Nicola Cockx with her baby sadly died just eight months after giving birth[Cavendish Press]

Nicola Cockx, 35, was so intent on having a child that she postponed having chemotherapy and a stem cell transplant for fear it would risk the health of her future child.

Instead she fought Multiple Myeloma - a form of bone marrow cancer which affects plasma cells- by using holistic methods of treatment and even completed a one year nutrition course to help with a healthy diet.

But, tragically, Mrs Cockx, from Little Bollington, Cheshire, passed away in February 2013, eight months after giving birth to her daughter Harriet.

She had began limping in July 2008 and three months later as she was about to see an orthopaedic specialist she slipped and broke her femur whilst on business trip in Germany with her father John Flowers, who runs a glazing company.

Mrs Cockx's husband Rudy, 39, an IT consultant, told a Manchester inquest: "Following the leg break in the hip area the multiple myeloma was diagnosed. It was extremely stressful."

The condition affects places in the body where there is bone marrow such as the spine, hips, skull and pelvis.

Nicola Cockx with her husband, Rudy [THE COCKX FAMILY]

Mr Cockx said his wife was initially treated with radiotherapy in the area of her hip where the cancer had struck but despite this she sought alternative medication and therapy.

She even considered an autologous stem cell transplant - where your own stem cells are removed and blasted with chemotherapy- but she backed out last minute for fear the chemo toxins would affect her fertility.

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Woman who delayed cancer treatment to give birth died eight months after becoming a mother

Karen Mitchell, 39, was inspired after reading plight of Alice Pyne Teenager lost battle with rare form of cancer in January 2013, aged 17 Before she died she urged people to join the bone marrow register Ms Mitchell tweeted Alice to promise she would - and teenager was delighted Butat 25st and with a BMI of 60, Ms Mitchell was rejected for being too fat Has now lost 11st 7lb and next week will donate bone marrow stem cells

By Anna Hodgekiss

Published: 05:19 EST, 15 July 2014 | Updated: 05:47 EST, 15 July 2014

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A woman so inspired by the plight of a young girl dying from cancer shed 11st in order to help other people battling the disease.

Encouraged by a tweet from terminally ill Alice Pyne, Karen Mitchell created her own 'bucket list', which included losing weight and saving lives.

Pride Of Britain winner Alice, who had fought Hodgkin's lymphoma from the age of 12, took to social media to urge people to join the bone marrow register.

Karen Mitchell shed 11st 7lb after promising a dying teenager she would join the bone marrow register

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Woman loses 11st after promise to join bone marrow register

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AP Photo/Agapito Sanchez, Baylor College of Medicine

MONTREAL Finding a donor for a stem cell transplant is perhaps one of the most difficult things for a cancer patient.

This is because stem cells are one of the few things that patients cannot rely on their immediate family to donate, according to to Doctor Silvy Lachance, Director of the stem cell transplant program at Hpital Maisonneuve-Rosemont.

Of course, we first look within the family, she said.

But there is only 25 per cent chance of identifying a donor. If we dont find a donor within the family, we try the international donor registry.

According to the National Cancer Institute, bone marrow and peripheral blood stem cell transplantations are most commonly used to treat leukemia, lymphoma, neuroblastoma (a cancer that affects mostly infants and children) and multiple myeloma.

While they wait for a compatible donor, patients will be assigned a conditioning regiment, which may include radiation.

This conditioning regiment will be followed by the infusion of stem cells that are compatible with the recipient, said Lachance.

Yet, for most ethnic minorities or anyone of mixed-birth, the chances of finding an anonymous donor remain very difficult.

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The possible alternatives to bone marrow transplant

University of Wisconsin-Madison

The ability to reliably and safely make in the laboratory all of the different types of cells in human blood is one key step closer to reality.

Writing today in the journal Nature Communications, a group led by University of Wisconsin-Madison stem cell researcher Igor Slukvin reports the discovery of two genetic programs responsible for taking blank-slate stem cells and turning them into both red and the array of white cells that make up human blood.

[ Watch the Video: What Are Stem Cells? ]

The research is important because it identifies how nature itself makes blood products at the earliest stages of development. The discovery gives scientists the tools to make the cells themselves, investigate how blood cells develop and produce clinically relevant blood products.

This is the first demonstration of the production of different kinds of cells from human pluripotent stem cells using transcription factors, explains Slukvin, referencing the proteins that bind to DNA and control the flow of genetic information, which ultimately determines the developmental fate of undifferentiated stem cells.

During development, blood cells emerge in the aorta, a major blood vessel in the embryo. There, blood cells, including hematopoietic stem cells, are generated by budding from a unique population of what scientists call hemogenic endothelial cells. The new report identifies two distinct groups of transcription factors that can directly convert human stem cells into the hemogenic endothelial cells, which subsequently develop into various types of blood cells.

