HEMATOPOIETIC CELL TRANSPLANTATION OVERVIEW

Hematopoietic cell transplantation (also called bone marrow transplantation or stem cell transplant), is a type of treatment for cancer (and a few other conditions as well). A review of the normal function of the bone marrow will help in the understanding of stem cell transplantation.

Hematopoietic stem cell functionBone marrow is the soft, spongy area in the center of some of the larger bones of the body. The marrow produces all of the different cells that make up the blood, such as red blood cells, white blood cells (of many different types), and platelets. All of the cells of the immune system are also made in the bone marrow. All of these cells develop from a type of precursor cell found in the bone marrow, called a "hematopoietic stem cell."

The body is able to direct hematopoietic stem cells to develop into the blood components needed at any given moment. This is a very active process, with the bone marrow producing millions of different cells every hour. Most of the stem cells stay in the marrow until they are transformed into the various blood components, which are then released into the blood stream. Small numbers of stem cells, however, can be found in the circulating blood, which allows them to be collected under certain circumstances. Various strategies can be employed to increase the number of hematopoietic stem cells in the blood prior to collection. (See 'Peripheral blood' below.)

Hematopoietic cell transplantationSome of the most effective treatments for cancer, such as chemotherapy and radiation, are toxic to the bone marrow. In general, the higher the dose, the more toxic the effects on the bone marrow.

In hematopoietic cell transplantation, you are given very high doses of chemotherapy or radiation therapy, which is intended to more effectively kill cancer cells and unfortunately also destroy all the normal cells developing in the bone marrow, including the critical stem cells. After the treatment, you must have a healthy supply of stem cells reintroduced, or transplanted. The transplanted cells then reestablish the blood cell production process in the bone marrow. Reduced doses of radiation or chemotherapy that do not completely destroy the bone marrow may be used in some settings. (See 'Non-myeloablative transplant' below.)

The cells that will be transplanted can be taken from the bone marrow (called a bone marrow transplant), from the bloodstream (called a peripheral blood stem cell transplant, which requires that you take medication to boost the number of hematopoietic stem cells in the blood), or occasionally from blood obtained from the umbilical cord at the time of birth of a normal newborn (called an umbilical cord blood transplant).

TYPES OF HEMATOPOIETIC CELL TRANSPLANTATION

There are two main types of hematopoietic cell transplantation: autologous and allogeneic.

Autologous transplantIn autologous transplantation, your own hematopoietic stem cells are removed before the high dose chemotherapy or radiation is given, and they are then frozen for storage and later use. After your chemotherapy or radiation is complete, the harvested cells are thawed and returned to you.

Allogeneic transplantIn allogeneic transplantation, the hematopoietic stem cells come from a donor, ideally a brother or sister with a similar genetic makeup. If you do not have a suitably matched sibling, an unrelated person with a similar genetic makeup may be used. Under some circumstances, a parent or child who is only half-matched can also be used; this is termed a haploidentical transplant.

Myeloablative transplantA myeloablative transplant uses very high doses of chemotherapy or radiation prior to transplantation with autologous or allogeneic hematopoietic stem cells.

Non-myeloablative transplantA non-myeloablative transplant, sometimes referred to as a "mini" or reduced intensity transplant, allows you to have less intensive chemotherapy before transplantation with allogeneic hematopoietic stem cells. This approach may be recommended for a variety of reasons including your age, type of disease, other medical issues, or prior therapies.

Which type of transplant is best?Your physician will determine whether allogeneic or autologous transplantation is best, based on many factors including the type of cancer, your age and overall health, and the availability of a suitable donor. As a general rule, autologous transplantation is associated with fewer serious side effects, since you are given cells from your own body. However, an autologous transplant may be less effective than an allogeneic transplant in treating certain kinds of cancer.

In an allogeneic transplant, the donor's immune system, which is generated from the transplanted hematopoietic stem cells, recognize your cells, including the tumor cells, as foreign and rejects them. This beneficial reaction is called the graft-versus-tumor effect. In many cancers, the immune response caused by the transplanted cells improves the overall effectiveness of the treatment. This immune response helps kill off any residual cancer cells remaining in your body.

A major concern is that you will have an immune response against normal tissues as well, called graft-versus-host disease. (See 'Graft-versus-host disease' below.)

In a non-myeloablative transplant, it is hoped that the graft-versus-tumor effect, rather than the high-dose chemotherapy, will help eradicate the cancer, although graft-versus-host disease is a concern (see 'Graft-versus-host disease' below).

CHOOSING A DONOR

There are many possible choices for an allogeneic hematopoietic stem cell donor. These are described below. (See "Donor selection for hematopoietic cell transplantation".)

Matched donorTo help minimize the problems that can be caused by the expected immune response, a donor who has similar genetic makeup to you is preferred. Your cells will seem "less foreign" to the transplanted donor cells. Siblings (ie, brothers and sisters who share the same parents as you) are typically the only members of your family that are tested for being a donor because they have a one in four chance of sharing genetic characteristics with you; these characteristics are critical for your body to accept the graft. In general, parents, children, and relatives are not suitable donors since they do not share the same parents, and therefore do not have the same genetic material.

An exception is called a haploidentical transplant, which may be considered under certain circumstances.

Matched unrelated donorIf no siblings are available, or if testing the blood of the siblings does not reveal a match, a matched unrelated donor may be used. The search for an appropriate donor can be accomplished using transplant registries throughout the world.

Mismatched related donor or umbilical cord blood donorSome patients are offered treatment with cells from a partially matched family member (called mismatched related donor). The hematopoietic stem cell product may be specially prepared to minimize the immune response in the patient. Another alternative is to use umbilical cord blood, collected from a healthy newborn infant at the time of delivery; this blood is a rich source of hematopoietic stem cells.

PRE-HEMATOPOIETIC CELL TRANSPLANTATION PROCEDURES

Stem cell transplantation regimens vary from one patient to another, and depend upon the type of cancer, the treatment program used by the medical center, the clinical trial protocol (if the patient is enrolled in a clinical trial), as well as other factors. The most common components of the hematopoietic cell transplantation procedure are outlined here. You should talk with your transplant team about specific details of their program. (See "Preparative regimens for hematopoietic cell transplantation".)

Health evaluationBefore undergoing hematopoietic cell transplantation, you will have a complete evaluation of your health. Your complete health history is reviewed by the transplant team. Most patients also have a number of tests.

Your mental health is reviewed because of the stress and demands of stem cell transplantation; some patients meet with a mental health counselor to discuss concerns and to plan coping strategies.

You will also meet with a transplant coordinator or nurse to discuss the transplant process. Because patients who receive donor bone marrow are hospitalized for several weeks to months, it is important that you have a clear understanding of what will happen and what services are available. Some patients prefer to have a friend or family member accompany them, tape record the conversation with the transplant physician, or have this information in writing so that they can review it later.

In many cases, patients undergo hematopoietic cell transplantation while they are in remission from their underlying disease. You may feel well going into treatment, but you should be prepared to feel poorly for a period of time. You must understand that you will require intensive treatment and monitoring, but that there are long-term benefits from the treatment.

Life planningPatients who will be in the hospital for several weeks or months need to make plans regarding their family, home, finances, pets, and employment. The National Marrow Donor Program has excellent information about these and other stem cell transplantation related topics.

During the pre-transplant planning process, you should consider completing an advanced directive. This is a legal document that describes the type of care you want in case you are unable to communicate. Advance directives include a living will, durable power of attorney, and healthcare proxy; a social worker or attorney can provide guidance about what documents are needed. The laws surrounding these documents vary from one state to another, so it is important to be sure the correct guidelines are used.

Central line placementA number of medications will be required before, during, and after hematopoietic cell transplantation. To avoid the need for multiple intravenous lines and needle sticks, most patients will have a central line placed before treatment begins. This requires a short surgical procedure to insert a thin, flexible plastic tube into a large vein in the chest, above the heart. The line usually has two or three ports, which can be used to infuse medications or blood products (including the hematopoietic stem cell product), as well as to withdraw blood samples.

After the central line is placed, you must keep the area clean and watch for signs and symptoms of infection (pain, redness, swelling, or fluid drainage from the site, fever or chills).

Harvesting hematopoietic stem cellsIf you are having an autologous transplant, hematopoietic stem cells will be removed from your body before intensive chemotherapy or radiation begins. The most common sources for hematopoietic stem cells are bone marrow and blood.

Bone marrowIf your bone marrow has been invaded with cancer cells, hematopoietic stem cell removal may be preceded by one or more courses of chemotherapy. Removal (called harvest) of bone marrow stem cells is done while you are under general or epidural anesthesia. The harvest is done by using a long needle to repeatedly remove a sample of bone marrow fluid from multiple areas in your pelvic and hip bones.

Peripheral bloodThe harvest of peripheral blood stem cells is similar to the process of platelet donation and is more frequently used than a bone marrow harvest. It uses an apparatus, called an apheresis device, which removes hematopoietic stem cells and other cells from blood by a filtration process. Blood is removed from a vein in one location, filtered, and then returned to a vein in another location. The process does not require anesthesia.

In order for there to be sufficient numbers of hematopoietic stem cells in the blood, you (or the donor) must first be treated with either chemotherapy or a growth factor that stimulates the production and release of hematopoietic stem cells into the blood. Healthy donors only receive growth factor; patients with cancer may receive growth factor alone or chemotherapy plus growth factor. The most commonly used growth factor is granulocyte colony-stimulating factor (G-CSF or Neupogen).

Allogeneic bone marrow harvestPeople who donate their bone marrow will undergo harvest the day of transplant or one day prior. The donor is usually given general anesthesia to prevent pain.

Following the procedure, pain in the donor is usually relatively minor and can be treated with pain medications such as acetaminophen. The donor may be hospitalized overnight following the procedure, and generally returns to his or her prior state of health within the following one to two weeks.

Myeloablative therapyAs noted above, many patients receiving hematopoietic cell transplantation will undergo myeloablative therapy, which destroys bone marrow function as part of the intensive treatment for the patient's underlying cancer. The purpose of this treatment is to reduce the amount of cancer in the body and also to suppress the immune system adequately so that the graft will not be rejected. Depending upon the underlying disease and other factors, this phase of treatment may involve intensive chemotherapy, total body irradiation (radiation therapy), or both.

