Other than surgery, there are other methods to help treat this type of cancer. These include, but are not limited to: -
Few people ever survive pancreatic cancer.
Pancreatic cancer, once it starts, tends to be one of the most aggressive of all cancers. It frequently kills rapidly and produces uncomfortable symptoms like these:
Despite its aggressive nature, there aren't many reliable screening options for pancreatic cancer yet. But, regular ultrasound and MRI/CT imaging tests should be performed on people who are at increased risk.
Aggressive chemotherapy and surgery are frequently required for people with this kind of cancer. When tumors cannot be removed, radiation may be used to reduce their size.
Only 10% to 20% of cancer patients are candidates for surgery. In the U.S., five-year survival rates for localized pancreatic cancer are around 42%, but for all stages of pancreatic cancer, this drops to 11%.
Prostate cancer is big killer of older men.
The prostate is located between the rectum and bladder in the center of the lower pelvis. Its main purpose is to produce the fluid that nourishes sperm in men.
Since the prostate is a gland rather than an organ, per se, it is an example of something called adenocarcinoma. It typically affects older men, is more prevalent in black men, and is more likely to run in families.
Prostate tumors typically grow slowly. This form of cancer may not immediately show signs in its victims, and in older men, in particular, it may move so slowly that only minimal treatment is recommended. Doctors might opt for a wait-and-see approach to treatment as a result. Interestingly, many people with prostate cancer die of unrelated causes, such as a heart attack or stroke.
Even if they have no symptoms, older men should be frequently checked for prostate cancer using a digital rectal exam and prostate-specific antigen (PSA) testing, although many professionals today dispute the usefulness of prostate screening.
Prostate cancer treatment usually involves one or more of the following:
Cancer of the esophagus also kills alot of people.
The esophagus is the muscular tube that carries food from the throat to the stomach. Older age, being a man, smoking, consuming alcohol, and having severe acid reflux (where stomach acid rises into the lower esophagus), are risk factors for esophageal cancer.
Depending on how far along the cancer is, there are a variety of possible treatments, such as surgery, chemotherapy, radiation, immunotherapy, and targeted therapies.
Liver cancer is sadly on the rise.
One of the most prevalent types of cancer in the world is liver cancer. Although liver cancer is not widespread in the U.S., it has been on the rise since the 1980s, with its incidence more than doubling.
Chronic hepatitis B or hepatitis C infections are the main cause of liver cancer. Blood and semen are just two body fluids that can spread either of these illnesses. Although there is no vaccine for hepatitis C, the CDC advises that all children receive the hepatitis B vaccine.
Intrahepatic bile duct cancer, which develops in the ducts that transfer bile from the liver and gallbladder to the small intestine, where the bile aids in the digestion of lipids from the diet, is a closely related cancer.
Brain cancer is less common, but very deadly.
In adults, brain tumors rarely begin in the brain.Instead, they usually spread there from other malignancies.
However, as malignancies are classified according to their location of origin, brain tumors that are caused by tumors that began elsewhere in the body are generally excluded from brain cancer survival statistics.
If a person passed away from cancer that started in the lung and spread to the brain, for instance, the death would have an impact on lung cancer survival numbers rather than brain cancer survival statistics.
According to the Mayo Clinic, most brain tumors in children, however, do start in the brain. Family history and radiation exposure to the head are risk factors for brain tumors. Typically, radiation exposure occurs while undergoing treatment for another cancer.
Treatment options for brain tumors can range from surgery to radiation to chemotherapy to immunotherapies to targeted medicines, depending on the tumor type and the extent of the malignancy at the time of diagnosis.
Leukemia is also a big killer.
Leukemias develop from stem cells in the bone marrow, which differentiate into different blood-cell precursors and eventually blood cells. It is caused by a rise in the number of white blood cells in your body. Those excess white blood cells don't work properly, and they crowd out the red blood cells and platelets your body needs.
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Here are the 9 most common types of cancer - Interesting Engineering
Are immunotherapy and chemotherapy the same thing? How cancer treatments work – Nebraska Medicine
As cancer treatments continue to advance and new therapies are introduced, it's easy to get lost in your search for information. To help you better understand the differences between specific cancer treatments and how they work, we spoke with medical oncologist Bhavina Sharma, MD, MPH.
"Chemotherapy are drugs designed to directly attack all rapidly dividing cells in the body, including cancer cells," explains Dr. Sharma. "It relies on the idea that cancer cells reproduce much faster than most healthy cells in our body."
Chemotherapy drugs can be given by infusion or in pill form. Unfortunately, these drugs can't tell the difference between cancerous cells and fast-growing healthy cells like the gastrointestinal tract and hair follicles, leading to side effects such as diarrhea and hair loss. Thankfully, recent advancements in chemotherapy have helped lessen side effects such as nausea, pain and lethargy.
Targeted therapy are special drugs designed to target differences within cancer cells that help them thrive. Unlike chemotherapy, targeted therapy drugs actually change the inner workings of the cancer cell. Because targeted therapy focuses on the part of the cancer cell that makes it different from the normal, healthy cell, it often has fewer side effects than standard chemotherapy treatments.
Immunotherapy is very different than chemotherapy in that it helps our immune system to find and kill cancer cells.
"Cancer cells are abnormal cells that have formed in our body because of cell damage or mutations," explains Dr. Sharma. "Cancer cells hide from your immune system by shutting down certain pathways of the immune response. Immunotherapy unlocks those pathways so your immune system can recognize and remove the cancer cells."