The factors identified by Slukvins group were capable of making the range of human blood cells, including white blood cells, red blood cells and megakaryocytes, commonly used blood products.

By overexpressing just two transcription factors, we can, in the laboratory dish, reproduce the sequence of events we see in the embryo where blood is made, says Slukvin of the Department of Pathology and Laboratory Medicine in the UW School of Medicine and Public Health and the Wisconsin National Primate Research Center.

The method developed by Slukvins group was shown to produce blood cells in abundance. For every million stem cells, the researchers were able to produce 30 million blood cells.

Excerpt from:
Wisconsin Scientists Find Genetic Recipe To Turn Stem Cells To Blood

For many years scientists have been trying to unravel mechanisms that guide function and differentiation of blood stem cells, those cells that generate all blood cells including our immune system. The study of human blood stem cells is difficult because they can only be found in the bone marrow in specialized "niches" that cannot be recapitulated in a culture dish. Now a group of scientists from Dresden led by stem cell researcher Prof. Claudia Waskow (Technische Universitt Dresden) was able to generate a mouse model that supports the transplantation of human blood stem cells despite the species barrier and without the need for irradiation. They used a mutation of the Kit receptor in the mouse stem cells to facilitate the engraftment of human cells.

In the new model human blood stem cells can expand and differentiate into all cell types of the blood without any additional treatment. Even cells of the innate immune system that can normally not be found in "humanized" mice were efficiently generated in this mouse. Of significance is the fact that the stem cells can be maintained in the mouse over a longer period of time compared to previously existing mouse models. These results were now published in the journal Cell Stem Cell.

"Our goal was to develop an optimal model for the transplantation and study of human blood stem cells," says Claudia Waskow, who recently took office of the professorship for "animal models in hematopoiesis" at the medical faculty of the TU Dresden. Before, Prof. Waskow was a group leader at the DFG-Center for Regenerative Therapies Dresden where most of the study was conducted.

The trick used by Claudia Waskow's team to achieve optimal stem cell engraftment was the introduction of a naturally occurring mutation of the Kit receptor into mice that lack a functional immune system. This way they circumvented the two major obstacles of blood stem cell transplantation: the rejection by the recipient's immune system and absence of free niche space for the incoming donor stem cells in the recipient's bone marrow. Space is usually provided by irradiation therapy, called conditioning, because it damages and depletes the endogenous stem cells and thus frees space for the incoming human cells. However, irradiation is toxic to many cell types and can lead to strong side effects. The Kit mutation in the new mouse model impairs the recipient's stem cell compartment in such a way that the endogenous blood stem cells can be easily replaced by human donor stem cells with a functional Kit receptor. This replacement works so efficiently that irradiation can be completely omitted allowing the study of human blood development in a physiological setting. The model can now be used to study diseases of the human blood and immune system or to test new treatment options.

The results from Prof. Waskow's group also show that the Kit receptor is important for the function of human blood stem cells, notably in a transplantation setting. Further studies will now focus on using this knowledge about the role of the receptor to improve conditioning therapy in the setting of therapeutic hematopoietic stem cell transplantation in patients.

Story Source:

The above story is based on materials provided by Technische Universitt Dresden. Note: Materials may be edited for content and length.

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Opening-up the stem cell niche: Hematopoietic stem cell transplantation without irradiation

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10-Jul-2014

Contact: Meng Zhao eic@nrren.org 86-138-049-98773 Neural Regeneration Research

There is evidence that selective serotonin reuptake inhibitor antidepressants can promote neuronal cell proliferation and enhance neuroplasticity both in vitro and in vivo. Dr. Javad Verdi and his team, Tehran University of Medical Sciences, Iran proposed that citalopram, a selective serotonin reuptake inhibitor, can increase the efficacy of bone marrow mesenchymal stem cells (BMSCs) differentiating into neuronal-like cells. Experimental results confirmed that citalopram can improve the neuronal-like cell differentiation of BMSCs by increasing cell proliferation and survival while maintaining their neuronal characteristics. These results were published in Neural Regeneration Research (Vol. 9, No. 8, 2014).

###

Article: "Citalopram increases the differentiation efficacy of bone marrow mesenchymal stem cells into neuronal-like cells" by Javad Verdi1, 2, Seyed Abdolreza Mortazavi-Tabatabaei1, 2, Shiva Sharif 2, 3, Hadi Verdi2, Alireza Shoae-Hassani1, 2 (1 Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran; 2 Department of Stem Cells and Tissue Engineering, Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran; 3 Department of Tissue Engineering, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran)

Contact:

Meng Zhao eic@nrren.org 86-138-049-98773 Neural Regeneration Research http://www.nrronline.org/

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

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Citalopram increases the differentiation efficacy of BMSCs into neuronal-like cells

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Newswise LA JOLLA-The ability to switch out one gene for another in a line of living stem cells has only crossed from science fiction to reality within this decade. As with any new technology, it brings with it both promise--the hope of fixing disease-causing genes in humans, for example--as well as questions and safety concerns. Now, Salk scientists have put one of those concerns to rest: using gene-editing techniques on stem cells doesn't increase the overall occurrence of mutations in the cells. The new results were published July 3 in the journal Cell Stem Cell.

