New Clinical Trial Aims to Reduce Risk of GVHD
Doctors at the University of Minnesota have developed new treatments that may increase the chance of curing the most difficult to treat cancers.
By John Wagner, M.D., Director, Pediatric Hematology/Oncology and BMT, and Bruce Blazar, M.D.,Director, Center for Translational Medicine
Clinical trials are currently in progress using cells that have the possibility of decreasing complications of marrow or umbilical cord blood transplants. Doctors are also researching a cell that has the capacity to kill leukemia.
Trials May Help Patients with the Most Difficult to Treat Cancers
Hundreds of thousands of children and adults are diagnosed with cancer each year. While many will be cured with conventional chemotherapy, too many will relapse. Marrow or umbilical cord blood transplants are treatment options for many patients with leukemia, lymphoma, or myeloma who have high risk or relapsed disease. Lack of suitably-matched donors and risk of immune complications, such as graft versus host disease (GVHD), limit the availability of transplant for some patients. GVHD is the culmination of a complex series of events resulting in the increase of donor T cells (cells of the immune system) that are poised to kill the patient’s own tissues because they are foreign.
Breakthrough Research
By providing funds, Children’s Cancer Research Fund helped doctors define a type of cell called regulatory T cells. These cells may prevent or stop GVHD, and are shown to be effective in laboratory models. Clinical trials are currently in progress. Drs. MacMillan, Brunstein, Miller, Wagner, and Blazar have generated regulatory T cells from umbilical cord and placental blood. They hope that the cells will speed bone marrow recovery and reduce the risk of GVHD.
In addition, doctors discovered immune system cells called natural killer cells (NK) that may have the capacity to kill leukemia. Testing of NK cells in patients with chemotherapy resistant leukemia is currently underway. Six children and adults have been treated to date, and early results are promising.
Children from other parts of the world are coming to Minnesota for these new treatments that offer the hope of a cure.
Uses Beyond Cancer
These new treatments have captured worldwide attention. Centers from around the country have asked University of Minnesota doctors to generate regulatory T cells and NK cells for them — but not just for children with leukemia. Regulatory T cells have the potential to stop autoimmune diseases such as lupus, rheumatoid arthritis, multiple sclerosis and even type I diabetes. Cord blood-derived NK cells have the potential to stop other cancers, such as breast cancer, melanoma and other solid tumors.