Stem cell therapy can be used to treat a wide range of conditions. It has been effectively used as a low-risk alternative to traditional knee replacement surgery, while also providing options and hopes for cancers that were previously untreatable with traditional mainstream options, such as radiation and chemotherapy. One common use of stem cell therapy has been to treat blood cancers, such as leukemia.
What Is Leukemia?
Leukemia is a cancer of the body’s white blood cells, as well as the body’s bone marrow and lymphatic system. White blood cells play a critical role in the body’s defense against infections, and leukemia leaves these cells unable to function normally. Because of this, left untreated leukemia can have deadly consequences for the patient (either pediatric or adult). Over the last several decades, improvements in treatment protocol have dramatically improved the outcomes for patients with leukemia, extending lifespans and improving the patients’ quality of life.
However, treatment options, such as radiation and chemotherapy, come with a wide range of side effects, since these treatments are not able to successfully differentiate between healthy cells and diseased, cancerous cells. They simply kill all of the cells that they encounter. Because of these side effects, doctors and medical researchers have looked for alternative options. One option that has emerged is stem cell transplants.
Stem Cell Transplants and Leukemia
In a stem cell transplant, patients are given high doses of chemotherapy that entirely wipe out the patient’s bone marrow. Once this happens, the patient receives an infusion of stem cells that will ideally help the patient rebuild healthy, non-cancerous bone marrow. These stem cells can come from a variety of different sources, such as related donors (most commonly a brother or sister), unrelated, but matched donors, or from the donor himself/herself. In the case of a self- or autologous transplant, the donor’s own cells are used after they have been washed and processed in the laboratory, ideally removing all cancerous cells.
Oftentimes, non-autologous transplants have the best results, in terms of putting the patient into a successful remission. But, these transplants come with a significant risk. Oftentimes, the patient’s body reacts to these stem cells, seeing them as a foreign invader and attacking them. This results in graft-versus-host disease, which can cause a wide range of symptoms, from severe rashes and jaundice to even death.
Graft-versus-host Disease and How to Counteract It
As noted above, some patients’ bodies may react to the stem cell transplants that they receive, attacking their own body in a variety of potentially damaging ways. Some studies suggest that between 30 and 60 percent of patients experience these challenges. And, these same studies indicate that approximately half of patients with graft-versus-host disease may die. Traditionally, the only way to treat these troubling symptoms has been with strong immuno-suppressant drugs. But, these drugs have troubling side effects, including the fact that they may make the stem cells less effective in fighting the patient’s leukemia cells.
Therefore, it is important to look for alternative treatment approaches.
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New Treatment Breakthroughs
Recently, researchers at the University of Zurich (Switzerland) have carried out cutting-edge research in an attempt to better understand what happens when the immune system attacks these stem cells and how to potentially stop this from happening. The research team attempted to get to the heart of why some patients experience graft-versus-host, whereas others do not. The researchers determined that in patients where these attacks and symptoms happened the body was producing cytokine. In healthy patients, cytokine is an important white blood cell that helps combat infections. However, for patients who have undergone a stem cell transplant, cytokine seems to trigger a strong inflammatory response to these transplanted cells, causing a wide range of problems for the patient.
The researchers then turned their attention to mice. They were able to show that if cytokine production was inhibited then the mice’s body would not experience a dangerous graft-versus-host allergic response. And, unlike with traditional immunosuppressant treatment it did not negatively impact the stem cells’ ability to fight the body’s cancerous cells. The researchers at the University of Zurich described it as a very specific and targeted form of immunosuppression that dramatically minimized the risk of graft-versus-host disease while still maximizing the cancer fighting benefits of stem cells for leukemia patients.
The next question that remains to be answered is: Will this approach have the same effect on human patients as it did in mice? The answer is most likely yes. Research indicates that in human patients with graft-versus-host disease most of them have significantly elevated levels of cytokine. Interestingly, these cytokine levels are highest in patients with the most severe forms of graft-versus-host disease. However, there are still significant questions that need to be explored. Not all scientific results translate from mice to humans. And, research needs to be carried out to determine if specifically suppressing cytokine will be safe for people (although preliminary results seem to say yes). Even though more specific research needs to be carried out, these research results are extremely promising and offer a clear alternative to traditional approaches to graft-versus-host disease and may provide hope to many struggling patients.
Thousands of people around the world are diagnosed with leukemia each year. Traditionally, these patients have been treated with radiation and chemotherapy. Unfortunately, these treatment modalities come with a wide range of side effects of varying degrees of severity and they do not successfully send all patients into remission. In response to this, many doctors have turned to using stem cell therapy to treat leukemias. These stem cell transplants have helped raise the survival rate for leukemia patients dramatically.
Unfortunately, despite the fact that stem cell transplants help countless patients, this treatment can have a devastating impact on some patients. In roughly 30 to 60 percent of patients who undergo stem cell transplants, patients develop a condition called graft-versus-host disease. In graft-versus-host, the patient’s body views the stem cells as foreign invaders and begins to attack them via a complex process. This causes a wide range of troubling symptoms (such as: dermatological problems, a pulmonary shutdown, and jaundice) and can, in fact, lead to a patient’s death in particularly severe cases.
Traditionally, graft-versus-host disease has been treated with strong doses of immunosuppressant drugs. These drugs may be effective, but they hamper the efficacy of the stem cells in fighting the body’s cancer cells. Recognizing this downside of immunosuppressants, researchers have begun to explore graft-versus-host disease in more detail, looking to better understand the mechanisms of what is happening. These researchers have determined that graft-versus-host disease is triggered by high levels of cytokine; the higher the level of cytokine, the more severe the graft-versus host response. Therefore, the scientists concluded that the best way to address this problem is by suppressing cytokine production. Although more research still needs to be conducted, the researchers were able to determine that suppressing cytokine does not have any negative impact on the stem cell’s cancer-fighting ability. Therefore, it seems to be a vast improvement over traditional approaches to graft-versus-host disease.
Again, this shows the ability of scientists to continue to push the envelope on what may be possible in stem cell treatment as technology continues to develop and evolve.
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