"The ability to precisely modify the DNA of stem cells has greatly accelerated research on human diseases and cell therapy," says senior author Juan Carlos Izpisua Belmonte, professor in Salk's Gene Expression Laboratory. "To successfully translate this technology into the clinic, we first need to scrutinize the safety of these modified stem cells, such as their genome stability and mutational load."

When scientists want to change the sequence of a stretch of DNA inside cells--either for research purposes or to fix a genetic mutation for therapeutic purposes--they have their choice of two methods. They can use an engineered virus to deliver the new gene to a cell; the cell then integrates the new DNA sequence in place of the old one. Or scientists can use what's known as custom targeted nucleases, such as TALEN proteins, which cut DNA at any desired location. Researchers can use the proteins to cut a gene they want to replace, then add a new gene to the mix. The cell's natural repair mechanisms will paste the new gene in place.

Previously, Belmonte's lab had pioneered the use of modified viruses, called helper-dependent adenoviral vectors (HDAdVs) to correct the gene mutation that causes sickle cell disease, one of the most severe blood diseases in the world. He and his collaborators used HDAdVs to replace the mutated gene in a line of stem cells with a mutant-free version, creating stem cells that could theoretically be infused into patients' bone marrow so that their bodies create healthy blood cells.

Before such technologies are applied to humans, though, researchers like Belmonte wanted to know whether there were risks of editing the genes in stem cells. Even though both common gene-editing techniques have been shown to be accurate at altering the right stretch of DNA, scientists worried that the process could make the cells more unstable and prone to mutations in unrelated genes--such as those that could cause cancer.

"As cells are being reprogrammed into stem cells, they tend to accumulate many mutations," says Mo Li, a postdoctoral fellow in Belmonte's lab and an author of the new paper. "So people naturally worry that any process you perform with these cells in vitro--including gene editing--might generate even more mutations."

To find out whether this was the case, Belmonte's group, in collaboration with BGI and the Institute of Biophysics, Chinese Academy of Sciences in China, turned to a line of stem cells containing the mutated gene that causes sickle cell disease. They edited the genes of some cells using one of two HDAdV designs, edited others using one of two TALEN proteins, and kept the rest of the cells in culture without editing them. Then, they fully sequenced the entire genome of each cell from the four edits and control experiment.

While all of the cells gained a low level of random gene mutations during the experiments, the cells that had undergone gene-editing--whether through HDAdV- or TALEN-based approaches--had no more mutations than the cells kept in culture.

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No Extra Mutations in Modified Stem Cells, Study Finds

The ability to switch out one gene for another in a line of living stem cells has only crossed from science fiction to reality within this decade. As with any new technology, it brings with it both promise-the hope of fixing disease-causing genes in humans, for example-as well as questions and safety concerns.

Now, Salk scientists have put one of those concerns to rest: using gene-editing techniques on stem cells doesn't increase the overall occurrence of mutations in the cells. The new results were published July 3 in the journal Cell Stem Cell.

"The ability to precisely modify the DNA of stem cells has greatly accelerated research on human diseases and cell therapy," says senior author Juan Carlos Izpisua Belmonte, professor in Salk's Gene Expression Laboratory. "To successfully translate this technology into the clinic, we first need to scrutinize the safety of these modified stem cells, such as their genome stability and mutational load."

When scientists want to change the sequence of a stretch of DNA inside cells-either for research purposes or to fix a genetic mutation for therapeutic purposes-they have their choice of two methods. They can use an engineered virus to deliver the new gene to a cell; the cell then integrates the new DNA sequence in place of the old one.

Or scientists can use what's known as custom targeted nucleases, such as TALEN proteins, which cut DNA at any desired location. Researchers can use the proteins to cut a gene they want to replace, then add a new gene to the mix. The cell's natural repair mechanisms will paste the new gene in place.

Previously, Belmonte's lab had pioneered the use of modified viruses, called helper-dependent adenoviral vectors (HDAdVs) to correct the gene mutation that causes sickle cell disease, one of the most severe blood diseases in the world.

He and his collaborators used HDAdVs to replace the mutated gene in a line of stem cells with a mutant-free version, creating stem cells that could theoretically be infused into patients' bone marrow so that their bodies create healthy blood cells.

Before such technologies are applied to humans, though, researchers like Belmonte wanted to know whether there were risks of editing the genes in stem cells. Even though both common gene-editing techniques have been shown to be accurate at altering the right stretch of DNA, scientists worried that the process could make the cells more unstable and prone to mutations in unrelated genes-such as those that could cause cancer.