Preventing infectionWhen bone marrow function is destroyed, you are at risk for developing life-threatening infections because you have temporarily lost your ability to produce white blood cells (the infection-fighting cells in the blood). You are also at risk for excessive bleeding due to the reduced number of platelets in the blood. (See "Prevention of infections in hematopoietic cell transplant recipients".)

It is important to minimize your exposure to bacteria, viruses, and fungi after myeloablative therapy because even a small number of organisms (that are usually encountered every day) can cause serious infection.

Patients who undergo allogeneic transplant are often placed in protective isolation in a private room. The room's air is filtered and air from the room is forced out when the door is opened (called a positive-pressure room). This isolation, combined with feeling poorly, can be challenging to some people who may feel depressed and/or anxious. Discussing these issues with your health care team is very important.

Special precautions are required for all persons who enter the room to reduce the chance of infection. Hand washing is one of the most important precautions, and has been shown to significantly reduce the chance of transmitting infection. Visitors should NOT bring fresh fruit, plants, or flowers into your room because these can harbor microorganisms that are dangerous.

Other measures may be taken to reduce the chance of infection. For example, antibiotics, antifungal, and/or antiparasitic medications may be given to prevent infections, and your diet may be restricted to exclude items that contain potentially infectious organisms. For example, all foods should be cooked until hot, raw fruits and vegetables should be avoided, and drinking water should be sterilized.

Most patients can shower. There has been a concern that showers can aerosolize fungal spores, and some centers prefer that patients take a tub or sponge bath. You can wear a hospital gown or your own clean clothing.

Different transplant centers use different precautions and your health care team will discuss the precautions and procedures that they expect.

Blood product transfusionsDuring the time that the marrow is not functioning, you will likely require transfusion of blood products, such as red cells, which carry oxygen to the tissues, or platelets, which help prevent bleeding. These blood products have no white blood cells and are irradiated to reduce the risk of an immune response.

HEMATOPOIETIC CELL TRANSPLANTATION PROCEDURE

When the intensive chemotherapy and/or radiation are complete, you will be given an infusion of the harvested bone marrow or peripheral blood stem cells. The infusion is given through an intravenous (IV) line, usually the central line. The infusion usually takes about an hour, and usually causes no pain.

The cells find their way to the bone marrow, where they will reestablish normal production of blood cells; this process is called engraftment. Determining when engraftment has occurred is important because it is used to determine when it is safe for you to go home and/or reduce isolation procedures. Medications that stimulate the bone marrow to produce white and red cells may be used when engraftment is slower than expected. (See "Hematopoietic support after hematopoietic cell transplantation".)

Engraftment is measured by performing daily blood cell counts. Neutrophils are a type of white blood cell that are a marker of engraftment; the absolute neutrophil count (ANC) must be at least 500 for three days in a row to say that engraftment has occurred. This can occur as soon as 10 days after transplant, although 15 to 20 days is common for patients who are given bone marrow or peripheral blood cells. Umbilical cord blood recipients usually require between 21 and 35 days for neutrophil engraftment.

Platelet counts are also used to determine when engraftment has occurred. The platelet count must be between 20,000 and 50,000 (without a recent platelet transfusion). This usually occurs at the same time or soon after neutrophil engraftment, but can take as long as eight weeks and even longer in some instances for people who are given umbilical cord blood.

HEMATOPOIETIC CELL TRANSPLANTATION SIDE EFFECTS

The high-dose chemotherapy and total body irradiation required for hematopoietic cell transplantation can have serious side effects. You should discuss the expected side effects, toxicities, and risks associated with stem cell transplant before deciding to undergo the procedure. You will be asked to sign a consent form indicating that you have received verbal and written information to understand the risks and benefits of the proposed treatment, possible treatment alternatives, and that all your questions have been answered.

Common side effectsSome of the most common side effects include:

Mucositis(mouth sores) and diarrhea Mucositis and diarrhea are caused by the damage done to rapidly dividing cells (such as skin cells in the mouth and digestive tract) by chemotherapy and radiation. If mucositis is severe and affects your ability to eat, intravenous nutrition (called TPN, total parenteral nutrition) may be given. Pain medications are usually given as well.

Nausea and vomiting Nausea and vomiting can be prevented and treated with a combination of medications, usually including a 5-HT3 receptor antagonist (dolasetron, granisetron, ondansetron, tropisetron, or palonosetron), an NK1 receptor antagonist (aprepitant [Emend]), and a steroid (dexamethasone).

Loss of hair Loss of hair is temporary, and generally includes hair on the head, face, and body. After high-dose chemotherapy and radiation are completed, hair begins to regrow. No treatment is available to prevent hair loss or speed its regrowth.

Infertility The risk of permanent infertility after stem cell transplant depends upon the treatments used (high-dose chemotherapy versus total body irradiation, ablative versus non-ablative regimen) and dosage given. If you are of reproductive age, you should speak with your healthcare provider about options for lowering the risks of infertility and the option of donating eggs or sperm before treatment begins. (See "Fertility preservation in patients undergoing gonadotoxic treatment or gonadal resection".)

Organ toxicity The lungs, liver, and bones are at greatest risk of damage as a result of treatments used with stem cell transplantation. People who have total body irradiation can develop cataracts in the eyes, although this complication is less common with current methods of delivering radiation treatment.

Secondary cancers There is a small risk of a second cancer developing in patients who undergo stem cell transplantation, probably as a result of the treatments used for the first cancer as well as the treatments required for transplant. The second cancer usually develops several years (typically three to five) after stem cell transplantation. (See "Malignancy after hematopoietic cell transplantation".)

Graft-versus-host diseaseBetween 10 and 50 percent of patients who receive an allogeneic transplant experience a side effect known as graft-versus-host disease (GVHD). Graft-versus-host disease is separated into acute and chronic phases due to timing and clinical presentation. This problem does not occur following autologous transplantation (when the patient is the donor). (See "Prevention of acute graft-versus-host disease".)

The "graft" refers to the transplanted hematopoietic stem cells; the "host" refers to the patient. Thus, graft-versus-host disease refers to a condition in which the donor's immune cells attack some of your organs. GVHD is the biggest single threat, other than the underlying disease, to the success of a stem cell transplant.

Treatments are given to help prevent GVHD, and generally include immunosuppressive medications, antibiotics, and sometimes steroids. If GVHD develops, additional treatment with high-dose steroids may lessen its severity. Symptoms can include skin rash, diarrhea, liver damage, or other problems, depending upon the organ that is affected. (See "Treatment of chronic graft-versus-host disease".)

Graft failureFailure of engraftment is a rare complication that occurs in approximately one percent of cases following hematopoietic cell transplantation. The risk of graft failure can be higher depending upon the type of transplant and the source of hematopoietic stem cells. Discuss these risks with the transplant team prior to treatment. (See "Immunotherapy for the prevention and treatment of relapse following hematopoietic cell transplantation".)

Risk of deathHematopoietic cell transplantation carries a risk of treatment-related death. The risk of death depends upon your age, the nature of the underlying disease, the type of transplant (autologous or allogeneic), and other factors, including the skill and expertise of the institution where treatment is offered. Your risk, as well as the potential benefits of hematopoietic cell transplantation, should be discussed with the treatment team before any decision is made about undergoing a transplant procedure.

POST-HEMATOPOIETIC CELL TRANSPLANTATION CARE

After engraftment occurs, blood cell counts continue to rise and the immune system becomes stronger. You will usually be cared for by the transplant team and monitored closely for complications.

Non-myeloablative transplants may be done on an outpatient basis, allowing you to sleep at home. Other types of transplantation require you to stay in the hospital for three to four weeks following transplantation. In all cases, frequent visits to the healthcare provider's office are needed following discharge. If you live a distance from your provider, you should arrange to live in a place within reasonable driving distance to the treatment center until at least 100 days have passed since the transplant.

Patients who undergo hematopoietic cell transplantation are at an increased risk of infection for many months following transplantation. You should be aware of these risks and monitor yourself for symptoms of infection, including fever (temperature greater than 100.4F or 38C), pain, or chills. You may be given antibiotics to prevent infections.

Studies have shown that most patients who undergo transplant and remain free of cancer have a good quality of life. Most patients are able to be active, employed, and in reasonably good health. Quality of life usually continues to improve in the months following transplant.

CLINICAL TRIALS

A clinical trial is a carefully controlled way to study the effectiveness of new treatments or new combinations of known therapies, and patients who will undergo hematopoietic cell transplantation may be asked to participate. Ask a healthcare provider for more information about clinical trials, or read further at the following web sites.

http://www.cancer.gov/clinicaltrials/

http://clinicaltrials.gov/

Videos addressing common questions about clinical trials are available from the American Society of Clinical Oncology (http://www.cancer.net/pre-act).

SUMMARY

Hematopoietic cell transplantation (also called bone marrow transplantation or stem cell transplant) is a treatment used in some types of cancer particularly malignancies of the blood.

Bone marrow is the soft, spongy area in the center of some of the larger bones of the body. The marrow produces all of the different cells that make up the blood, such as red blood cells, white blood cells, and platelets. All of these cells develop from a type of basic cell found in the bone marrow, called a stem cell.

In hematopoietic cell transplantation, the patient is given very high doses of chemotherapy or radiation therapy, which kills cancer cells and destroys all the normal cells developing in the bone marrow, including the critical stem cells. After the treatment, the patient must have a healthy supply of hematopoietic stem cells reintroduced, or transplanted.

There are two types of hematopoietic cell transplantation, autologous and allogeneic. An autologous hematopoietic cell transplant uses a patient's own bone marrow or blood. An allogeneic hematopoietic cell transplant uses a donor's bone marrow or blood. The donor is usually a relative of the patient (eg, sister), although unrelated donors are sometimes used.

Most patients who have hematopoietic cell transplantation must remain in the hospital for several days or weeks during their treatment and recovery. It is important to understand and follow the hospital's stem cell transplantation treatment plan to minimize the risk of complications (eg, infection) and to know what to expect in advance.

The treatments required before and during hematopoietic cell transplantation can have serious side effects. Patients should be aware of the most common side effects (eg, diarrhea, nausea, vomiting, mouth sores) as well as the types of treatments that are available to improve comfort.

Following hematopoietic cell transplantation, most people stay in the hospital for several weeks. However, even after going home, frequent visits with a doctor or nurse are needed for three to six months.