Cellular therapies are treatments that improve the body's ability to fight cancer. "Stem cell therapy falls under the umbrella of cellular therapy," explains Dr. Sharma. "It uses stem cells to mount an immune response to attack your cancer cells."
Stem cells from blood and bone marrow can be used in transplants. These stem cells can either come from a matched donor (allogeneic) or from the patient themselves (autologous).
Chimeric antigen receptor therapy or CAR T-cell, is a type of cellular therapy.
"T cells are white blood cells that help our bodies fight infection and cancer," explains Dr. Sharma. "With CAR T-cell therapy, your own T cells are collected from your blood. These T cells are modified to recognize cancer as a foreign cell and attack it."
CAR T-cell therapy has been approved by the Food and Drug Administration to treat lymphoma, leukemia and multiple myeloma.
Hormone therapy slows or stops the growth of cancer that uses hormones to grow. It is also called hormonal therapy, hormone treatment or endocrine therapy. Hormone therapy is recommended for cancers that are hormone-receptor positive, such as certain breast and prostate cancers. It can't be used in cancers that don't carry hormone receptors.
"Hormone therapy can be used for both early stage and metastatic hormone-receptor positive breast cancers," explains Dr. Sharma. "In patients with early-stage breast cancer, it is used after surgery to help reduce the risk of the cancer coming back."
Chemotherapy, immunotherapy, targeted therapy, and hormone therapy are just a few of the treatments we use to treat cancer. Many of these cancer treatments can be combined with others like cancer surgery and radiation therapy. Every person's journey through cancer is different. Your oncology team will help you sort through the best therapies available to create your treatment plan.
The information in this article is for information purposes only. For specific questions regarding your medical condition or treatment plan, please consult with your doctor directly. To schedule an appointment with a Nebraska Medicine cancer specialist, call 402.559.5600.
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Are immunotherapy and chemotherapy the same thing? How cancer treatments work - Nebraska Medicine
Global Cord Blood Banking Market – Competition Forecast and Opportunities, 2027 – Yahoo Finance
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Global Cord Blood Banking Market By Service (Sample Preservation & Storage, Sample Analysis, Sample Processing, Sample Collection & Transportation), By Component (Cord Blood v/s Cord Tissue), By Application (Cancer Disease, Diabetes, Blood Disease, Immune Disorders, Metabolic Disorders, Others), By Sector (Public Cord Blood Banks v/s Private cord Blood Banks), By Company, and By Region, Competition Forecast and Opportunities, 2027
New York, Oct. 07, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Global Cord Blood Banking Market - Competition Forecast and Opportunities, 2027" - https://www.reportlinker.com/p06325897/?utm_source=GNW
The global cord blood banking market is anticipated to observe impressive growth during the forecast period, 2023-2027.The major factors include the increase in genetic diseases and the growing awareness among parental population.
Cord blood stem cells treat various invasive diseases such as leukemia, anemia, and blood cancer.Moreover, there is an upsurge in the utilization of cord blood banking services for the treatment of immunodeficiency disorders across the world.
This, coupled with the growing awareness among masses about the benefits and broad availability of cord blood banking service donors, is impelling the growth of the market. The other factors supporting the markets growth are extensive investments by governments of different countries in research and development (R&D) activities to expedite clinical trials of cord blood stem cells, and expansion of healthcare industry.Increasing Prevalence of Hematological DisordersNowadays, more and more people are suffering from various hematological disorders and chronic diseases due to which storing of cord blood stem cells is very crucial.Cord blood holds a rich source of stem cells, which can cure hematological disorders such as leukemia, thalassemia, hemophilia, sickle cell anemia, lymphoma, and others.
The growing occurrence of different cancers, such as leukemia and lymphoma, due to longer working hours, hectic lives, and excessive smoking and alcohol intake signifies one of the key factors driving the cord blood banking market.Cord blood stem cells can cure chronic diseases such as cancer, blood diseases, diabetes, and immune diseases due to which an increase in the utilization of cord blood banking services for the treatment of these diseases is becoming more common.
For instance, in 2020, CIBMTR reported 4,864 unrelated and 4,160 related bone marrow and cord blood transplants which were performed in the United States.Growing Awareness regarding the Therapeutic Potential of Stem cellsStem cells have been proven to treat over 80 genetic diseases and other chronic diseases due to which people are becoming more aware regarding the therapeutic potential of stem cells across the globe.Parental as well as expectant populations are becoming more aware as health professionals are starting to educate them about the importance and benefits of storing cord blood stem cells which is driving the growth of the market, globally.
Additionally, increase in awareness among the public regarding the massive availability of service providers is likely to propel the growth of cord blood banking market.For instance, in the United States, the donor registry contains more than 9 million potential donors.
Also, the donor registry includes 266,000 cord blood units from which 115,000 units are from National Cord Blood Inventory (NCBI), with over 4000 NCBI units added in 2021.Increasing Investments for Cord Blood Banking SectorIncrease in fundings and initiatives by government for R&D, technological advancements and expansion of healthcare infrastructure is propelling the growth of the cord blood banking market, globally. Increasing investments in research and development for treating life threatening diseases and clinical trials for cord blood stem cells are expected to drive the market.Market SegmentationThe global cord blood banking market is segmented into service, component, application, sector, and company.Based on service, the market is divided into sample preservation & storage, sample analysis, sample processing, and sample collection & transportation.