"As cells are being reprogrammed into stem cells, they tend to accumulate many mutations," says Mo Li, a postdoctoral fellow in Belmonte's lab and an author of the new paper. "So people naturally worry that any process you perform with these cells in vitro-including gene editing-might generate even more mutations."

To find out whether this was the case, Belmonte's group, in collaboration with BGI and the Institute of Biophysics, Chinese Academy of Sciences in China, turned to a line of stem cells containing the mutated gene that causes sickle cell disease.

See the original post here:
No extra mutations in modified stem cells

By Marcus Johnson

Researchers at Brown University have found that adipose-derived human stem cells (ASCs) might be highly resistant to methotrexate (MTX), a common chemotherapy drug. ASCs can ultimately become bone and other vital tissues throughout the body, which could be key for researchers looking to protect bone tissue from the damage caused by MTX treatment. MTX, which is used to treat a number of different cancers including acute lymphoblastic leukemia, causes the loss of bone density and has an adverse effect on bone marrow derived stem cells.

Kids undergo chemotherapy at such an important time when they should be growing, but instead they are introduced to this very harsh environment where bone cells are damaged with these drugs, said Olivia Beane, a Brown University graduate student in the Center for Biomedical Engineering and lead author of the study. That leads to major long-term side effects including osteoporosis and bone defects. If we found a stem cell that was resistant to the chemotherapeutic agent and could promote bone growth by becoming bone itself, then maybe they wouldnt have these issues.

Beane examined how MTX affects stem cells and certain tissues in the body and said that the resistance of certain stem cells to the drugs toxicity could mean new possibilities in the drug development realm. The researchers are now looking to find a way to make their study practical for doctors that are treating patients suffering from cancer. The next step is to test ASC survival in animal trials, where researchers will determine how the cells fare in mice that are also hit with the chemotherapy drug.

The study was published in the journal, Experimental Cell Research.

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Brown University Researchers Discover Chemo Resistant Stem Cells

A woman in the US has developed a tumour-like growth eight years after a stem cell treatment to cure her paralysis failed. There have been a handful of cases of stem cell treatments causing growths but this appears to be the first in which the treatment was given at a Western hospital as part of an approved clinical trial.

At a hospital in Portugal, the unnamed woman, a US citizen, had tissue containing olfactory stem cells taken from her nose and implanted in her spine. The hope was that these cells would develop into neural cells and help repair the nerve damage to the woman's spine. The treatment did not work far from it. Last year the woman, then 28, underwent surgery because of worsening pain at the implant site.

The surgeons removed a 3-centimetre-long growth, which was found to be mainly nasal tissue, as well as bits of bone and tiny nerve branches that had not connected with the spinal nerves.

The growth wasn't cancerous, but it was secreting a "thick copious mucus-like material", which is probably why it was pressing painfully on her spine, says Brian Dlouhy at the University of Iowa Hospitals and Clinics in Iowa City, the neurosurgeon who removed the growth. The results of the surgery have now been published.

"It is sobering," says George Daley, a stem cell researcher at Harvard Medical School who has helped write guidelines for people considering stem cell treatments. "It speaks directly to how primitive our state of knowledge is about how cells integrate and divide and expand. "

The case shows that even when carried out at mainstream hospitals, experimental stem cell therapies can have unpredictable consequences, says Alexey Bersenev, a stem cell research analyst who blogs at Cell Trials. "We have to realise complications can also happen in a clinical trial," he says.

Stem cells have the prized ability to divide and replenish themselves, as well as turn into different types of tissues. There are several different stem cells, including ones obtained from an early embryo, aborted fetuses, and umbilical cord blood. There are many sources within adult tissues, too, including bone marrow.

While often hailed as the future of medicine, stem cells' ability to proliferate carries an inherent danger and the fear has always been that when implanted into a person they could turn cancerous.

Still, a few stem cell therapies have now been approved, such as a treatment available in India that takes stem cells from the patient's eye in order to regrow the surface of their cornea, and a US product based on other people's bone stem cells.

Many groups around the world are investigating a wide range of other applications, including treating heart attacks, blindness, Parkinson's disease and cancer. Research groups at universities and hospitals need to meet strict safety guidelines for clinical trials but some small private clinics are offering therapies to people without research or marketing approval. There is a growing number of lawsuits against such clinics and a few cases have been reported of tumours or excessive tissue growth (see "Ongoing stem cell trials" below).

More here:
Stem cell treatment causes nasal growth in woman's back

Sarasota Stem Cell Specialist Inject Knees for Bone on Bone as alliterative
http//:Geckojoiontandspine.com Using adipose and bone marrow stem cells combined as well as PRP or the growth factors from the blood she was able to avoid a ...