Clinical trials are carefully controlled studies of new treatments or new combinations of current treatment. Clinical trials help researchers to learn the best way to treat specific conditions. Some patients who have stem cell transplantation will be asked to participate in a clinical trial.

WHERE TO GET MORE INFORMATION

Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our website (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for healthcare professionals, are also available. Some of the most relevant are listed below.

Patient level informationUpToDate offers two types of patient education materials.

The BasicsThe Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Bone marrow transplant (The Basics)Patient education: Donating bone marrow or blood stem cells (The Basics)Patient education: Leukemia in adults (The Basics)Patient education: Leukemia in children (The Basics)Patient education: Lymphoma (The Basics)Patient education: Acute lymphoblastic leukemia (ALL) (The Basics)Patient education: Acute myeloid leukemia (AML) (The Basics)Patient education: Chronic lymphocytic leukemia (CLL) (The Basics)Patient education: Chronic myeloid leukemia (CML) (The Basics)Patient education: Diffuse large B cell lymphoma (The Basics)Patient education: Follicular lymphoma (The Basics)Patient education: Hodgkin lymphoma in adults (The Basics)Patient education: Hodgkin lymphoma in children (The Basics)Patient education: Myelodysplastic syndromes (MDS) (The Basics)Patient education: Sickle cell disease (The Basics)Patient education: Immune thrombocytopenia (ITP) (The Basics)Patient education: Beta thalassemia major (The Basics)Patient education: Chronic granulomatous disease (The Basics)Patient education: Invasive aspergillosis (The Basics)Patient education: When your child has sickle cell disease (The Basics)Patient education: Neutropenia and fever in people being treated for cancer (The Basics)

Beyond the BasicsBeyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

This topic currently has no corresponding Beyond the Basics content.

Professional level informationProfessional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Donor selection for hematopoietic cell transplantationHematopoietic support after hematopoietic cell transplantationImmunotherapy for the prevention and treatment of relapse following hematopoietic cell transplantationPreparative regimens for hematopoietic cell transplantationPrevention of acute graft-versus-host diseaseSources of hematopoietic stem cellsTreatment of chronic graft-versus-host diseasePrevention of infections in hematopoietic cell transplant recipientsFertility preservation in patients undergoing gonadotoxic treatment or gonadal resectionMalignancy after hematopoietic cell transplantation

The following organizations also provide reliable health information.

National Library of Medicine

(www.nlm.nih.gov/medlineplus/healthtopics.html)

National Marrow Donor Program

Go here to read the rest:
Hematopoietic cell transplantation (bone marrow ...

Bone Marrow Stem Cells Comments Off on Hematopoietic cell transplantation (bone marrow … | November 11th, 2017

If you or a loved one will be having a bone marrow transplant or donating stem cells, what does it entail? What are the different types of bone marrow transplants and what is the experience like for both the donor and recipient?

A bone marrow transplant is a procedure in which when special cells (called stem cells) are removed from the bone marrow or peripheral blood, filtered and given back either to the same person or to another person.

Since we now derive most stem cells needed from the blood rather than the bone marrow, a bone marrow transplant is now more commonly referred to as stem cell transplant.

Bone marrow is found in larger bones in the body such as the pelvic bones. This bone marrow is the manufacturing site for stem cells. Stem cells are "pluripotential" meaning that the cells are the precursor cells which can evolve into the different types of blood cells, such as white blood cells, red blood cells, and platelets.

If something is wrong with the bone marrow or the production of blood cells is decreased, a person can become very ill or die. In conditions such as aplastic anemia, the bone marrow stops producing blood cells needed for the body. In diseases such as leukemia, the bone marrow produces abnormal blood cells.

The purpose of a bone marrow transplant is thus to replace cells not being produced or replace unhealthy stem cells with healthy ones.

This can be used to treat or even cure the disease.

In addition for leukemias, lymphomas, and aplastic anemia, stem cell transplants are being evaluated for many disorders, ranging from solid tumors to other non-malignant disorders of the bone marrow, to multiple sclerosis.

There are two primary types of bone marrow transplants, autologous and allogeneic transplants.

The Greek prefix "auto" means "self." In an autologous transplant, the donor is the person who will also receive the transplant. This procedure, also known as a "rescue transplant" involves removing your stem cells and freezing them. You then receive high dose chemotherapy followed by infusion of the thawed out frozen stem cells. It may be used to treat leukemias, lymphomas, or multiple myeloma.

The Greek prefix "allo" means "different" or "other." In an allogeneic bone marrow transplant, the donor is another person who has a genetic tissue type similar to the person needing the transplant. Because tissue types are inherited, similar to hair color or eye color, it is more likely that you will find a suitable donor in a family member, especially a sibling. Unfortunately, this occurs only 25 to 30 percent of the time.

If a family member does not match the recipient, the National Marrow Donor Program Registry database can be searched for an unrelated individual whose tissue type is a close match. It is more likely that a donor who comes from the same racial or ethnic group as the recipient will have the same tissue traits.

Learn more about finding a donor for a stem cell transplant.

Bone marrow cells can be obtained in three primary ways. These include:

The majority of stem cell transplants are done using PBSC collected by apheresis (peripheral blood stem cell transplants.) This method appears to provide better results for both the donor and recipient. There still may be situations in which a traditional bone marrow harvest is done.

Donating stem cells or bone marrow is fairly easy. In most cases, a donation is made using circulating stem cells (PBSC) collected by apheresis. First, the donor receives injections of a medication for several days that causes stem cells to move out of the bone marrow and into the blood. For the stem cell collection, the donor is connected to a machine by a needle inserted in the vein (like for donating blood.) Blood is taken from the vein, filtered by the machine to collect the stem cells, then returned back to the donor through a needle in the other arm. There is almost no need for a recovery time with this procedure.

If stem cells are collected by bone marrow harvest (much less likely,) the donor will go to the operating room and while asleep under anesthesia, a needle will be inserted into either the hip or the breastbone to take out some bone marrow. After awakening, there may be some pain where the needle was inserted.

A bone marrow transplant can be a very challenging procedure for the recipient.

The first step is usually receiving high doses of chemotherapy and/or radiation to eliminate whatever bone marrow is present. For example, with leukemia, it is first important to remove all of the abnormal bone marrow cells.

Once a person's original bone marrow is destroyed, the new stem cells are injected intravenously, similar to a blood transfusion. The stem cells then find their way to the bone and start to grow and produce more cells (called engraftment.)

There are many potential complications. The most critical time is usually when the bone marrow is destroyed so that few blood cells remain. Destruction of the bone marrow results in greatly reduced numbers of all of the types of blood cells (pancytopenia.) Without white blood cells there is a serious risk of infection, and infection precautions are used in the hospital (isolation.) Low levels of red blood cells (anemia) often require blood transfusions while waiting for the new stem cells to begin growing. Low levels of platelets (thrombocytopenia) in the blood can lead to internal bleeding.

A common complication affecting 40 to 80 percent of recipients is graft versus host disease. This occurs when white blood cells (T cells) in the donated cells (graft) attack tissues in the recipient (the host,) and can be life-threatening.

An alternative approach referred to as a non-myeloablative bone marrow transplant or "mini-bone marrow transplant" is somewhat different. In this procedure, lower doses of chemotherapy are given that do not completely wipe out or "ablate" the bone marrow as in a typical bone marrow transplant. This approach may be used for someone who is older or otherwise might not tolerate the traditional procedure. In this case, the transplant works differently to treat the disease as well. Instead of replacing the bone marrow, the donated marrow can attack cancerous cells left in the body in a process referred to as "graft versus malignancy."

If you'd like to become a volunteer donor, the process is straightforward and simple. Anyone between the ages of 18 and 60 and in good health can become a donor. There is a form to fill out and a blood sample to give; you can find all the information you need at the National Marrow Donor Program Web site. You can join a donor drive in your area or go to a local Donor Center to have the blood test done.

When a person volunteers to be a donor, his or her particular blood tissue traits, as determined by a special blood test (histocompatibility antigen test,) are recorded in the Registry. This "tissue typing" is different from a person's A, B, or O blood type. The Registry record also contains contact information for the donor, should a tissue type match be made.

Bone marrow transplants can be either autologous (from yourself) or allogeneic (from another person.) Stem cells are obtained either from peripheral blood, a bone marrow harvest or from cord blood that is saved at birth.

For a donor, the process is relatively easy. For the recipient, it can be a long and difficult process, especially when high doses of chemotherapy are needed to eliminate bone marrow. Complications are common and can include infections, bleeding, and graft versus host disease among others.

That said, bone marrow transplants can treat and even cure some diseases which had previously been almost uniformly fatal. While finding a donor was more challenging in the past, the National Marrow Donor Program has expanded such that many people without a compatible family member are now able to have a bone marrow/stem cell transplant.

Sources:

American Society of Clinical Oncology. Cancer.Net. What is a Stem Cell Transplant (Bone Marrow Transplant)? Updated 01/16. http://www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-stem-cell-transplant-bone-marrow-transplant

U.S. National Library of Medicine. MedlinePlus. Bone Marrow Transplant. Updated 10/03/17. https://medlineplus.gov/ency/article/003009.htm

See the original post here:
bone marrow/stem cell transplant - verywell.com

Bone Marrow Stem Cells Comments Off on bone marrow/stem cell transplant – verywell.com | November 8th, 2017

The following was written withProf. Gerold Riempp, a professor of information systems who was diagnosed with Parkinsons disease 16 years ago at age 36. He is co-founder of a charitable organization in Germany that supports the development of therapies that aim to cure PD.

The idea behind cell replacement therapy(CRT) for PD is pretty simple: lack of mobility in PD is the result of the dysfunction and death of a specific kind of cell in the midbrain. While there are a few other things that go wrong in PD, the progressive loss of motor skills is the biggest problem most diagnosed face. Since we are reasonably sure that this lack of mobility results from the impairment and death of dopamine producing cells in an area of the midbrain called the substantia nigra,why not try to replace those cells?

A group of iPS cells grown from human skin tissue at Osaka University

Replacing those cells is one of three core problems that each person diagnosed with PD needs to address. They are:

1. Keeping remaining cells healthyOnce diagnosed, most people have already lost production of 50-80% of dopamine in their midbrain. The problem then is to stop further disease progression by figuring out how to get rid of everything that might be harming the remaining 20-50% of cells while giving their body everything it needs to keep those cells alive and active.