Based on component, the market is divided into cord blood and cord tissue.Based on application, the market is divided into cancer disease, diabetes, blood disease, immune disorders, metabolic disorders, and others.
Based on sector, the market is divided into public cord blood banks and private cord blood banks. In terms of country, the United States is expected to be a lucrative market in the forecast period due to growing prevalence of hematological disorders and increasing R&D activities in the country.Market PlayersAmericord Registry LLC, Covis Group, Cordlife Group Limited, Cryo-Cell International, Inc., FamiCord Group, Cordvida, Perkinelmer Inc., Lifecell International Pvt. Ltd., ViaCord LLC, Global Cord Blood Corporation, and StemCyte Inc. are some of the leading companies operating in the market.
Report Scope:
In this report, global cord blood banking market has been segmented into following categories, in addition to the industry trends which have also been detailed below: Cord Blood Banking Market, By Service:o Sample Preservation & Storageo Sample Analysiso Sample Processingo Sample Collection & Transportation Cord Blood Banking Market, By Component:o Cord Bloodo Cord Tissue Cord Blood Banking, By Application:o Cancer Diseaseo Diabeteso Blood Diseaseo Immune Disorderso Metabolic Disorderso Others Cord Blood Banking Market, By Sector:o Public Cord Blood Bankso Private Cord Blood Banks Cord Blood Banking Market, By Region:o North AmericaUnited StatesCanadaMexicoo Asia-PacificChinaIndiaJapanAustraliaSouth Koreao Europe & CISGermanyFranceUnited KingdomSpainItalyo South AmericaBrazilArgentinaColombiao Middle East & AfricaSouth AfricaSaudi ArabiaUAE
Competitive Landscape
Company Profiles: Detailed analysis of the major companies present in Cord Blood Banking Market
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With the given market data, we offers customizations according to a companys specific needs. The following customization options are available for the report:
Company Information
Detailed analysis and profiling of additional market players (up to five).Read the full report: https://www.reportlinker.com/p06325897/?utm_source=GNW
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Global Cord Blood Banking Market - Competition Forecast and Opportunities, 2027 - Yahoo Finance
GPRC5D AntigenTargeted CAR T-cell Therapy Induces Strong Response in Resistant Multiple Myeloma – OncLive
MCARH109, a CAR T-cell therapy targeting the enigmatic GPRC5D antigen, generated remissions in 70.6% of patients with relapsed/refractory multiple myeloma.
MCARH109, a CAR T-cell therapy targeting the enigmatic GPRC5D antigen, generated remissions in 70.6% of patients with relapsed/refractory multiple myeloma, according to data from a first-in-human phase 1 trial (NCT04555551).1
Twelve of 17 patients experienced a measurable decline in their cancer after receiving MCARH109 CAR T cells. Six patients (35%) achieved complete response, and 10 patients (59%) had very good partial response or better. Eight patients (47%) had minimal residual disease negativity in bone marrow.
Although the study population was small, coauthor Renier Brentjens, MD, PhD, The Katherine Anne Gioia Endowed Chair in Cancer Medicine, chair of the department of medicine, and deputy director at Roswell Park Comprehensive Cancer Center; said these findings open up a new plan of attack for treating multiple myeloma.
Whats scientifically exciting is that we now have 2 populations of targeted cells which we think we can now feasibly treat patients with concomitantly, potentially, and that is very exciting, he explained in an interview with OncLive. That will certainly help set a proof of principle for other malignancies that we will target with CAR T cells, including solid tumor malignancies. It really is a significant step forward in the field. Its still to be seen how meaningful this iswhether its an opportunity to prolong responsesor to potentially enhance responses. Were very excited about that part of it.
Physicians have achieved deep, durable responses using B-cell maturation antigen (BCMA)targeting CAR T-cell therapies in patients with multiple myeloma. However, data from some studies show that progression-free survival is less than 12 months, an indicator of myeloma recurrence despite the persistence of CAR T cells.2 Relapse is common, and mechanisms of resistance are not fully defined, although recent data suggests that the identification of BCMA expression, copy number variation, and point mutations appeared to be key indicators of resistance for patients receiving BCMA-targeting CAR T-cell therapy or T-cell engagers.3
Investigators at Roswell Park developed MCARH109 in partnership with Memorial Sloan Kettering Cancer Center (MSKCC) and Dana-Farber Cancer Institute. Brentjens said investigators began exploring cellular therapeutic targets for multiple myeloma about 10 years ago. They identified 3 targets including BCMA, which is now FDA approved in the form of drugs, such as ciltacabtagene autoleucel (Carvykti), and the antigen GPRC5D.
GPRC5D is an intriguing target because its really nicely upregulated on multiple myeloma cells, but not expressed in most normal tissues, with some exceptions in the skin, for example, he explained. We knew even back then that we were likely going to have to go after more than 1 target.
Duration is limited for BCMA-directed therapy and there are few treatment options for patients who relapse. In preclinical models, investigators found in vitro and in vivo antitumor efficacy with GPRC5D CAR T cells in multiple myeloma, including in a BCMA antigen escape model. GPRC5D is highly expressed in myeloma cell lines and in bone marrow plasma cells of patients with multiple myeloma. The antigen is found less often in plasma cells in normal tissue and has low expression in a subset of cells in the hair follicles and hard keratinizing tissue.
