« on: June 03, 2010, 02:15:49 PM »
Bone-marrow transplants -- long a treatment solely for cancer -- are now the subject of research at Northwestern University and elsewhere to ease the risks of the procedure so it can be used with more people with more diseases, from sickle cell to deadly metabolic disorders.
The old way: High doses of radiation and chemotherapy wipe out a patient's own bone marrow before someone else's is infused. The aim: Do so before infection strikes.
Dr. Joseph Leventhal, of Northwestern, has had some success giving Ildstad-treated stem-cell infusion to a handful of kidney recipients.
(Sun-Times Media File)
http://www.suntimes.com/lifestyles/2285496,CST-NWS-marrow18.article
The new way: Rather than destroy the patient's own bone marrow, just tamp it down enough to make space for donated marrow to squeeze in alongside, so a sort of twin immune system can take root.
Different mixes of low-dose radiation and immune-suppressing drugs are under study. The goal is to allow transplants even when donors aren't a good genetic match, said Dr. Suzanne Ildstad of the University of Louisville, whose technique involves a tweaking of donated cells to help them grow better.
''It makes it possible for anyone who has a mom or dad willing to donate marrow to them to have a transplant,'' Ildstad said.
Several hospitals are testing how to combine kidney transplants with bone-marrow transplants from the same donor, in hopes a hybrid immune system will lessen the need for a lifetime of anti-rejection drugs.
Doctors long have known a traditional bone-marrow transplant can cure young kids of sickle cell if they have a well-matched donor. But only about 17 percent of children have a suitable donor, usually a sibling. Attempts to transplant adults have failed, their bodies too ravaged from the disease. Also, certain immune cells in donated marrow sometimes attack the recipient, called graft-versus- host disease or GVHD.
Enter the new research. First came a tantalizing success in severely ill adults. Nine of 10 patients who underwent a less-intense transplant had their sickle cell apparently eliminated. They developed a hybrid immunity that produces normal red blood cells. Those people had perfectly matched donor cells provided by healthy siblings, but few patients do.
Dr. Joseph Leventhal of Northwestern gave an Ildstad-treated stem-cell infusion to a handful of kidney transplant recipients. They developed hybrid immune systems that seem to be holding nearly a year later.
''We're doing this in patients where it could have potentially the biggest impact,'' those with unrelated donors, Leventhal said