2. Clearing clogged cellsOf those 50-80% of non-dopamine producing cells, a portion are still alive, they are just not doing their job, producing dopamine. This impairment is a result of a range of interrelated factors that harm the cells and eventually lead to their death. Most researchers believe the problem can be boiled down to the clumping of a misfolded protein called alpha-synuclein. Many different methods are being tried in labs around the world to clear these clumps and stop more from accumulating. But this might only be part of the story since a wide variety of other factors also lead to cell death.

3. Replacing dead cellsThen we come to what to do about all of those dead cells. A couple of different options are being considered to get the brain tostimulate the production of new neurons orreplace the function of dead ones. However, the most promising therapy being developed is stem cell therapy, now commonly referred to as cell replacement therapy. It works by placing new dopamine producing neurons into the part of the brain where the dead neurons used to release dopamine.

If a patient manages to address problems one and two they might have no need for CRT. The reason for this is that he or she can likely rescue a considerable portion of the damaged but still living cells and thereby bring dopamine production back to a level that allows for normal movement. CRT will generally be for people who have had PD for a longer time and whose remaining healthy cells plus the rescued ones together are not capable of providing enough dopamine.

The late 80s and 90s saw a number of CRT trials for Parkinsons disease with mixed results. But we nowhave a much better understanding of what kind of cells to use, how to culture and store those cells, how to implant them, and who this therapy would be best for.

We also now have iPS cells (induced pluripotent stem cells). Discovered in 2006, these are cells that have been chemically reprogrammed, usually from adult skin tissue, back into pluripotent stem cells. (Pluripotent means they are capable of becoming almost any cell in the body). Using these cells for transplantation has two major advantages. One, it eliminates the need for potentially harmful immuno-suppressors. Two, it has none of the ethical issues that come with using fetal stem cells. But iPS cells are much more expensive and technically difficult to produce.

Despite all the progress made, cell replacement therapy is still very controversial and fraught with all sorts of technical issues. Luckily, CRT for PD is one of the only fields of medical science where the top labs around the world are cooperating with each other. An international consortium of labs has come together under a name that sounds like it was ripped out of a Marvel comic, the GForce-PD. Each lab in the GForce-PD aims to bring CRT for PD to clinical trial within the next few years.

Infographic made by PhD neuroscientist Kayleen Schreiber at kayleenschreiber.com

The GForce-PD

New York City Run by Dr. Lorenz Studer out of the Rockefeller research labs in New York City. Dr. Studer pioneered many of the reprogramming techniques being used around the world to convert pluripotent stem cells into dopamine producing neurons. His lab wasrecently announced to be part of a huge funding initiative from Bayer Pharmaceuticals to help speed up development of CRT. Studers lab is aiming to start transplantation of embryonic stem cells in human trials in early 2018.

Kyoto, Japan Dr. Jun Takahashis lab in Kyoto is working on producing several iPS lines for the Japanese population. One advantage they have is the relative homogeneity of Japanese people allows them to use a dozen or so iPS lines for almost everyone in the country. The lab recently made headlines with results from monkey trials that showed human iPS cells graft safely, with no signs of malignant growth, two years after transplantation.

Cambridge, England Dr. Roger Barkers lab has been working on cell replacement therapy for Parkinsons disease for a number of years through the Transeuro project. His lab is pushing forward with more embryonic stem cell transplantations expected to begin in 2020. They also work very closely with the team in Sweden.

Lund, Sweden The lab in Lund has been working on CRT for PD since the 80s and has been part of a number of human trials. The lab is now run by Dr. Malin Parmar whose team has also pioneered many of the techniques used in direct programming that will one day allow researchers to skip the stem cell phase all together and produce dopamine cells directly in the brain.

San Diego, California The team is moving rapidly towards iPS cell transplantation under Dr. Jeanne Loring at the Scripps research center. They are the only lab that uses patients own cells for transplantation. Another unique feature of this lab is that it has been a community funded initiative under theSummit For Stem Cellsfoundation.

(Dr. Roger Barker talking about CRT for PD)

Though there is a lot of excitement building around cell replacement therapy, we need to proceed carefully. The field has potential for setbacks from some of the less rigorous trials being conducted in places like Australia and China where regulatory standards are more lax. Researchers in these areas are already going ahead with trials that do not meet the standards set by the GForce-PD. These have the potential to put a black-eye on all cell replacement therapies.

Also, producing pure batches of dopamine neurons is still a highly technical process that only a few labs in the world are capable of doing safely and effectively. Thankfully a few other labs around the world are joining the efforts of the GForce-PD, such as Dr. Tilo Kunaths lab in Edinburgh, which is working on techniques to better differentiate and characterize the cell lines used for transplantation.

(The pictures above show human embryonic stem cells being differentiated into dopamine cells at days 2, 4 and 7. Courtesy of Dr. Tilo Kunaths lab at the University of Edinburgh)

The Future of Cell Replacement Therapy

These therapies being developed for Parkinsons disease will, in essence, be version 1.0 of CRT. Clinical trials are set to begin next year and the therapy is expected to be widely available to people diagnosed with Parkinsons disease within the next 5-10 years.

Version 2.0 will be CRISPR-modified, disease resistant grafts, with genetic switches to modulate dopamine production and graft size.

Version 3.0 will make use of an emerging field called in vivo direct programming where viruses are inserted into the brain and transform other existing cells into dopamine producing cells.

(Edit: Credit to Dr. Tilo Kunath for correcting versions 2.0 and 3.0)

Dopamine neurons grown from iPS cells at 40 times magnification, from the Gladstone Institute

CRT for PD is one of the most exciting areas of research on the planet. It is a powerful demonstration of the progress we as a species have made in our attempt to gain mastery over the forces of biology.It has the potential to improve the lives of the millions living with PD, and the millions yet to be diagnosed. Once the transplanted cells have connected with their surroundings and start delivering dopamine to the right places, it should allow patients to gradually reduce their medication. Being able to move normally and not deal with the side effects of all the drugs and other therapies is what PD patients around the world are dreaming of.

Click here for more information on the future of cell replacement therapy for Parkinsons disease and the work of the GForce-PD.

And if you want to be part of bringing CRT to the clinic you can do so by supporting organizations like Summit For Stem Cells.

Like Loading...

Related

Originally posted here:
Cell Replacement Therapy For Parkinsons Disease And The ...

IPS Cell Therapy Comments Off on Cell Replacement Therapy For Parkinsons Disease And The … | November 8th, 2017

Stem cells (magenta with green nuclei) encapsulated in nanogel (yellow) for heart repair. Credit: MolGraphics.com

Cardiac stem cell therapy is a promising treatment for damaged hearts. However, researchers are still working on two major issues with the therapy how to keep the stem cells in place and how to prevent rejection when the stem cells are not from the patients own body. A new approach from NC State researcher Ke Cheng and a team of international collaborators may solve both of these problems.

The heart is a powerful muscle. Thats great if youre running a marathon, but if youre trying to inject stem cells into the heart with the hopes that theyll stay put, its a problem. One of the major drawbacks of cardiac stem cell therapy is simply that the cells do not stick to the injured heart tissue.

Enter a thermosensitive nanogel that is liquid at room temperature but becomes a thick, sticky gel as it warms. Cheng, associate professor of molecular biomedical sciences at NC States College of Veterinary Medicine and associate professor in the NC State/UNC Joint Department of Biomedical Engineering, partnered with chemical engineers from the University of Adelaide and cardiac specialists from the University of Zhengzhou and UNC-Chapel Hill to test the nanogel as a delivery mechanism for cardiac stem cells.

The nanogel, poly(N-isopropylacrylamine-co-acrylic acid), or P(NIPAM-AA) for short, had another property that made it appealing for use: in its thickened state it had porous openings large enough for a stem cells healing factors to escape, but not large enough for immune cells to enter. And it could be adjusted to slowly degrade over time, giving stem cells enough time to repair a damaged heart before dissolving away.

Autologous stem cells grown from a patients own cells are ideal to use in therapies, but that isnt always practical, Cheng says. For one thing, growing the cells takes time, which a patient may not have. For another, the heart cells themselves may be affected by disease, so stem cells taken from that source would not be useful.

Thats why were working on allogeneic stem cell therapies, but whenever you introduce cells from an outside source into the body, the immune system will attack them. The nanogel delivery method keeps the cells in place, protects them from the bodys immune response, and allows the regenerative factors released by the stem cells to reach the heart.

Cheng and his collaborators tested the nanogel delivery system in mice and pigs with hearts damaged by a heart attack. Without the nanogel, only about one percent of injected stem cells stayed in the heart. With the gel, up to 15 percent of the stem cells stayed put. They also found that in both animal models heart function improved three to four weeks after treatment. Mice showed a greater improvement than pigs, but in both models heart function was maintained and did not decrease.

We are pleased with these results, Cheng says. The nanogel is a safe, cost-effective way to deliver the cells directly to the affected area, and the large animal (pig) data is promising, which may lead to a human clinical trial in the future.

Chengs work appears in the journal ACS Nano, and was supported by the NIH and by NC States Chancellors Faculty Excellence Program and Chancellors Innovation Fund.

Continued here:
Stuck on You: Nanogel Capsule Helps Cardiac Stem Cells ...

Cardiac Stem Cells Comments Off on Stuck on You: Nanogel Capsule Helps Cardiac Stem Cells … | October 28th, 2017

A stem cell or bone marrow transplant replaces damaged blood cells with healthy ones. It can be used to treat conditions affecting the blood cells, such as leukaemia and lymphoma.

Stem cells arespecial cells produced bybone marrow (aspongytissue found in the centre of some bones) that can turn into different types of blood cells.

The three maintypes of blood cellthey can become are:

A stem cell transplant involves destroying any unhealthy blood cells and replacing them with stem cells removed from the blood or bone marrow.

Stem cell transplants are used to treat conditions in which the bone marrow is damaged and is no longer able to produce healthy blood cells.

Transplants can also be carried out to replace blood cells that are damaged or destroyed as a result of intensive cancer treatment.

Conditions that stem cell transplants can be used to treat include:

A stem cell transplant will usually only be carried out if other treatments haven't helped, the potential benefits of a transplant outweigh the risks and you're in relatively good health, despite your underlying condition.