The 17 patients in the phase 1 trial, conducted at MSKCC, had undergone a median of 6 prior treatments for myeloma, including CAR T-cell therapy targeting BCMA, proteasome inhibitors, immunomodulatory agents (IMiDs), and anti-CD38 antibodybased therapies. Eligible patients had an ECOG score of 0 or 1 and adequate organ function. Baseline GPRC5D expression in the bone marrow was not required for enrollment.
Patients could receive bridging therapy following apheresis but had to discontinue at least 2 weeks before initiating lymphodepleting chemotherapy. Lymphodepletion consisted of daily 300 mg/m2 cyclophosphamide plus 30 mg/m2 fludarabine for 3 consecutive days. Two days after the completion of lymphodepletion, investigators administered MCARH109 at 4 dose levels: 25 106, 50 106, 150 106, and 450 106 CAR T cells.
Investigators followed all patients until disease progression. Long-term follow-up continued until death or withdrawal of consent.
The median patient age was 60 years (range, 38-76). All patients received previous treatment with 2 proteasome inhibitors, 2 IMiDs, and 1 anti-CD38 antibody. Sixteen patients (94%) had triple-refractory disease.
Ten patients (59%) had received previous treatment with BCMA-targeted therapies, including 8 (47%) who received previous BCMA CAR T-cell therapy. Nine responded to BCMA-targeted therapy and 2 were refractory to the treatment. The median time from last BCMA therapy to MCARH109 infusion was 16.4 months (range, 4.4-36.6).
All patients had previously received high-dose melphalan and undergone an autologous stem cell transplantation. Three patients (18%) had previously received allogeneic transplantation.
Fourteen patients (82%) were refractory to their last line of therapy. Sixteen patients (94%) received bridging therapy after leukapheresis; 15 were refractory to bridging therapy.
Three patients (18%) had nonsecretory myeloma at baseline, and 8 (47%) had extramedullary plasmacytoma. Thirteen (76%) had one or more high-risk cytogenetic features, defined by the presence of 1q gain, del(17p), t(4;14), or t(14;16).
At a median follow-up of 10.1 months (95% CI, 8.5not reached [NR]), 6 of 12 patients (50%) with a partial response or better remained progression free. Two patients have completed more than 1 year of follow-up after MCARH109 infusion.
The median duration of response (DOR) was 7.8 months (95% CI, 5.7-NR) in the entire cohort. The median DOR was also 7.8 months (95% CI, 4.6-NR) in patients who received 25 106 to 150 106 CAR T cells.
At the maximum tolerated dose of 150106 cells, 58% of patients had a response.
Seven of 10 patients who received previous BCMA-targeted therapies had partial response or better. The same was true for 3 of 6 patients (50%) treated at doses of 25 106 to 150 106 cells.
Fourteen patients experienced grade 1/2 cytokine release syndrome (CRS). One patient at the highest dose level (450 106 CAR T cells) had a grade 4 CRS event. Investigators said this patient had grade 4 immune effector cellassociated neurotoxicity syndrome (ICANS) and grade 4 macrophage activation syndrome, which constituted a dose-limiting toxic effect. No other patients had ICANS or macrophage activation syndrome.
Two other patients at the highest dose level experienced a grade 3 cerebellar disorder that investigators determined was possibly related to MCARH109 and constituted a dose-limiting toxic effect for this dose.
The most common grade 3 or higher adverse effects (AEs) included neutropenia (94%), thrombocytopenia (65%), and anemia (35%). Nonhematologic grade 3 or higher events were uncommon.
Three patients (18%) experienced infections. Two experienced grade 3 events (bacterial infection and parvovirus infection, respectively).
Twelve patients were treated at dose levels that did not produce unacceptable AEs (25 106 to 150 106 CAR T cells). Seven of those (58%; 95% CI, 28%-85%) had an objective response.
They had relapsed or been refractory to BCMA-targeted CAR T cells, and yet we are still able to demonstrate clinical meaningfully clinical responses using the GPRC5D CAR T cells, Brentjens said. We now actually have 2 targets for patients with multiple myeloma rather than just 1. We can start to potentially explore [targeting 2] different antigens on the multiple myeloma tumor cell, either sequentially or concurrently, which is really exciting to potentially utilize this dual targeted approach to get more durable and long-term remissions in patients.
To the best of my knowledge, this the first time that we really have identified 2 targets on 1 tumor cell, both of which demonstrate really promising and significant responses. That really begs the question of, if we put the 2 populations together, will there be a synergistic benefit when assessing durability of response?
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GPRC5D AntigenTargeted CAR T-cell Therapy Induces Strong Response in Resistant Multiple Myeloma - OncLive
How a select few people have been cured of HIV – PBS
Over the past year, news of two new people cured of HIV grabbed headlines, stirring hopeful talk of what these scientific wonders might portend for the four-decade fight against the virus.
To researchers working in the HIV cure arena, these cases are inspiring because they prove it is in fact possible to eradicate this extraordinarily complex virus from the body.
That said, such cures are the result of treatments too toxic to attempt on all but a select few. So while they provide a scientific roadmap toward success, they do not necessarily make researchers job any easier as they work to develop alternatives: safe, effective and, crucially, scalable therapies to cure HIV.
HIV has been a tough nut to track, says Marshall Glesby, an infectious disease specialist at Weill Cornell Medicine in New York City and a coauthor of one of the recent HIV cure case studies. But there is incremental progress being made in terms of our understanding of where the virus hides within the body and potential ways to purge it from those sites.