By: AskDoctorJL

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Sarasota Stem Cell Specialist Inject Knees for Bone on Bone as alliterative - Video

Federal funding blocked mainly over opposition to use of blastocysts

PORTSMOUTH Dr. Amy Sievers, an oncologist at Portsmouth Regional Hospital, does stem cell transplants with great success for her patients and is a firm advocate for stem cell research.

Sievers is allowed to do stem cell blood transplants because she does not use the source of controversy, embryonic stem cells. Instead, she can use stem cells from bone marrow, where blood is made. The cells can become new blood for transfusion into patients with blood-related cancers like leukemia.

"When we get past the chemo and radiation, the hope is we can replace blood and give the patient healthy blood and a chance to build a good immune system," Sievers said.

Parents saving cord blood when they give birth is an option, but Dr. Alexandra Bonesho of Core Physicians in Epping said it is very costly for the patient, is not covered by insurance and is not something pediatricians recommend widely unless there is a reason.

"It's not something we use as a practical course of events," Bonesho said. "Cord blood banking is very expensive, less so if the blood stem cells are donated to the National Cord Blood Bank. In most cases, the chance that you will need it for your own child is unlikely, unless there is already a known condition in the family."

For example, if there is a history of leukemia in another child, it may be worthwhile. Bonesho said in a case like that, having the baby's own blood stem cells can be the perfect answer.

"However, chances are good that if there is a sibling, they may also be a good match if a bone marrow transplant is needed," Bonesho said. "However, transplants are not the normal course of treatment in children with leukemia."

That being said, the cord blood could eventually be used for research in the future to find a cure for diseases like sickle cell anemia, Bonesho said.

Federal funding for much stem cell research is blocked mainly over the opposition to using embryonic stem cells. The cells come from blastocysts (fertilized eggs) from an in-vitro facility. The blastocysts are excess and are usually donated by people who have already been successfully treated for fertility problems.

More here:
The promise and hazards of stem cell research

CHICAGO Bone marrow transplants can reverse severe sickle cell disease in adults, a small study by government scientists found, echoing results seen with a similar technique used in children.

The researchers and others say the findings show age need not be a barrier and that the technique may change practice for some adult patients when standard treatment fails. The transplant worked in 26 of 30 adults, and 15 of them were even able to stop taking drugs that prevent rejection one year later.

We're very pleased,'' said Dr. John Tisdale, the study's senior author and a senior investigator at the National Institutes of Health. This is what we hoped for.''

The treatment is a modified version of bone marrow transplants that have worked in kids. Donors are a brother or sister whose stem cell-rich bone marrow is a good match for the patient.

Tisdale said doctors have avoided trying standard transplants in adults with severe sickle cell disease because the treatment is so toxic. Children can often tolerate it because the disease typically hasn't taken as big a toll on their bodies, he said.

The disease is debilitating and often life-shortening; patients die on average in their 40s, Tisdale said. That's one reason why the researchers decided to try the transplants in adults, with hopes that the technique could extend their lives.

The treatment involves using chemotherapy and radiation to destroy bone marrow before replacing it with healthy donor marrow cells. In children, bone marrow is completely wiped out. In the adult study, the researchers only partially destroyed the bone marrow, requiring less donor marrow. That marrow's healthy blood cells outlast sickle cells and eventually replace them.

Sickle cell disease is a genetic condition that damages oxygen-carrying hemoglobin in red blood cells, causing them to form abnormal, sickle shapes that can block blood flow through the veins. It can cause anemia, pain and organ damage. The disease affects about 100,000 Americans, mostly blacks, and millions worldwide.

Results from the adult study, involving patients aged 29 on average, were published Tuesday in the Journal of the American Medical Association. The usual treatment hadn't worked, a drug called hydroxyurea, and they had transplants at an NIH research hospital in Bethesda, Maryland.

The treatment failed to reverse sickle cell in four of the 30 patients and one died of a disease-related complication. Another patient died suddenly a few weeks ago an elderly man whose transplant four years ago had been a success. Tisdale said that man had lived longer than the normal lifespan for sickle cell patients but that his death was unexpected and an autopsy was to be performed.

More here:
Marrow transplants can reverse adult sickle cell

A new study shows that adipose-derived human stem cells, which can become vital tissues such as bone, may be highly resistant to the common chemotherapy drug methotrexate (MTX). The preliminary finding from lab testing may prove significant because MTX causes bone tissue damage in many patients.

MTX is used to treat cancers including acute lymphoblastic leukemia, the most common form of childhood cancer. A major side effect of the therapy, however, is a loss of bone mineral density. Other bone building stem cells, such as bone marrow derived stem cells, have not withstood MTX doses well.