A stem cell transplant can involve taking healthy stem cells from the blood or bone marrow of one person ideally a close family member with the same or similar tissue type (see below) and transferring them to another person. This is called an allogeneic transplant.

It's also possible to remove stem cells from your own body and transplant them later, after any damaged or diseased cells have been removed. This is called an autologous transplant.

Astem celltransplant has five main stages. These are:

Having a stem cell transplant can be an intensive and challenging experience. You'll usually need to stay in hospital fora month or more until the transplant starts to take effect and itcan takea year or two to fully recover.

Read more about what happens during a stem cell transplant.

Stem celltransplants arecomplicated procedures with significant risks. It's important that you're aware of both the risks and possible benefits before treatment begins.

Possible problems that can occur during or after the transplant process include:

Read more about the risks of having a stem cell transplant.

Ifit isn't possible to use your own stem cells for the transplant (see above), stem cells will need to come from a donor.

To improve the chances ofthetransplant being successful, donated stem cells need tocarry a special genetic marker known as a human leukocyte antigen (HLA) that'sidentical or very similar to that of the person receiving the transplant.

The best chance of getting a match is from a brother or sister, or sometimes another close family member. If there are no matches in your close family,a search of theBritish Bone Marrow Registry will be carried out.

Most peoplewill eventually find a donor in the registry,although a small number of people may find it very hard or impossibleto find a suitable match.

The NHS Blood and Transplant website has more information about stem cell and bone marrow donation.

Page last reviewed: 08/10/2015

Next review due: 01/10/2018

Read the rest here:
Stem cell and bone marrow transplants - NHS Choices

Bone Marrow Stem Cells Comments Off on Stem cell and bone marrow transplants – NHS Choices | October 24th, 2017

New Jersey's Premier Heart Transplant Program

The Barnabas Health Heart Failure and Transplant program is the most experienced and comprehensive center in New Jersey. It has been at the forefront of highly specialized care for more than twenty years. Our cardiac surgeons and heart specialists' expertise has made RWJBarnabas Health a regional and national training center for physicians, nurses and emergency services technicians.

Dr. Joseph Clemente, host of MHC-TV, interviews Mark J. Zucker, M.D., J.D., Director, Heart Failure Treatment and Transplant Program at Newark Beth Israel Medical Center. They discuss getting a heart transplant, other treatments such as the Left Ventricular Assist Device (LVAD), and about stem cell research ongoing today.

Learn about CardioMEMS, a new treatment for heart failure

Barnabas Health Heart Centers Earn Recognition from American Heart Association in Heart Failure Treatment

The Barnabas Health Heart Centers provide progressive heart failure management that optimizes the patient's transition to home and empowers them to improve their heart health. Advanced practice nurses contact patients within days of discharge and facilitate daily medical monitoring, education, and counseling. Patient-centered programs bring together all the medical resources necessary to combat heart failure and the reduction in hospital readmission rates has been significant. Heart failure clinics are based at all Barnabas Health hospitals.

Clinical trials provide patients with access for breakthrough medications, devices, and therapies, while being continually monitored and evaluated. Our participation in new cardiac stem cell research for patients with refractory angina and chronic myocardial ischemia may someday help the heart heal itself. Improved technology has made positive outcomes with ECMO more likely both at our center and nationally, and has resulted in increased referrals for this critical care.

The Newark Beth Israel Medical Center heart transplant program is one of the top ten heart transplant centers in the United States with survival rates that consistently meet or exceed national benchmarks. The center is at the forefront of improving the quality of life for transplant candidates and recipients, as well as increasing access to transplant. Our unique work in establishing successful protocols for discontinuing steroid medications for immunosuppression is improving the medical management and survival rates for transplant recipients worldwide. Noninvasive gene expression testing offers an alternative technique for assessing immunosuppression and predicting rejection. The center is also part of groundbreaking research that is exploring innovating methods for preserving donor organs for transplant.

Implantable VADs are placed for myocardial recovery, bridge to transplant, and destination therapy. Because the VAD program is totally integrated with heart failure and transplant services, patients are thoroughly and continually evaluated for all treatment options. The heart transplant center's experience has made it a principal site for clinical research trials of the latest generation of mechanical assist devices and a regional VAD transplantation training site. With virtually all FDA-approved and investigational implantable devices available, patients receive the device that meets their individual needs.

[top ]

Continued here:
Heart Failure and Transplant Program New Jersey

Cardiac Stem Cells Comments Off on Heart Failure and Transplant Program New Jersey | October 23rd, 2017

During the last decade, an increased interest in somatic stem cells has led to a flurry of research on one of the most accessible tissues of the body: skin. Much effort has focused on such topics as understanding the heterogeneity of stem cell pools within the epidermis and dermis, and their comparative utility in regenerative medicine applications. In Skin Stem Cells: Methods and Protocols, expert researchers in the field detail many of the methods which are now commonly used to study skin stem cells. These include methods and techniques for the isolation, maintenance and characterization of stem cell populations from skin. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls.

Authoritative and practical, Skin Stem Cells: Methods and Protocols seeks to aid scientists in the further understanding of these diverse cell types and the translation of their biological potential to the in vivo setting.

Originally posted here:
Skin Stem Cells - Methods and Protocols | Kursad Turksen ...

Skin Stem Cells Comments Off on Skin Stem Cells – Methods and Protocols | Kursad Turksen … | October 15th, 2017

Nov. 14, 2011 -- The first use of heart stem cells in humans looks like a major breakthrough for people suffering heart failure after heart attacks.

It's early -- results are in for only the first 16 patients -- but the results already are drawing praise from experts not easily impressed by first reports.

"This is a groundbreaking study of extreme importance," Joshua Hare, MD, director of the University of Miami's Interdisciplinary Stem Cell Institute, tells WebMD via email. Hare was not involved in the study.

"The reported benefits are of an unexpected magnitude," writes Gerd Heusch, MD, PhD, chair of the Institute of Pathophysiology at the University of Essen, Germany, in an editorial in the Nov. 14 online issue of The Lancet.

Study researcher John H. Loughran, MD, of the University of Louisville, Ky., could barely contain his excitement in an interview with WebMD.

"The improvement we have seen in patients is quite encouraging," he says. "Michael Jones, our first patient, could barely walk 30 feet [before treatment]. I saw him this morning. He says he plays basketball with his granddaughter, works on his farm, and gets on the treadmill for 30 minutes three times a week. It is stories like that that makes these results really encouraging."

The breakthrough comes just as researchers were becoming discouraged by studies in which bone-marrow stem cells failed to heal damaged hearts.

Instead of getting stem cells from the bone marrow, the new technique harvests stem cells taken from the patients' own hearts during bypass surgery. Just 1 gram of heart tissue -- about 3.5 hundredths of an ounce -- is taken.

Using a technique invented by Brigham & Women's Hospital researchers Piero Anversa, MD, and colleagues, heart stem cells are taken from the tissue and grown in the lab. These adult stem cells already are committed to becoming heart cells, but they can transform into any of the three different kinds of heart tissues.

It's the first time tissue-specific stem cells, other than bone-marrow cells, have been tested in humans, Hare says.

In the study, about a million of the cells were infused into each patient's heart with a catheter. Calculations suggest that each of these infused cells could generate 4 trillion new heart cells.

The study was designed to show whether the technique was safe. It was: No harmful effects have been seen. But to the researchers' surprise, the relatively small number of cells infused into patients had a major effect.

Of the 14 patients analyzed so far, heart function improved dramatically. And in the eight patients seen one year after treatment, improvement appears to have continued. Moreover, the scars on patients hearts -- areas of dead tissue killed during their heart attacks -- are healing.

And patients aren't just doing better on measures of heart function. Like Michael Jones, they report vastly improved quality of life and ability to perform daily tasks.

"Now this is an open-label trial, so patients know they are treated. This means we have to take what they say with a grain of salt," Loughran says. "But we see these patients not only are feeling better but doing more."

The only downside of this early success is that the ongoing study already has enrolled all 20 of the patients who will be treated. The experimental treatment simply will not be available to other patients in the near future. A larger, phase II study is planned.

"All the patients that call in to us, and there are quite a few interested, we encourage them to maintain close contact with their doctors," Loughran says. "Lifestyle changes and medical management are the most important things for them right now. We will be working very hard to get new trials under way."

The findings were reported at the American Heart Associations Scientific Sessions meeting in Orlando, Fla., and in the Nov. 14 online edition of The Lancet.

SOURCES:

John H. Loughran, MD, fellow in cardiovascular medicine, University of Louisville, Ky.

Joshua Hare, MD, director, Interdisciplinary Stem Cell Institute, University of Miami.

Bolli, R. The Lancet, published online Nov. 14, 2011.

Heusch, G. The Lancet, published online Nov. 14, 2011.

Traverse, J.H. Journal of the American Medical Association, published online Nov. 14, 2011.

Hare, J. Journal of the American Medical Association, published online Nov. 14, 2011.

See original here:
Stem Cells Repair Heart in First-Ever Study - webmd.com

Cardiac Stem Cells Comments Off on Stem Cells Repair Heart in First-Ever Study – webmd.com | October 13th, 2017

Spinal cord injury is the injury to the spinal cord, a very serious form of trauma with enduring effects on the patients daily life. The spinal cord is approximately 18 inches long and extends from brain base at the neck and ending just above the buttocks. It has numerous nerves known as upper motor neurons (UMNs) and is responsible for transmitting signals back and forth from the brain to different parts on the body.Human beings are in a position to feel pain and move their limbs because messages are sent via the spinal cord, therefore if the spinal cord is damaged some or all of these impulses may not be sent.

Usually, a spinal cord injury happens as a result of an impulsive accident or event, we list here some of the most common causes of spinal cord injury:

An aggressive attack like being stabbed or shot Diving into very shallow water and hitting the bottom Trauma to the face, head, back or the neck region during a motor accident Falling from a very high height Electrical accident Injuries while engaging in sports Severe twist of the torso middle portion

1) Incomplete spinal cord injuries; the spinal cord is partially affected and in this case, the patient retains some functions depending on the degree of the injury. Some of the common types of partial spinal cord include anterior cord syndrome, central cord syndrome and brown-sequard syndrome.

2) Complete spinal cord injuries; this type occurs when the spinal cord is fully damaged and there is no function below the level of injury. However, with proper treatment and physical therapy, it is possible for a patient to regain some functions.