The HIV cure research field is yet quite young. And it likely never would have ballooned as it has in recent years were it not for the very first successful cureone that served as a catalyst and guiding light for scientists.
During the late 1990s and early 2000s, the HIV research establishment focused the lions share of its energy and resources on treatment and prevention of the virus. Actually curing HIV was generally regarded as a distant dream, with only a small set of researchers pursuing such a goal.
Then, in 2008, German scientists announced the first case of what would ultimately be deemed a successful cure of the virus. This proof of concept ignited the field and sent financial investment soaringto $337 million in nonpharmaceutical industry funding in 2020, according to the HIV nonprofit AVAC.
Clinicians were able to cure HIV in an American man living in Berlin named Timothy Ray Brown, by exploiting the fact that he had also been diagnosed with acute myeloid leukemia, or AML. This made Brown a candidate for a stem cell (bone marrow) transplant to treat his blood cancer.
Browns treatment team relied on the existence of a rare genetic abnormality found among people with northern European ancestry. Known as the CCR5-delta32 mutation, it gives rise to immune cells lacking a certain coreceptor called CCR5 on their surface. This is a hook to which HIV typically latches to begin the process of infecting an immune cell and hijacking its machinery to manufacture new copies of the virus.
The clinicians found a stem cell donor who was not only a good genetic match for Brown, but who also had the CCR5-delta32 mutation. First they destroyed Browns immune system with full-dose chemotherapy and full-body radiation. Then they effectively gave him the donors immune system through the stem cell transplant. This cured his HIV by ensuring that any remaining virus in his body was incapable of infecting his new immune cells.
Variations of this method have yielded cures, or likely cures, in four other people during the years since. These cases provide researchers with increasing certainty that it is possible to achieve the ultimate goal: a sterilizing cure, in which the body has been rid of every last copy of virus capable of producing viable new copies of itself.
It was not a given that if you completely replace the immune system, even with a purportedly non-susceptible immune system, that you would cure infection, says Louis Picker, associate director of the Vaccine and Gene Therapy Institute at the Oregon Health & Science University. It was possible that HIV could be hiding in non-immune cells, like endothelial cells, and still find targets to infect.
But the small cohort of people who have been cured or likely cured to date, Picker says, show thats not the case.
Nevertheless, these successes have not opened the door to a cure for HIV available to much more than a few of the estimated 38 million people living with the virus worldwide. Critically, it is unethical to provide such a dangerous and toxic treatment to anyone who does not already qualify for a stem cell transplant to treat blood cancer or another health condition.
Brown, for one, nearly died from his treatment. And a number of efforts to repeat his case have failed.
Highly effective treatment for HIV hit the market in 1996, transforming what was once a death sentence into a manageable health condition. Today, the therapy, a combination of drugs called antiretrovirals, is so safe, tolerable and effective, that it has extended recipients life expectancy to near normal. But despite the fact that these medications can inhibit viral replication to such a degree that its undetectable by standard tests, they cannot eradicate HIV from the body.
Standing in the way is whats known as the HIV reservoir.
This viral reservoir is composed in large part of long-lived immune cells that enter a resting, or latent, state. Antiretrovirals only target cells that are actively producing new copies of the virus. So when HIV has infected a cell that is in a non-replicating state, the virus remains under the radar of these medications. Stop the treatment, and at any moment, any of these cells, which clone themselves, can restart their engines and repopulate the body with HIV.
This phenomenon is why people with HIV typically experience a viral rebound within a few weeks of stopping their antiretrovirals. And it is the reason why, given the harm such viral replication causes the body, those living with HIV must remain on treatment for the virus indefinitely to mitigate the deleterious impacts of the infection.
A key new advance is the finding that those cells which harbor the virus seem resistant to dying, a problem with cancer cells, HIV cure researcher Steven Deeks, a professor of medicine at University of California, San Francisco, says of the viral reservoir. We will be leveraging new cancer therapies aimed at targeting these resilient, hard-to-kill cells.
Brown stood alone on his pedestal for over a decade.
Then, at the 2019 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, researchers announced two new case studies of men with blood cancer and HIV who had received treatments similar to Browns. The men, known as the Dsseldorf and London patients, were treated for Hodgkin lymphoma and AML, respectively. By the time of the conference, both had spent extended periods off of antiretroviral treatment without a viral rebound.
To this day, neither man has experienced a viral reboundleading the authors of the London and Dsseldorf case studies recently to assert that they are definitely and almost definitely cured, respectively.
In February 2022, a team of researchers reported at CROI, held virtually, the first possible case of an HIV cure in a woman. The treatment she received for her leukemia represented an important scientific advance.
Called a haplo-cord transplant, this cutting-edge approach to treating blood cancer was developed to compensate for the difficulty of finding a close genetic match in the stem cell donorwhich is traditionally needed to provide the best chance that the stem cell transplant will work properly. Such an effort is made even more challenging when attempting to cure HIV, because the CCR5-delta32 mutation is so rare.
The American woman received a transplant of umbilical cord blood from a baby, who had the genetic mutation, followed by a transplant of stem cells from an adult, who did not. While each donor was only a partial match, the combination of the two transplants was meant to compensate for this less-than-ideal scenario. The result was the successful blooming of a new, HIV-resistant immune system.
The authors of the womans case study, including Weill Cornells Marshall Glesby, estimate that this new method could expand the number of candidates for HIV cure treatment to about 50 per year.