"Kids undergo chemotherapy at such an important time when they should be growing, but instead they are introduced to this very harsh environment where bone cells are damaged with these drugs," said Olivia Beane, a Brown University graduate student in the Center for Biomedical Engineering and lead author of the study. "That leads to major long-term side effects including osteoporosis and bone defects. If we found a stem cell that was resistant to the chemotherapeutic agent and could promote bone growth by becoming bone itself, then maybe they wouldn't have these issues."

Stem cell survivors

Originally Beane was doing much more basic research. She was looking for chemicals that could help purify adipose-derived stem cells (ASCs) from mixed cell cultures to encourage their proliferation. Among other things, she she tried chemotherapy drugs, figuring that maybe the ASCs would withstand a drug that other cells could not. The idea that this could help cancer patients did not come until later.

In the study published online in the journal Experimental Cell Research, Beane exposed pure human ASC cultures, "stromal vascular fraction" (SVF) tissue samples (which include several cell types including ASCs), and cultures of human fibroblast cells, to medically relevant concentrations of chemotherapy drugs for 24 hours. Then she measured how those cell populations fared over the next 10 days. She also measured the ability of MTX-exposed ASCs, both alone and in SVF, to proliferate and turn into other tissues.

Beane worked with co-authors fellow center member Eric Darling, the Manning Assistant Professor in the Department of Molecular Pharmacology, Physiology and Biotechnology, and research assistant Vera Fonseca.

They observed that three chemotherapy drugs -- cytarabine, etoposide, and vincristine -- decimated all three groups of cells, but in contrast to the fibroblast controls, the ASCs withstood a variety of doses of MTX exceptionally well (they resisted vincristine somewhat, too). MTX had little or no effect on ASC viability, cell division, senescence, or their ability to become bone, fat, or cartilage tissue when induced to do so.

The SVF tissue samples also withstood MTX doses well. That turns out to be significant, Darling said, because that's the kind of tissue that would actually be clinically useful if an ASC-based therapy were ever developed for cancer patients. Hypothetically, fresh SVF could be harvested from the fat of a donor, as it was for the study, and injected into bone tissue, delivering ASCs to the site.

To understand why the ASCs resist MTX, the researchers conducted further tests. MTX shuts down DNA biosynthesis by binding the protein dihydrofolate reductase so that it is unavailable to assist in that essential task. The testing showed that ASCs ramped up dihydrofolate reductase levels upon exposure to the drug, meaning they produced enough to overcome a clinically relevant dose of MTX.

Link:
Stem cell type resists chemotherapy drug

July 2, 2014

News Review From Harvard Medical School -- Transplant May Help Adults with Sickle Cell

A partial transplant of bone-marrow stem cells may reverse sickle cell disease in adults, a new study finds. People with sickle cell disease have abnormally shaped red blood cells. They get stuck in blood vessels. This causes organ damage, pain and other medical problems. The new study included 30 adults with severe sickle cell disease. Each of them had a brother or sister who was a suitable match for a bone-marrow stem cell transplant. The sibling donor's cells were mixed with some of the patient's own cells. During 3.4 years of follow-up, the partial transplant reversed sickle cell disease in 26 out of 30 people, researchers said. In these patients, the bone marrow began making normal red blood cells. Fifteen people also were able to stop taking drugs to prevent rejection of the transplant. Overall, people were much less likely than before to need hospital treatment for the disease. Use of narcotic drugs for pain also was greatly reduced. The Journal of the American Medical Association published the study. HealthDay News wrote about it July 1.

By Howard LeWine, M.D.Harvard Medical School

What Is the Doctor's Reaction?

In the United States, more than 90,000 people are affected by sickle cell disease. Most of them are African-American. Worldwide, the number is much higher. About 300,000 babies are born with this genetic disease every year.

In sickle cell disease, the red blood cells made in the bone marrow are abnormal. Instead of having a normal round shape, the cells are curved and stiff. This causes the red blood cells to get stuck inside blood vessels before they reach the tissues. The result:

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News Review From Harvard Medical School -- Transplant May Help Adults with Sickle Cell

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Newswise INDIANAPOLIS -- Like a line of falling dominos, a cascade of molecular events in the bone marrow produces high levels of inflammation that disrupt normal blood formation and lead to potentially deadly disorders including leukemia, an Indiana University-led research team has reported.

The discovery, published by the journal Cell Stem Cell, points the way to potential new strategies to treat the blood disorders and further illuminates the relationship between inflammation and cancer, said lead investigator Nadia Carlesso, M.D., Ph.D., associate professor of pediatrics at the Indiana University School of Medicine.

Bone marrow includes the cells that produce the body's red and white blood system cells in a process called hematopoiesis. The marrow also provides a support system and "home" for the blood-producing cells called the hematopoietic microenvironment. The new research demonstrates the importance of the hematopoietic microenvironment in the development of a group of potentially deadly diseases called myeloproliferative disorders.

