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Senior Citizen Health & Medicine
Cancer Patient in Remission Three Years after Stem
Cell Implant of Immune Response
Next step in the research is a larger-scale
vaccination trial of myeloma patients
| |
Growing
older increases the chance of developing multiple myeloma. Most
people with myeloma are diagnosed after age 65.
Read more below story. |
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Nov. 26, 2007 – The potential for a cancer
vaccination seems a lot more promising after researchers transferred an
immune response in a healthy individual to a patient with multiple
myeloma, a cancer of the bone marrow, using a stem cell transplant. This
patient remains in remission nearly three years after the transplant,
report researchers at the University of Arkansas for Medical Sciences (UAMS).
In the study, conducted in the UAMS Myeloma
Institute for Research and Therapy, a healthy individual was immunized
with a cancer protein that can kick start the body’s immune system to
kill cancer cells. The cancer-killing antibodies produced by the healthy
patient’s immune system were then transferred via stem cell transplant
to her twin sister, who had been diagnosed with multiple myeloma, in
conjunction with chemotherapy.
The same immune response was subsequently observed
in the patient, whose cancer is still in remission. An article on the
study, “Immunization with a recombinant MAGE-A3 protein after high-dose
therapy for myeloma” was published in the November/December 2007 issue
of the Journal of Immunotherapy.
“Vaccination therapies have not yet been proven
clinically effective for myeloma, possibly due to disruptions in the
patient’s immune system caused by chemotherapy or the disease itself,”
said Frits van Rhee, M.D., Ph.D., leader of the research team and
director of clinical research in the Myeloma Institute.
“The ability to define and transfer an immune
reaction from a healthy donor to a patient with multiple myeloma may
give us another tool with long-lasting protection against disease
recurrence.”
Van Rhee, also a professor in the UAMS College of
Medicine, said that the donor and patient being identical twins provided
an ideal situation to test the vaccination. Because the stem cells came
from an identical twin, the researchers were able to avoid
immunosuppressive therapy that would normally be necessary and could
have hampered the immune response, he said.
The vaccine targeted a “cancer-testis” antigen
known as MAGE-A3. Cancer-testis antigens are a group of proteins which
have been found to be produced in cancerous cells but not in normal
tissues. Cancer testis antigen-targeted therapy will therefore only
destroy the malignant tissues which express them, making this type of
therapy far less toxic than non-specific chemotherapies, van Rhee said.
After receiving the stem cell transplant, the
patient also was vaccinated to boost the anti-myeloma response. The
vaccines produced strong antibody and cellular responses in both the
donor and the patient, said the researchers.
The MAGE-A3 vaccine used in this study is
manufactured by Glaxo-Smith-Kline, and is currently showing promise in
Phase III trials in small cell lung cancer, the researchers said.
They said the next step in the research is a
larger-scale vaccination trial of myeloma patients, van Rhee said.
(For more about this
research see Editor's Notes at bottom of page.)
What Is Multiple Myeloma?
Multiple myeloma is
cancer that begins in
plasma cells, a type of
white blood cell. To understand multiple myeloma, it is helpful to
know about normal blood cells.
Normal Blood Cells
Most blood cells develop from cells in the
bone marrow called
stem cells. Bone marrow is the soft material in the center of most
bones.
Stem cells mature into different types of blood
cells. Each type has a special function:
White blood cells help fight
infection. There are several types of white blood cells.
Red blood cells carry oxygen to
tissues throughout the body.
Platelets help form blood clots that control bleeding.
Plasma cells are white blood cells that make
antibodies. Antibodies are part of the
immune system. They work with other parts of the immune system to
help protect the body from germs and other harmful substances. Each type
of plasma cell makes a different antibody.
Normal plasma cells help protect the body from
germs and other harmful substances.
Myeloma Cells
Myeloma, like other cancers, begins in cells.
Normally, cells grow and divide to form new cells as the body needs
them. When cells grow old, they die, and new cells take their place. In
cancer, this orderly process goes wrong. New cells form when the body
does not need them, and old cells do not die when they should. These
extra cells can form a mass of tissue called a growth or
tumor.
Myeloma begins when a plasma cell becomes
abnormal. The abnormal cell divides to make copies of itself. The
new cells divide again and again, making more and more abnormal cells.