A variety of antiretroviral drugs used to treat HIV infection. Image Credit: NIAID, Flickr
In July, at the International AIDS Conference in Montreal, researchers announced the case of a fifth person possibly cured of HIV. Diagnosed with the virus in 1988 and 63 years old at the time of his stem cell transplant three years ago, the American man is the oldest to have achieved potential success with such a treatment and the one living with the virus for the longest. Because of his age, he received reduced intensity chemotherapy to treat his AML. Promisingly, he still beat both the cancer and the virus.
The lead author of this mans case study, Jana K. Dickter, an associate clinical professor of infectious disease at City of Hope in Duarte, California, says that such cases provide a guide for researchers. If we are able to successfully modify the CCR5 receptors from T cells for people living with HIV, she says, then there is a possibility we can cure a person from their HIV infection.
Scientists also know of two women whose own immune systems, in an extraordinary feat, appear to have cured them of HIV. Both are among the approximately 1 in 200 people with HIV, known as elite controllers, whose immune systems are able to suppress replication of the virus to low levels without antiretroviral treatment.
Researchers believe that these womens immune systems managed to preferentially eliminate immune cells infected with viral DNA capable of producing viable new virus, ultimately succeeding in eradicating every last such copy.
As they seek safer and more broadly applicable therapeutic options than the stem cell transplant approach, HIV cure researchers are pursuing a variety of avenues.
Some investigators are developing genetic treatments in which, for example, they attempt to edit an individuals own immune cells to make them lack the CCR5 coreceptor.
The science that I am particularly excited about and that we and others are working on is to make this treatment as an in vivo deliverable therapy that would not rely on transplant centers and could ultimately be given in an outpatient setting, says Hans-Peter Kiem, director of the stem cell and gene therapy program at the Fred Hutchinson Cancer Center in Seattle.
Then there is whats known as the shock and kill method, in which drugs are used to flush the virus from the reservoir and other treatments are then used to kill off the infected cells. Conversely, block and lock attempts to freeze the reservoir cells in a latent state for good. Researchers are also developing therapeutic vaccines that would augment the immune response to the virus.
Progress will be incremental and slow, Picker predicts, unless there is a discovery from left fieldan unpredictable advance that revolutionizes the field. I do think it will happen. My personal goal is to be a very good left fielder.
This reporting was supported by the Global Health Reporting Center.
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How a select few people have been cured of HIV - PBS
Organ transplantation: what it consists of and what the stages – Emergency Live International
An operation that has its roots, conceptually, in the earliest history of mankind (it was first spoken about by Chinese doctors), it is nevertheless a very recent therapeutic solution: the knowledge that made it possible (immunology, study of antigens) was only acquired at the beginning of the 20th century.
From 1950 onwards, transplantation became an established choice in the treatment of those pathologies that lead to the irreparable destruction of the organ and, therefore, to the death of the patient.
But transplantation is not only the last prospect for those whose lives are in danger: this operation also makes it possible to improve the quality of life for those patients suffering from chronic disabling diseases (e.g. kidney transplantation for dialysed patients).
The future of transplantation is still to be sketched out, but is very clear in the minds of scientists and doctors engaged in research: implantation of artificial organs or organs taken from genetically modified animals (xenotransplantation), cloning and implantation of stem cells are just some of the directions in which the worlds scientific landscape is moving.
The word transplant often indicates, in a reductive way, the operation of replacing a diseased organ with a healthy one.
In reality, there is a whole organisation and preparation behind this operation that involves extreme precision and synchronisation of people and instruments.
The practice of the operation differs depending on the donor: if the organ removal is from a living person, in fact, it is possible to plan the operation; which is obviously not feasible if the organs come from a cadaveric donor, who died of accidental and unforeseeable causes.
Once the medical committee has obtained the familys consent and declares the potential donors brain death to have occurred, the evaluation of his data begins: compatibility with potential recipients on the waiting lists, medical history, immune characteristics, blood group, etc.
PHASE 1
A person with injuries that could be a donor (for example, a very serious head injury) is admitted to intensive care.
A doctor speaks to the family about the possibility of donating his or her organs; if they are available, the coordination centre is immediately alerted, which is responsible for reporting the potential donor and identifying the potential recipient.
Meanwhile, the donor patients data are assessed: compatibility with potential recipients on the list, medical history, immune characteristics. The 6-hour observation period begins, which is mandatory before the certification of brain death.
PHASE 2
The explantation team is activated and must be available in a very short time.
The doctors usually reach the facility by helicopter. Meanwhile, at the hospital where the transplant will be performed, the recipient is called in to undergo various examinations and to assess his or her state of health.
Numerous checks are also carried out on the organs to be donated to prevent the transmission of infectious diseases or tumours from donor to recipient.
PHASE 3
At the end of the observation period, if all indications point to a diagnosis of irreversible brain death, explantation can begin (approximately 2 hours).
The recipient enters the operating theatre and is prepared for the operation. The administration of immunosuppressive drugs starts now to prevent the lymphocytes from recognising the organ as foreign and causing rejection.
PHASE 4
The organ finally arrives, immersed in a special solution to protect its cells and transported in a special container filled with ice to slow down its cellular activity.
One team of doctors prepares the recipient, the other takes care of cleaning the organ to be transplanted.
PHASE 5
The transplant can now begin: the blood vessels are connected, the bleeding is controlled.
STEP 6
The patient comes out of the operating theatre, but is still under anaesthesia, which will be prolonged for at least another 6 to 8 hours to allow the new organ to get used to the temperature difference between the container with the ice and the body and, of course, to the organ itself.