"It has been known for years that there are links between inflammation and cancer, but these studies have been challenged by the lack of genetic models, especially for blood-based malignancies," said Dr. Carlesso, a member of the hematologic malignancy and stem cell biology program within the Wells Center of Pediatric Research at IU.

The researchers focused on what happens when there are abnormally low levels of a molecule called Notch, which plays an important role in the process of blood cell production. Using a genetically modified mouse, they found that the loss of Notch function in the microenvironment causes a chain of molecular events that result in excess production of inflammatory factors.

The high levels of inflammation in the bone marrow were associated with the development of a myeloproliferative disorder in the mice. Myeloproliferative diseases in humans can result in several illnesses caused by overproduction of myeloid cells, which are normally are used to fight infections. These diseases can put patients at risk for heart attack or stroke, and frequently progress into acute leukemia and bone marrow failure, which have fatal outcomes. Unfortunately, there are no effective therapies for the majority of myeloproliferative diseases.

When Dr. Carlessos team blocked the activity of one of the molecules in this biochemical cascade, the myeloproliferative disorder in the mice was reversed. In addition, elevated levels of the blocked molecule were found in samples from human patients with myeloproliferative disease. These findings suggest that developing drugs that target this inflammatory reaction at different key points could be a promising strategy to limit the development of myeloproliferative disease in humans.

The molecular cascade leading to inflammation was not occurring directly in the bone marrow cells that produce blood cells, but in cells of the bone marrow microenvironment, especially in endothelial cells that line the capillaries -- tiny blood vessels -- inside the bone marrow. This was a key discovery, Dr. Carlesso said.

Continued here:
Biochemical Cascade Causes Bone Marrow Inflammation, Leading to Serious Blood Disorders

By Steven Reinberg HealthDay Reporter

TUESDAY, July 1, 2014 (HealthDay News) -- A new bone marrow transplant technique for adults with sickle cell disease may "cure" many patients. And it avoids the toxic effects associated with long-term use of anti-rejection drugs, a new study suggests.

This experimental technique mixes stem cells from a sibling with the patient's own cells. Of 30 patients treated this way, many stopped using anti-rejection drugs within a year, and avoided serious side effects of transplants -- rejection and graft-versus-host disease, in which donor cells attack the recipient cells, the researchers said.

"We can successfully reverse sickle cell disease with a partial bone marrow transplant in very sick adult patients without the need for long-term medications," said researcher Dr. John Tisdale, a senior investigator at the U.S. National Heart, Lung, and Blood Institute.

In the United States, more than 90,000 people have sickle cell disease, a painful genetic disorder found mainly among blacks. Worldwide, millions of people have the disease.

Many adults with sickle cell disease have organ damage. This makes them ineligible for traditional transplants, which destroy all their bone marrow cells and use unmatched donor cells, he said. "Doing it this way would allow them access to a potential cure," Tisdale said.

"Adult patients, in whom symptoms are very severe, should consider whether a transplant could be right for them," he said. "A simple blood test for their siblings could tell them whether this approach is an option."

One expert was enthusiastic about the report, published July 2 in the Journal of the American Medical Association.

"The outcomes look every bit as good, if not better, than anything reported so far," said Dr. John DiPersio, chief of the division of oncology at Washington University School of Medicine in St. Louis.

"The issue is whether this can be extended to unrelated donors and to mismatched donors," said DiPersio, also the author of an accompanying journal editorial.

Continued here:
Less Toxic Transplant Treatment Offers Hope for Sickle Cell Patients

Last reviewed and revised on May 20, 2013

By Anthony L. Komaroff, M.D. Brigham and Women's Hospital

Both adult and umbilical cord stem cells already are used to treat disease.

Adult stem cells:

For many years, doctors have used adult stem cells successfully to treat human disease, through bone marrow transplantation (also known as hematopoietic stem cell transplantation). Most often, this treatment is used to treat cancers of the bloodlymphomas and leukemias. When all other treatments have failed, the only hope for a cure is to wipe out all of the patients blood cellsthe cancerous ones and the healthy onesand to give a patient an entirely new blood system. The only way to do this is to transplant blood stem cellscells that can reproduce themselves indefinitely and turn into all types of specialized blood cells.

Here's how it's done. First, the doctors need to collect blood stem cells from a patient's bone marrow, and let them multiply.

Second, the patient is given a dose of chemotherapy that kills all of the cancer cells a dose that, unfortunately, also kills the cells in the patient's bone marrow.

Third, the blood stem cellsthe cells designed to give the patient a whole new blood systemare given to the patient through an intravenous catheter. Hopefully, the blood stem cells then travel through the blood to the bone marrow, where they take up residence and start to make a new blood system.