Challenges walking Loss of control of bladder or bowels Difficulties moving arms and legs Headaches Unconsciousness Pain, pressure, and stiffness in the neck/or back region Spreading numbness feelings Unnatural head positioning Signs of shock Loss of libido Loss of fertility Bedsores How are spinal cord injuries diagnosed?

Usually, physicians examine patients for spinal cord injuries based on factors like the location, type and the symptoms of the injury. However, no single test can assess 100% these injuries; instead, doctors depend on a number of protocols such as:

Clinical evaluation; the doctor will keenly observe your symptoms, carry out blood tests, ask detailed questions about your condition and follow your eye movement Imaging tests; the doctor may request a magnetic reasoning imaging or radiological imaging to view the spinal column, spinal cord, and brain

Stem cells are found in all multi-cellular organisms and are well known for their remarkable ability to differentiate into almost any other type of cell. Therefore depending on the disease, stem cells can be transplanted into the patient to assist renewal and regeneration of the previously dying cells.This principle is now being used for a spinal cord injury using stem cells; it assists patients with the recovery process and restores their physiological and sensory ability.Currently, no stem cell therapy has been approved as a complete cure for spinal injuries. Stem cell therapy is used to improve conditions and symptoms whilst allowing the patient to enjoy a better quality of life after injury.

Exogenous and endogenous repair.While in exogenous repair the stem cells are first grown in the lab and then injected into the patient, in endogenous repair stem cells are injected into the injured site and the results depend on the bodys ability to change stem cells into the needed cells.

Adult neural stem cells can differentiate into different cell types. Consequently, researchers are taking advantage of this regenerative ability and are trying to come up with ways to reintroduce the bodys own stem cells into the damaged spinal cord. Research in rats shows that transplanting oligodendrocyte (support cells that make myelin) and astrocyte (boost nerve function) precursors from the neural stem cells can protect axons and reduce motor neuron damage.

Embryonic stem cells are the best type of stem cells and researchers are developing ways to turn embryonic stem cells into oligodendrocyte which have successfully repaired neural functions in animal models. However, using the same approach in a clinical trial is very challenging; it is close to impossible to make oligodendrocyte without also making other unasked for cells.

Induced Pluripotent Stem cells (IPs) are just like embryonic stem cells and can be made from the skin or any other tissue cell. They are easily reachable and offer a great source of cells that match the patients profile, hence theres no chance of rejection.

By combining the Anti CD2 human clonal antibodies and Anti-cytokines monoclonal antibodies, we create injections. This helps to reduce the inflammation, axonal degeneration and to prevent demyelination. Lysis functions of leukocyte cells get enhanced as well.

Spinal laser therapyIV laser therapyIV OxygenShock Wave TherapyPeptides injectionsPhysiotherapyEnzymes & Nutrition

Go here to read the rest:
Spinal Cord Injury Treatment with Stem Cells - Stem Cells ...

Spinal Cord Stem Cells Comments Off on Spinal Cord Injury Treatment with Stem Cells – Stem Cells … | October 3rd, 2017

Stem cells are found in the early embryo, the foetus, amniotic fluid, the placenta and umbilical cord blood. After birth and for the rest of life, stem cells continue to reside in many sites of the body, including skin, hair follicles, bone marrow and blood, brain and spinal cord, the lining of the nose, gut, lung, joint fluid, muscle, fat, and menstrual blood, to name a few.In the growing body, stem cells are responsible for generating new tissues, and once growth is complete, stem cells are responsible for repair and regeneration of damaged and ageing tissues. The question that intrigues medical researchers is whether you can harness the regenerative potential of stem cells and be able to grow new cells for treatments to replace diseased or damaged tissue in the body.

To find out more about how stem cells are used in research and in the development of new treatments download a copy of The Australian Stem Cell Handbook or visit Stem Cell Clinical Trials to find out more about the latest clinical research using stem cells.

Stem cells can be divided into two broad groups:tissue specific stem cells(also known as adult stem cells) andpluripotent stem cells(including embryonic stem cells and iPS cells).

To learn more about the different types of stem cells visit our frequently asked questions page.

Read the original post:
About Stem Cells

Cardiac Stem Cells Comments Off on About Stem Cells | September 30th, 2017

CHOLLEY PhytocellBooster is ideal for smoothening wrinkles and eliminating the signs of aging or fatigue. It is a perfect product in many situations, such as after waking up in the morning, an exhausting day at work, and prior to attending a business meeting or party.

CHOLLEY Phytocell Booster instantly reduces wrinkles and imparts a lifted and younger-looking appearance to the skin. With Swiss guarantee of quality and excellence, the stem cells serum is clinically tested and found to be suitable for all skin type and complexions.

To exploit the power of IC-RAMP technology and Swiss stem cells technology, use CHOLLEY Phytocell Cream in combination with CHOLLEY Phytocell Booster. They provide your skin with full spectrum, day and night abti-aging care.

For best results, in morning and at night, apply CHOLLEY Phytocell Booster on the face, neck and dcollet. When the product is fully absorbed, complete the treatment with the application of CHOLLEY Phytocell Cream. It is the perfect Anti-aging and Antioxidant program.

Read this article:
Buy Serum Stem Cells Skin Care Products | CHOLLEY

Skin Stem Cells Comments Off on Buy Serum Stem Cells Skin Care Products | CHOLLEY | September 24th, 2017

What Is Quadriplegia?

Paralysis can be either partial, periodic, complete, or incomplete. Paralysis of both the arms and legs has been traditionally been called quadriplegia. Quad comes from the Latin for four and plegia comes from the Greek for inability to move. Currently the term tetraplegia is becoming more popular, but it means the same thing. Tetra is from the Greek for inability to move.

The primary cause of quadriplegia is a spinal cord injury, but other conditions such as cerebral palsy and strokes can cause a similar appearing paralysis. The amount of impairment resulting from a spinal cord injury depends on the part of the spinal cord injured and the amount of damage done. Injury to the spinal cord can be devastating because the spinal cord and the brain are the main parts of the central nervous system, which sends messages throughout your body.

When the spinal cord is injured the brain cannot properly communicate with it and so sensation and movement are impaired. The spinal cord is not the spine itself; it is the nerve system encased in the vertebrae and discs which make up the spine.

Quadriplegia occurs when the neck area of the spinal cord is injured. The severity of the injury and the place it occurred at determine the amount of function a person will maintain. A major spinal cord injury may interfere with breathing as well as with moving the limbs. A patient with complete quadriplegia has no ability to move any part of the body below the neck; some people do not even have ability to move the neck.

Sometimes people with quadriplegia can move their arms, but have no control over their hand movements. They cannot grasp things or make other motions which would allow them a little independence. New treatment options have been able to help some of these patients regain hand function.

Quadriplegia causes many complications which will need careful management:

Immediate treatment of quadriplegia consists of treating the spinal cord injury or other condition causing the problem. In the case of a spinal cord injury, you will immobilized with special equipment to prevent further injury, while medical personnel work to stabilize your heart rate, blood pressure, and over all condition. You may be intubated to assist your breathing. This means that flexible tube carrying oxygen will be inserted down your throat. Imaging tests will be used to determine the extent of your injury.

Surgery may be needed to relieve pressure on the spine from bone fragments or foreign objects. Surgery may also be used to stabilize the spine, but no form of surgery can repair the damaged nerves of the spinal cord. Unfortunately, the nerve damage caused by the initial spinal cord injury has a tendency to spread. The reasons for this tendency are not completely understood by researchers, but it is related to spreading inflammation as blood circulation decreases and blood pressure drops.

The inflammation causes nerve cells not directly in the injured area to die. A powerful corticosteroid, methylprednisolone (Medrol) can sometimes help prevent the spread of this damage if it is given within eight hours of the original injury; however, methylprednisolone can cause serious side effects and not all doctors are convinced that it is beneficial.

Rehabilitation for quadriplegia once consisted primarily of training to learn how to deal with your new limitations. Passive physical therapy was given to help prevent the muscles from atrophying. Today, many new options are offering quadriplegia patients new hope. These new options combine older methods with new technology with encouraging results.

While passive physical therapy once consisted solely of the therapists manipulating the patients arms and legs in an effort to increase circulation and retain muscle tone, today therapists can use electrodes to stimulate the patients muscles and give them an optimal workout. This technology is called functional neuromuscular stimulation (FNS). FNS stimulates the intact peripheral nerves so that the paralyzed muscles will contract.

The contractions are stimulated using either electrodes that have been placed on the skin or that have been implanted. With FNS, the patient may ride a stationary bicycle to improve muscle and cardiac function and prevent the muscles from atrophying. An implantable FNS system has been used to help people with some types of spinal injury regain use of their hands.

This is an option for people with quadriplegia, who have some voluntary use of their arms. The shoulders position controls the stimulation to the hands nerves, allowing the individual to pick up objects at will. Tendon transfer is another option which allows some people with quadriplegia more use of the arms and hands. This complicated surgery transfers a nonessential muscle with nerve function to the shoulder or arm to help restore function. FNS may be used in conjunction with tendon transfer.

Other forms of treatments for quadriplegia are still in the experimental stage. Many clinical trials of new treatment options are run every year. If you or a loved one suffers from quadriplegia, you may want to consider one of these trials. Ask your doctor to help you find a suitable trial.

See more here:
Quadriplegia | Types of Paralysis | Brain and Spinal Cord ...

Spinal Cord Stem Cells Comments Off on Quadriplegia | Types of Paralysis | Brain and Spinal Cord … | September 22nd, 2017

Treatment

The Stem Cell treatment performed at our clinics is a painless medical procedure where Stem Cells (cellular building blocks) are usually administered intravenously and subcutaneously (under the skin). The whole procedure takes approximately one hour and has no known negative side effects.

Following the treatment, the Fetal Stem Cells will travel throughout the body, detecting damaged cells and tissue and attempts to restore them. The Fetal Stem Cells can also stimulate existing normal cells and tissues to operate at a higher level of function, boosting the bodys own repair mechanisms to aid in the healing process. These highly adaptive cells then remain in the body, continually locating and repairing any damage they encounter.

As with any medical treatment, safety should be of the highest priority. The Stem Cells used in our treatment undergo extensive screening for possible infection and impurities.