The patient remains connected to the machine to breathe.
STEP 7
The patient wakes up in the intensive care unit; if his general condition is good, he is taken off the artificial respirator.
After about 4 days, he starts walking again and eating.
After about 10 days, he will be able to leave the hospital and live with his new organ.
Initially, he will have to return to the hospital every day for immunological checks; after a year, he will be able to return once every two months.
Once brain death has been ascertained and the familys consent obtained (in the case of a lack of explicit donor wishes), the potential donor is no longer assisted by the mechanical respirator and the organs can be harvested for transplantation in the same hospital that established suitability.
The previously alerted team enters the operating theatre for the removal operation.
Opposing the removal never means helping the patient to have better care; care, in fact, ends the moment brain death is established; opposing it would therefore only mean depriving someone else of a better life thanks to a new organ.
Today, another type of transplant is also gaining ground, that from living people.
Indeed, it is now possible to take a kidney, liver or lung lobe for transplantation in particularly at-risk people who would not survive on the waiting list.
These are usually children, both because of the shortage of paediatric transplant organs and because of the small size, which also means that the donor does not face too high a risk.
Once taken, organs require special procedures to preserve them for transplantation.
There is, for each organ, a maximum preservation time, beyond which the tissues, no longer receiving blood, and therefore oxygen, go into necrosis, i.e. their cells die, and are therefore unusable.
These times vary from organ to organ: heart (4-6 hours), lung (4-6 hours), liver (12-18 hours), kidney 48-72 hours, pancreas (12-24 hours).
Rejection is the reaction that the recipient organism has towards the transplanted organ or tissue.
In fact, the recipients immune system recognises the organ as foreign and attacks it as if it were a pathogen.
There are four types of rejection
Experiencing rejection of the transplanted organ does not necessarily mean inevitably losing it; on the contrary, rejection is successfully treated if action is taken within a reasonable time frame through the use of immunosuppressive drugs.
The immunosuppressants that the doctor prescribes after the transplant will help the transplanted organ not to risk rejection and to remain healthy.
Since the cells of the immune system are different, the drugs prescribed for immunosuppression will also be different.
The largest and most immediate indication for transplantation is irreversible failure of vital organs such as kidneys, liver, lungs, pancreas, but also corneas, bone marrow, intestines.
Indeed, in these cases, transplantation is the only effective treatment to ensure survival.
Therefore, any pathological condition that prevents the organ from functioning in such a way as to threaten the patients survival is to be considered an indication for transplantation.
After transplantation, recipients are admitted for the first few days to a ward equipped for intensive care, where immunosuppressive therapy is started.
The immunosuppressed patient requires isolation in sterile rooms, specially created to avoid contamination of any kind from the outside environment.
The box in which the recipient is admitted after the transplant operation is completely isolated from the rest of the resuscitation unit used for conventional surgery.
The condition of strict isolation persists for as long as it takes for the patient to overcome the critical post-surgical phase (usually 5-6 days), or in cases where anti-rejection therapy is required.
In the immediate post-surgical period, visits to close relatives are permitted as long as they are appropriately dressed (according to the clean room entry procedures).
Each person is admitted to the filter zone one at a time and, of course, persons with suspicion and/or evidence of infectious diseases may not be admitted.
The most serious issues in transplant medicine are, on the one hand, the rejection of the transplanted organ and, on the other, the insufficiency of donated organs compared to those needed.
In both directions, research is experimenting with various solutions to overcome these problems.
With regard to rejection, attempts are being made to create solutions that manage to trick the immune system, thus reducing the immunosuppressive therapy currently in use, or that protect the transplanted organ from attack by T lymphocytes, which are responsible for eliminating agents outside the body.
On the other front, that of organ shortage, artificial organs, tissue engineering or xenotransplantation are being experimented with that can replace human organs.
Through gene therapy, it is possible to go to the source of the problem and eliminate genetic defects directly in the affected cells, tissues or organs.
The healthy gene is introduced directly into the affected spot, where it begins to produce those substances that the diseased body cannot produce on its own.
However, gene therapy is still far from being used. In order to be able to transport foreign DNA into the cell nucleus, special vectors are needed viruses that have lost their infectious characteristics, but are still able to attack cells and transmit their genetic heritage to them.
To avoid rejection, the organ to be transplanted would have to be treated in the laboratory, transferring genes into it that would make it capable of defending itself against the recipients immune system.
Now the genes are known, but they are not yet handled with the necessary precision. The next step will be to search for the perfect combination of genes that prevents the action of all the recipients immunological mechanisms.
The aim of this type of therapy is to find an alternative to human organs.
Already now, researchers are able to produce tissues such as blood vessels, heart valves, cartilage and skin in the laboratory.
It has been possible to overcome this new frontier thanks to the fact that cells tend to aggregate to form organs and tissues.
Stem cells are the undifferentiated cells found in human embryos one week after fertilisation.
They are also the starting cells from which the tissues and organs of the child to be born will develop.
Their function is to regulate the turnover of blood cells (red blood cells, white blood cells and platelets) and those of the immune system (lymphocytes).
Today, computerised machines, separators, are used to collect these cells, allowing the selection of the necessary cells. The recipients of the cells are patients suffering from skin diseases, blood diseases or solid tumours.
In addition to the fact that stem cells are still largely unknown, there is also an ethical problem: harvesting embryonic stem cells implies the death of the embryo.