Where do the blood stem cells come from? Most of the time, they come from the patient himself. They are sucked out of the patients bone marrow through a needle, or taken from the patients blood (some blood stem cells travel in the blood). So the blood stem cells are outside the patients body, growing in a laboratory dish, when the patient is given the chemotherapy that kills all the blood cells still inside the body.

Read the original:
Special Harvard Commentary: How Stem Cells Help Treat Human Disease

This image provided by the National Institutes of Health shows red blood cells in a patient with sickle cell disease at the National Institutes of Health Clinical Center in Bethesda, Md.AP Photo/National Institutes of Health

This image provided by the National Institutes of Health shows red blood cells in a different sickle cell patient, after a bone marrow transplant at the National Institutes of Health Clinical Center in Bethesda, Md.AP Photo/National Institutes of Health

Bone marrow transplants can reverse severe sickle cell disease in adults, a small study by government scientists found, echoing results seen with a similar technique used in children.

The researchers and others say the findings show age need not be a barrier and that the technique may change practice for some adult patients when standard treatment fails.

The transplant worked in 26 of 30 adults, and 15 of them were even able to stop taking drugs that prevent rejection one year later.

"We're very pleased," said Dr. John Tisdale, the study's senior author and a senior investigator at the National Institutes of Health. "This is what we hoped for."

The treatment is a modified version of bone marrow transplants that have worked in kids. Donors are a brother or sister whose stem cell-rich bone marrow is a good match for the patient.

Tisdale said doctors have avoided trying standard transplants in adults with severe sickle cell disease because the treatment is so toxic. Children can often tolerate it because the disease typically hasn't taken as big a toll on their bodies, he said.

The disease is debilitating and often life-shortening; patients die on average in their 40s, Tisdale said. That's one reason why the researchers decided to try the transplants in adults, with hopes that the technique could extend their lives.

The treatment involves using chemotherapy and radiation to destroy bone marrow before replacing it with healthy donor marrow cells. In children, bone marrow is completely wiped out. In the adult study, the researchers only partially destroyed the bone marrow, requiring less donor marrow. That marrow's healthy blood cells outlast sickle cells and eventually replace them.

Here is the original post:
Bone marrow transplants can reverse adult sickle cell disease

PUBLIC RELEASE DATE:

1-Jul-2014

Contact: Krysten Carrera krysten.carrera@nih.gov 301-435-8112 The JAMA Network Journals

Use of a lower intensity bone marrow transplantation method showed promising results among 30 patients (16-65 years of age) with severe sickle cell disease, according to a study in the July 2 issue of JAMA.

Myeloablative (use of high-dose chemotherapy or radiation) allogeneic hematopoietic stem cell transplantation (HSCT; receipt of hematopoietic stem cells "bone marrow" from another individual) is curative for children with severe sickle cell disease, but associated toxicity has made the procedure prohibitive for adults. The development of nonmyeloablative conditioning regimens (use of lower doses of chemotherapy or radiation to prepare the bone marrow to receive new cells) may facilitate safer application of allogeneic HSCT to eligible adults, according to background information in the article.

Matthew M. Hsieh, M.D., of the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md., and colleagues explored a nonmyeloablative approach in a pilot group of 10 adults with severe sickle cell disease, using a simplified HSCT regimen (with stem cell donation from a immunologically matched sibling), that had few toxic effects, yet all patients continued taking immunosuppression medication. The researchers have since revised the protocol to include an option to stop immunosuppression after 1 year in selected patients (those with donor CD3 engraftment of greater than 50 percent and normalization of hemoglobin). In this report, the authors describe the outcomes for 20 additional patients with severe sickle cell disease, along with updated results from the first 10 patients. All 30 patients (ages 16-65 years) were enrolled in the study from July 2004 to October 2013.

As of October 25, 2013, 29 patients were alive with a median follow-up of 3.4 years, and 26 patients (87 percent) had long-term stable donor engraftment without acute or chronic graft-vs-host disease. Hemoglobin levels improved after HSCT; at 1 year, 25 patients (83 percent) had full donor-type hemoglobin. Fifteen engrafted patients discontinued immunosuppression medication and had no graft-vs-host disease.

The average annual hospitalization rate was 3.2 the year before HSCT, 0.63 the first year after, 0.19 the second year after, and 0.11 the third year after transplant. Eleven patients were taking narcotics long-term at the time of transplant. During the week they were hospitalized and received their HSCT, the average narcotics use per week was 639 mg of intravenous morphine-equivalent dose. The dosage decreased to 140 mg 6 months after the transplant.

There were 38 serious adverse events including pain, infections, abdominal events, and toxic effects from the medication sirolimus.

"In this article, we extend our previous results and show that this HSCT procedure can be applied to older adults, even those with severe comorbid conditions " the authors write. "These data reinforce the low toxicity of this regimen, especially among patients with significant end-organ dysfunction."

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Bone marrow transplantation shows potential for treating adults with sickle cell disease