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New doubling of the amount of physical radiation available to patients undergoing donor bone marrow transplantation increases new cell count from about 50% to about 100, according to a new study by researchers at Johns Hopkins University %. These results, published online in Lancet Hematology on March 13, may offer much more effective treatment for patients with serious and fatal blood disorders, including sickle cell disease and beta-thalassemia, said Dr. Robert Brodsky, a professor of medicine and science. Oncology at the Johns Hopkins University School of Medicine and Director of the Hematology Department: "These results are really interesting because we are approaching a cure rate of 90% of sickle cell and thalassemia cells." bone marrow are not reserved for patients who have a well-matched donor. "
Dr. Javier Boulanios Meed, Associate Professor of Oncology at the Sydney-Kimmel Cancer Research Center and Dr. Brodsky, explain that in the late 1980s, researchers discovered that a bone marrow transplant could cure sickle cell disease. A disease that has only a few effective treatments and usually kills patients aged 40 to 40 years. However, this treatment has been used only recently – and until recently, donors and recipients of bone marrow have been forced to pair closely in a group of proteins called human white blood cell antigens. Brodsky says that without a perfect match, the recipient's body recognizes these imported cells as extra-terrestrial cells and launches a devastating attack on them.
Because it is difficult to find a complete match in this group of patients – less than 15% have a complete match with siblings not having the same genetic defect that causes sickle cell disease, and less than a quarter have a Full match in independent recordings – Johns Hopkins researchers, published in 2012, allow patients to receive organ transplants from parents who are only partially matched to patients. Brodsky says that these advances have greatly contributed to the expansion of the pool of potential donors, but that the resulting transplantation has been developed in only 50% of cases.
In an effort to increase the likelihood of increased hematopoietic generation of these medium-term matches between donors and transplant recipients, Polanius Meade and colleagues tested a new bone marrow transplant protocol in patients with acute sickle cell disease and beta-thalassemia, two disorders related to hemoglobin, hemoglobin. Caused by defects in the beta-globin gene. They recruited 17 patients, including 12 with sickle cell anemia and 5 with thalassemia, aged 16 years on average. Each of these close patients could act as a half identical bone marrow transplant.
As in the previous protocol, all study participants received doses of chemotherapy and irradiation of the entire body in order to destroy the immune response to the bone marrow given before transplantation. Instead of injecting them with 200 centigray (cGy), a low dose of radiation given in the previous protocol, patients received 400 centigrams in the new study, a relatively small amount well tolerated by the participants. After transplantation, all participants received a dose of cyclophosphamide, a drug that has been shown to be essential to avoid a potentially life-threatening disease called new cell growth compared to the common GVHD disease, which appears especially during medium term matches.
During 30, 60, 180 and 360 days, and later every year, the researchers tested in the blood of patients what is called kyramizm, the amount of DNA found in their donors, suggesting the growth of new cells in the body of patients. They found that all patients, with the exception of a patient with sickle cell disease, had successfully initiated the growth of transplanted cells into their donor's body. Although five of the participants were contaminated with baits, the status of each patient was treated.
At the time of the study, only three patients were yet to take immunosuppressive drugs. All patients who successfully initiated the development of new cells had a severe reduction or a lack of symptoms of their disease – sickle cell patients no longer suffered from painful crises, which are the main fingerprints of their disease. Similarly, beta-thalassemic patients no longer depend on transfusions.
"These recent discoveries add to an increasingly wide range of evidence supporting the safety and effectiveness of unmatched bone marrow transplants," said Richard Jones, director of the bone marrow transplant program at the University of Toronto. Kimmel Cancer Center.
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