Utilizing tests more sophisticated than those regularly used in the United States for Stem Cell research and transplant. Our testing process ensures we use only the healthiest cells to enable the safest and most effective Fetal Stem Cell treatment possible. And, unlike other types of Stem Cells, there is no danger of the bodys rejection of Fetal Stem Cells due to the fact they are immune privileged. This means that you can give the cells to any patient without matching, use of immunosuppressive drugs and without rejection. This unique quality eliminates the need for drugs used to suppress the immune system, which can leave a patient exposed to serious infections.

With over 4,000 patients treated, Stem Cell Of America has achieved positive results with a wide variety of illnesses, conditions and injuries. Often, in cases where the diseases continued to worsen, our patients have reported substantial improvements following the Stem Cell treatment.

Patients have experienced favorable developments such as reduction or elimination of pain, increased strength and mobility, improved cognitive function, higher tolerance for chemotherapy, and quicker healing and recovery.

To view follow up letters from patients, please visit the patient experiences page on our website.

All statements, opinions, and advice on this page is provided for educational information only. It is not a substitute for proper medical diagnosis and care. Like all medical treatments and procedures, results may significantly vary and positive results may not always be achieved. Please contact us so we may evaluate your specific case.

Read more:
Stem Cell of America - Breakthrough Stem Cell Treatments ...

Spinal Cord Stem Cells Comments Off on Stem Cell of America – Breakthrough Stem Cell Treatments … | September 20th, 2017

Stem cells have the remarkable potential to develop into many different cell types in the body during early life and growth. In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive. When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell.

Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. In some organs, such as the gut and bone marrow, stem cells regularly divide to repair and replace worn out or damaged tissues. In other organs, however, such as the pancreas and the heart, stem cells only divide under special conditions.

Until recently, scientists primarily worked with two kinds of stem cells from animals and humans: embryonic stem cells and non-embryonic "somatic" or "adult" stem cells. The functions and characteristics of these cells will be explained in this document. Scientists discovered ways to derive embryonic stem cells from early mouse embryos more than 30 years ago, in 1981. The detailed study of the biology of mouse stem cells led to the discovery, in 1998, of a method to derive stem cells from human embryos and grow the cells in the laboratory. These cells are called human embryonic stem cells. The embryos used in these studies were created for reproductive purposes through in vitro fertilization procedures. When they were no longer needed for that purpose, they were donated for research with the informed consent of the donor. In 2006, researchers made another breakthrough by identifying conditions that would allow some specialized adult cells to be "reprogrammed" genetically to assume a stem cell-like state. This new type of stem cell, called induced pluripotent stem cells (iPSCs), will be discussed in a later section of this document.

Stem cells are important for living organisms for many reasons. In the 3- to 5-day-old embryo, called a blastocyst, the inner cells give rise to the entire body of the organism, including all of the many specialized cell types and organs such as the heart, lungs, skin, sperm, eggs and other tissues. In some adult tissues, such as bone marrow, muscle, and brain, discrete populations of adult stem cells generate replacements for cells that are lost through normal wear and tear, injury, or disease.

Given their unique regenerative abilities, stem cells offer new potentials for treating diseases such as diabetes, and heart disease. However, much work remains to be done in the laboratory and the clinic to understand how to use these cells for cell-based therapies to treat disease, which is also referred to as regenerative or reparative medicine.

Laboratory studies of stem cells enable scientists to learn about the cells essential properties and what makes them different from specialized cell types. Scientists are already using stem cells in the laboratory to screen new drugs and to develop model systems to study normal growth and identify the causes of birth defects.

Research on stem cells continues to advance knowledge about how an organism develops from a single cell and how healthy cells replace damaged cells in adult organisms. Stem cell research is one of the most fascinating areas of contemporary biology, but, as with many expanding fields of scientific inquiry, research on stem cells raises scientific questions as rapidly as it generates new discoveries.

I.Introduction|Next

Follow this link:
Stem Cell Basics I. | stemcells.nih.gov

Skin Stem Cells Comments Off on Stem Cell Basics I. | stemcells.nih.gov | September 20th, 2017

Stem cell therapy is a two-step process. First, the patients blood cells are destroyed by chemotherapy, radiation therapy or immunosuppression. This conditioning process also eradicates any cancer cells that survived first-line treatment. Second, the patient receives stem cells harvested from a donors bone marrow or peripheral blood (circulating blood). While this can be an effective cure, it can cause graft-versus-host disease (GVHD) in up to 50% of patients. GVHD is more likely to develop in patients who have received a peripheral blood transplant and can kill 15%-20% of patients.

Two types of GVHD can develop, acute and chronic, and patients may develop either one, both or neither type. GVHD is less likely to occur and symptoms are milder if the donor cells closely match those of the patient. Acute GVHD can develop within 100 days of a transplant. The first step of stem cell therapy can cause tissue damage, and bacteria from the gut can escape into the bloodstream. This primes the patients antigen-presenting cells (cells that activate the immune response), which subsequently encourage donor T cells to proliferate and attack the patients tissues. Symptoms include vomiting, diarrhea, skin rashes, nausea, vomiting and liver problems. This can be resolved relatively quickly in one third of patients using immunosuppressive treatments, but some patients can progress to chronic GVHD.

The biological mechanisms responsible for chronic GVHD are not completely understood, but scientists believe that other immune system cells from the donor (B cells and macrophages) are stimulated and damage the patients tissues. Symptoms include dry eyes, mouth sores, muscle weakness, fatigue and joint problems.

Unfortunately, development of effective treatments for GVHD is not keeping up with the increasing number of GVHD patients or with advances in understanding this disease. At present, standard treatments include corticosteroids and drugs that reduce IL-2, an immune system chemical that helps T-cells multiply and diversify. These treatments have various side effects including suppressing the patients immune system, thereby increasing risk of infection.

One challenge stalling drug research is that a small degree of graft-versus-host response must occur for successful stem cell therapy: donor cells will destroy any cancer cells that remain after the first stage of therapy. This challenge is discussed in a recent article in Science Health.Although several treatments have been trialed, success is variable and often targets only acute GVHD or chronic GVHD. Biomarkers have also been detected that may help identify individuals at risk of developing severe GVHD, information that may aid the development of personalized treatment strategies. Drugs that have been approved for other diseases, but not for GVHD, show promise and include ibrutinib for chronic GVHD (approved for specific blood cancers) and ruxolitinib for acute GVHD (approved for bone marrow disorders).

The impact of stem cell therapy must not be underestimated: up to 50% of recipients will develop GVHD. Unfortunately, some individuals will develop chronic GVHD, a condition that is just as difficult to survive as cancer. This highlights the importance of developing continued care strategies for individuals receiving stem cell therapy as a final defence against cancer.

Written byNatasha Tetlow, PhD

Reference: Cohen J. A stem cell transplant helped beat back a young doctors cancer. Now, its assaulting his body. Science Health. 2017. Available at: DOI: 10.1126/science.aan7079

Read this article:
Stem Cell Therapy: A Lethal Cure - Medical News Bulletin

Bone Marrow Stem Cells Comments Off on Stem Cell Therapy: A Lethal Cure – Medical News Bulletin | September 8th, 2017

The Oncology Institute of Hope Innovation welcomes Dr. Homsi to its team of specialists.

Downey, CA (PRWEB) September 08, 2017

The Oncology Institute of Hope Innovation welcomes Dr. Homsi to its team of specialists.

Dr. Yaser Homsi is a passionate and knowledgeable Hematologist that received his Medical education from the University of Aleppo in Aleppo, Syria. After graduation, Homsi moved to Indianapolis, Indiana where he completed his internship, residency and fellowship at the Indiana School of Medicine. Homsi's fellowship training included: Blood and Bone Marrow Stem Cell Transplant, Hematology and Oncology.

Dr. Homsi has completed multiple medical researches including Cellular Therapy and Hematopoietic Stem Cell Transplantation for Cancer and has published papers in various disciplines of Oncology including the Role of Angiogesis in Cancer and The Outcome of the combination of Tacrolimus, Sirolimus and ATF.

Dr. Homsi is Fluent in Arabic.

Professional Memberships:

American Society of Clinical OncologyAmerican Society of HematologyPatient Philosophy:

Dr. Homsi believes in treating each of his patients as individuals as he aids his patients and their families through their treatment plan. He believes strongly in communication and strives to clearly educate all of his patients. He and his staff make every effort to give the best treatment and care possible.

For the original version on PRWeb visit: http://www.prweb.com/releases/2017/09/prweb14669766.htm

Continue reading here:
Dr. Yaser Homsi Joins The Oncology Institute of Hope and Innovation - Benzinga

Bone Marrow Stem Cells Comments Off on Dr. Yaser Homsi Joins The Oncology Institute of Hope and Innovation – Benzinga | September 8th, 2017

On Saturday morning, a convoy of vintage Ford Broncos carrying some very precious cargo made a stop at La Caadas Descanso Gardens.

En route from Childrens Hospital Los Angeles, the motorcade was led by a golden 1971 Bronco with Thousand Oaks resident Tyler Kelly at the helm. Tucked safely into a car seat in the back was 2-year-old Pierce Kelly, known by family and friends as Fierce Pierce, still recovering from a July 21 bone marrow transplant.

At the La Caada home of relatives Donna and Dave McLaughlin, Pierce will recuperate under the watchful eye of mom Aubrey. For 100 days following the procedure, he must reside within a 30-minute drive of Childrens Hospital for monitoring.

Saturdays 13-mile drive was just one portion of a tumultuous journey the Kellys have been on since April 7, when Pierce was diagnosed with acute myeloid leukemia. His chance of surviving the devastating illness with treatment alone was only 50%, according to mom Aubrey. But there was one hope if the Kellys could find a bone marrow donor, Pierces odds would improve by at least another 15%.

We were at the mercy of whoever had registered, Aubrey Kelly recalled.

Among the nearly 13.5 million Americans already listed as donors on the Be the Match Marrow Registry, there were no donors close enough to be a match with Pierce.

Raquel Edpao, a community outreach specialist for Be the Match, said on any given day there are 14,000 people like the Kellys, searching registries for a bone marrow match. Its her job to help educate people how simple it is to join the registry and to donate if called.

Potential donors register online at bethematch.org, then receive and turn in a cheek swab. After that, theyre contacted if they are a potential match for someone. Edpao estimates about one out of every 430 registrants will be asked to donate.