The abnormal plasma cells are myeloma cells. Myeloma cells make
antibodies called
M proteins.
In time, myeloma cells collect in the bone
marrow. They may crowd out normal blood cells. Myeloma cells also
collect in the solid part of the bone. The disease is called "multiple
myeloma" because it affects many bones. (If myeloma cells collect in
only one bone, the single mass is called a
plasmacytoma.)
Multiple myeloma is not bone cancer. Although
multiple myeloma affects the bones, it begins in blood cells, not bone
cells.
Bone cancer is a different disease. It begins in
bone cells, not blood cells. Bone cancer is diagnosed and treated
differently from multiple myeloma.
Risk Factors
No one knows the exact causes of multiple myeloma.
Doctors can seldom explain why one person develops this disease and
another does not. However, we do know that multiple myeloma is not
contagious. You cannot "catch" it from another person.
Research has shown that people with certain risk
factors are more likely than others to develop multiple myeloma. A risk
factor is something that may increase the chance of developing a
disease.
Studies have found the following risk factors for
multiple myeloma:
● Age: Growing older increases the chance of
developing multiple myeloma. Most people with myeloma are diagnosed
after age 65. This disease is rare in people younger than 40.
● Race: The risk of multiple myeloma is highest
among African Americans and lowest among Asian Americans. The reason for
the difference between racial groups is not known.
● Personal history of monoclonal gammopathy of
undetermined significance (MGUS): MGUS is a condition in which abnormal
plasma cells make a low level of M proteins. MGUS is a benign condition,
but it increases the risk of certain cancers, including multiple myeloma.
Scientists are studying other possible risk
factors for multiple myeloma. Radiation, pesticides, hair dye, certain
viruses, obesity, and diet are under study. But it is not clear that
these factors are involved in the development of the disease.
Researchers also are studying families in which more than one person has
multiple myeloma. However, such families are extremely rare.
>>
Read more about multiple myeloma at the National Cancer Institute
Editor's Notes:
Lead author of the research article was Susann
Szmania, a research assistant in the UAMS Myeloma Institute for Research
and Therapy. Other authors from the Myeloma Institute were Guido Tricot,
M.D., Ph.D.; Katie Stone, research assistant; Fenghuang Zhan, M.D.,
assistant professor in the UAMS College of Medicine; Amberly Moreno,
research assistant; Brad Thuro, research assistant; John D. Shaughnessy
Jr., Ph.D., chief of the basic sciences division; Bart Barlogie, M.D.,
Ph.D., director of the Myeloma Institute; and van Rhee.
Joining the UAMS researchers in the study was
Sacha Gnjatic and Lloyd J. Old of the Ludwig Institute for Cancer
Research in New York, N.Y.; Jos Melenhorst and John Barrett of the Stem
Cell Allogenic Transplantation Section in the National Heart, Lung, and
Blood Institute of the National Institutes of Health; and Vincent G.
Brichard of GlaxoSmithKline Biologicals in Rixensart, Belgium.
The Myeloma Institute, a part of the UAMS
Winthrop P. Rockefeller Cancer Institute, has performed more blood stem
cell transplants for myeloma than any other facility in the world. UAMS
treats more than 2,250 patients with myeloma annually at the Myeloma
Institute – more myeloma patients than are treated at any other facility
in the country.
UAMS is the state’s only comprehensive academic
health center, with five colleges, a graduate school, a medical center,
six centers of excellence and a statewide network of regional centers.
UAMS has 2,538 students and 733 medical residents. Its centers of
excellence include the Winthrop P. Rockefeller Cancer Institute, the
Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma
Institute for Research and Therapy, the Harvey & Bernice Jones Eye
Institute, the Psychiatric Research Institute and the Donald W. Reynolds
Institute on Aging.
It is one of the state’s largest public employers
with about 9,600 employees, including nearly 1,000 physicians who
provide medical care to patients at UAMS, Arkansas Children’s Hospital,
the VA Medical Center and UAMS’ Area Health Education Centers throughout
the state. UAMS and its affiliates have an economic impact in Arkansas
of $5 billion a year. For more information, visit
http://www.uams.edu.
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