That is why the way to harvest stem cells from adults is being perfected.
The cloning technique would make it possible to circumvent the problem of organ rejection altogether.
It would involve introducing the patients cell nucleus, with all its genetic heritage, into the stem cell of a human embryo or oocyte that previously had no nucleus of its own.
Cultivated in vitro in the laboratory, these modified cells would be genetically identical to those of the patients immune system, which would not recognise them as foreign.
This technique is not a viable option at present because both cloning, stem cell harvesting and the indiscriminate use of oocytes are prohibited by law.
Xenotransplantation, i.e. the transplantation of animal cells, tissues and organs into humans, seems to be the future solution to the shortage of organs for transplantation.
Experiments in this field are numerous and face ethical, psychological and, last but not least, immune problems.
The few attempts that have been made, in fact (a pig liver and a baboon heart transplanted into two different human beings) have not yielded the desired results.
The rejection crisis, in fact, was particularly violent and impossible to control.
Yet this technique could really be the solution to the organ shortage.
In fact, what is most feared is the development of typically animal infections, transferred to humans via pathogens present in the organ to be transplanted, which could prove disastrous.
A possible alternative to this handicap could be genetic modifications on donor animals; in practice, the animals would be bred in a sterile environment and genetically modified to make their organs more compatible with the recipients organism.
For the time being, however, some milestones have been achieved; these are cell xenotransplants and not organ xenotransplants, such as pig embryo cells for the treatment of Parkinsons disease, baboon marrow cells transplanted into terminally ill AIDS patients in an attempt to recover the patients immune system, or pancreas insulae still from pigs in the stimulation of insulin production as a therapy against diabetes.
Another solution to organ failure such as rejection is artificial organs.
The main problem is biological compatibility; these are, after all, mechanical organs that have to adapt to a biological organism.
Biocompatibility must cover all morphological, physical, chemical and functional characteristics that are able to provide for the organs functionality and, at the same time, its survival without the risk of rejection.
It is all these implications that make the production of artificial organs capable of completely and perfectly replacing natural organs in their functions complex.
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Organ transplantation: what it consists of and what the stages - Emergency Live International
Prevalence Of Blood Cancer In India: Know Its Prevention And Management | TheHealthSite.com – TheHealthSite
Diagnosis, Treatment, and Prevention of Blood Cancer By Dr Gaurav Kharya
Written by Tavishi Dogra | Updated : October 4, 2022 9:56 PM IST
In India, the increase in cancer cases over the past ten years has become a significant public health problem for the country. These cases have a long latent period, are primarily lifestyle-related and require specialised infrastructure and human resources to be treated. Cancer's physical, psychological and financial toll on people, families, communities and health systems keeps rising. The prevalence of cancer varies across India's regions, making prevention and management extremely difficult. Due to cancer not being a notifiable disease, the national burden assessment is still a task for which many developing nations, including India, rely on statistical models. The estimated number of cancer-related Disability-adjusted life years (DALYs) (AMI) in India in 2021 was 26.7 million, and that number was predicted to rise to 29.8 million in 2025.
Each year, 1.24 million new instances of blood cancer are reported worldwide, making up about 6% of all cancer cases. Blood cancer develops in the bone marrow, tissues that create blood and compromise the immune system. According to incidence rates, there are primarily three different forms of blood cancers: lymphoma/leukaemia, multiple myeloma, myelodysplastic syndromes (MDS)/myeloproliferative neoplasms (MPN). In addition, blood cancer may arise when the body produces abnormal White Blood Cells (WBCs). It typically starts in the bone marrow, which produces blood in our body. This malignancy impairs the normal development, growth and functioning of blood cells that fight infection and produce healthy blood cells.
White blood cells produced by the body during leukaemia are incapable of battling infections. Depending on the type of blood cell involved and whether it is fast-growing or slow-growing (acute or chronic), leukaemia is divided into distinct forms (myeloid or lymphoid). Consequently, it can be broadly divided into four subtypes: acute lymphocytic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL) and chronic myeloid leukaemia (CML). Apart from these are some rare blood cancers such as Juvenile myelomonocytic leukaemia (JMML).
Diagnosis, Treatment, and Prevention of Blood Cancer By Dr Gaurav Kharya, Clinical Lead Apollo Center & Indraprastha Apollo Hospital
Various diagnostic techniques are used to identify blood cancer, including clinical examination, blood testing, bone marrow tests, cytogenetic/karyotyping, molecular analyses, and flow cytometry. Most pediatric patients diagnosed with ALL or AML can be treated by chemotherapy. However, a smaller percentage of patients who don't respond well to chemotherapy are candidates for Bone marrow transplant to offer a long-term cure to these patients. In contrast, almost half of adult patients need BMT as consolidation to provide long-term treatment. If required, BMT can safely be done now using half HLA identical donors in case HLA matching donors are unavailable in experienced centres.
In most cases, the doctor will make a treatment recommendation based on research on the most effective treatments and national recommendations developed by experts. They will assess the type of blood cancer, the outcomes of any tests the patient has had, the state of the overall health, the available therapies, their effectiveness, and any potential risks or side effects.
There is a range of different treatments for blood cancer. But the most common ones include:
The cost of blood cancer therapy in India has several significant advantages. First, the most outstanding hospitals in India, equipped with the most cutting-edge equipment and a staff of oncologists and doctors with years of experience, are accessible to offer blood cancer patients comprehensive care.
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