There are so many misconceptions about donating, she said, invoking myths about spinal drilling, painful extractions and missed days at work. Its usually as simple as donating blood.

In about 20% of cases donors are asked to undergo a marrow extraction, a 45-minute outpatient procedure involving a general anesthetic.

Luckily for the Kellys, a search of donors worldwide returned a single donor in France whose human leukocyte antigen (HLA) protein was a 10-out-of-10 match with Pierces. While the marrow was shipped, the 2-year-old underwent chemotherapy to destroy most of his damaged stem cells in preparation for the donation.

Its a fine balance of leaving him with enough cells to receive the new ones, but not so many that the new cells dont have enough room to grow, Aubrey Kelly said, explaining how her sons blood type switched from A positive, his own type, to the donors O negative.

Pierces recovery from the transplant requires a sterile environment that means he cannot stay with siblings Sierra, 4, and 6-month-old Harper. Donna McLaughlin, a cousin of Aubrey Kellys dad, said she and husband Dave were happy to offer their home in La Caadas Paradise Valley neighborhood for his recovery.

Ive worked for the past week cleaning my house its never been so clean, she said of her preparation for Pierce and Aubreys 57-day visit. Im being paranoid, I know, but he is going to be OK on my watch.

Knowing he would have to return to Thousand Oaks to take care of Pierces sisters, Tyler Kelly wanted to ensure his sons trip from the hospital would be a special one. The Bronco the same vehicle his mother drove to the hospital in 1981 so he could be delivered, and the same one he and Aubrey have used to get to the delivery room in time for the birth of their own three children seemed a fitting conveyance.

We wanted to continue the tradition, he said.

Hoping to assemble a retinue for the drive, Tyler Kelly reached out to enthusiast club SoCal Broncos and classicbroncos.com. Several people responded, including Agoura Hills Bronco owner Dan Bennett, for whom the cause was personal. About 10 years ago he saved a life by donating his own bone marrow.

To be able to go in and help play an intrinsic role in saving someones life is a really special thing, Bennett said. I think everybody should do it.

sara.cardine@latimes.com

Twitter: @SaraCardine

Read more here:
Convoy from Children's Hospital to La Caada carries precious cargo a 2-year-old bone marrow recipient - Los Angeles Times

Bone Marrow Stem Cells Comments Off on Convoy from Children’s Hospital to La Caada carries precious cargo a 2-year-old bone marrow recipient – Los Angeles Times | September 8th, 2017

Cellular Renovation

Why build something from the ground up when one can just renovate an already existing structure? Essentially, thats what researchers from the University of Washington School of Medicine in St. Louis had in mind when they developed a method for transforming adult human skin cells into motor neurons in a lab. They published their work in the journal Cell Stem Cell.

In this study, we only used skin cells from healthy adults ranging in age from early 20s to late 60s, senior author Andrew S. Yoo said in a press release. Our research revealed how small RNA molecules can work with other cell signals called transcription factors to generate specific types of neurons, in this case motor neurons. In the future, we would like to study skin cells from patients with disorders of motor neurons. Our conversion process should model late-onset aspects of the disease using neurons derived from patients with the condition.

They did this by exposing skin cells in a lab to certain molecular signals usually found at high levels in the human brain. They focused on two short snippets of RNA: microRNAs (mRNAs) called miR-9 and miR-124, which are involved in repurposing the genetic instructions of the cell. These mRNAs, combined with certain transcription factors, successfully turned skin cells into spinal cord motor neurons within just 30 days. These new cells closely resembled normal mouse motor neurons in terms of which genes were turned on and off, and how they functioned.

Usually, when researchers find ways to replace damaged cells or organs, they resort to using stem cells. In particular, they use embryonic stem cells (a type of pluripotent stem cells) to grow the cells or organs needed.

While this type of stem cell has the potential to grow into whatever adult cell type is needed, the procedure carries some ethical concerns. In bypassing a stem cell phase, the new cell transformation technique doesnt have any of these ethical issues.

Keeping the original age of the converted cells can be crucial for studying neurodegenerative diseases that lead to paralysis, such as amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy, the condition the new research focused on. In particular, researchers hope that it could enhance the understanding of these diseases in order to improve regenerative medicine.

Going back through a pluripotent stem cell phase is a bit like demolishing a house and building a new one from the ground up, Yoo explained. What were doing is more like renovation. We change the interior but leave the original structure, which retains the characteristics of the aging adult neurons that we want to study.

Like embryonic stem cells, the technique can also allow for converting human skin cells into other cell types by using different transcription factors. Before this technique can be applied to actual humans with neurodegenerative diseases, the researchers still need to find out how much the cells made in their lab match native human motor neurons. Still, its a promising start.

The rest is here:
Researchers Turn Skin Cells into Motor Neurons Without Using ... - Futurism

Skin Stem Cells Comments Off on Researchers Turn Skin Cells into Motor Neurons Without Using … – Futurism | September 8th, 2017

A Decatur elementary student and her mother are recovering following a stem cell transplant in a Cincinnati-area hospital.

It will be six to eight weeks, however, before doctors know whether the membrane Nicole Richey gave her daughter Phoenix is working.

What were praying for is that Phoenix will start producing her own stem cells, Joey Richey said by telephone Thursday.

In January, Phoenix, a fourth-grade student at Chestnut Grove Elementary, was diagnosed with Stevens-Johnsons syndrome, a rare and serious disorder of the skins mucous membranes.

According to the Mayor Clinic, the syndrome is caused by a reaction to medication or infection and begins with flu-like symptoms, which Phoenix had. The disease is followed by painful rashes and blisters that ultimately cause the top layer of skin to die.

The disease affected between 60 and 65 percent of Phoenixs body and damaged her eyes.

During the outpatient procedure, which is called a limbal stem cell transplant, said Joey Richey, surgeons took about 40 percent of the cornea from his wifes left eye and placed it in Phoenixs right eye.

Nicole Richey said she was close to a perfect match, but doctors have put her daughter on immunosuppression therapy to lower the possibility of Phoenix rejecting the stem cells.

I am still having a hard time after my surgery, but were OK, Nicole Richey said.

The procedure took place at St. Elizabeth North Kentucky Surgical Center, and Phoenix will miss about six weeks of school.

Chestnut Grove Principal Luke Bergeson said Phoenix will continue to receive homebound instructional services until she is ready to return to school.

Phoenixs body is still not able to grow its own skin, so she has been fitted with a prokera ring, which is a therapeutic device to protect her eyes. Her left eye is temporarily sewn shut and will be until doctors see how the right eye reacts to the transplant, Joey Richey said.

They are working on one eye at a time, he said.

Phoenix was diagnosed with Stevens-Johnsons syndrome while she was out of school on Christmas break last year. The outer layer of skin started to die and was peeling two days before she was admitted to Huntsville Hospital. On Jan. 12, doctors transferred Phoenix to the burn unit at Childrens Hospital of Birmingham for treatment.

She stayed there a week before being moved to Shriners Hospital for Children in Cincinnati, where she stayed until Feb. 8.

Phoenix missed the remainder of the school term, but she came back to Chestnut Grove when classes started in August.

Read more here:
Decatur elementary student gets stem cells from mother - The Decatur Daily

Skin Stem Cells Comments Off on Decatur elementary student gets stem cells from mother – The Decatur Daily | September 8th, 2017

Nancy Crotti

Researchers have developed tissue nanotransfection, a process for regrowing tissue inside the human body.

Researchers at Ohio State University have developed breakthrough stem cell technology that can regrow tissue inside the human body, rather than in a laboratory.

Their work has implications for critical limb ischemia, brain disorders, and possibly even organ engineering and bone regrowth, according to Chandan Sen, PhD, director of the Center for Regenerative Medicine and Cell-Based Therapies at Ohio State's Wexner Medical Center in Columbus. Sen led the team that developed the technology.

Here's how the process, known as nanotransfection, works: The scientists make synthetic RNA and DNA to match that of the patient. They load it into nanochannels inside tiny needles embedded in a chip and apply the chip to the skin. The needles electrocute about 2% of the cell surface with the patient's nucleic acid. The procedure takes 1/10th of a second, and has been shown to work with up to 98% efficiency.

In experiments on mice, the technology restored blood flow to injured legs by reprogramming the animals' skin cells to become vascular cells. With no other form of treatment, active blood vessels had formed within two weeks, and by the third week, blood flow returned and the legs of the mice were saved.

The researchers also induced strokes in mice and used the chips to grow new brain tissue from the animals' skin and transplant it to their brains. Bodily function damaged by the strokes was restored. The study of the technique, which worked with up to 98% efficiency, was reported in the journal Nature Nanotechnology.

The technology marks an advance over cell regeneration conducted in a laboratory, because those cells mostly underperform or die once transplanted into the body, according to Sen. The researchers use skin cells in their work because, as Sen explained, everybody has some to spare.

"We grow it in you and we move it over to the organ so you have your own cells populating your organ," he said. "It's all coming from you."

The synthetic RNA and DNA reprogram cells in the same way that fetal cells develop different functions to become different body parts, Sen added. The researchers worked on the technology for more than four years, also conducting successful blood flow restoration experiments on pigs. When they begin human trials, their first patients will likely be those whose critical limb ischemic has reached the stage where amputation is the only option.

The scientists' work has generated interest in Europe, Asia, the Middle East, and in the United States. Ohio State will decide where to pursue human trials first, and is searching for industry partners.

"The cost is extremely low and complexity-wise it is extremely low. I see very little barrier to take it to humans," Sen said.

The researchers' work marks another interface between silicon chips and biology. Other applications picked up by manufacturers include DNA sequencing machines, miniaturized diagnostic tests using disposable photonic chips, accurate body monitoring sensors, and brain stimulation probes.

Sen and his team acknowledge that their work will be met with skepticism.

"Whenever you do something that is sort of transformative, you will expect that," Sen said. "Therefore, we actually published this in the most rigorous journal possible. We went through 16 months of criticism and response, after which this was published."

Nancy Crotti is a freelance contributor to MD+DI.

[Image courtesy of THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER]

See the article here:
'Nanotransfection' Turns Animal Skin into Blood Vessels and Brain Cells - Medical Device and Diagnostics Industry

Skin Stem Cells Comments Off on ‘Nanotransfection’ Turns Animal Skin into Blood Vessels and Brain Cells – Medical Device and Diagnostics Industry | September 8th, 2017