Blood Cancer Patients and Stem Cell Transplants

(American Health Newswire) -- A new study shows older blood cancer patients should be able to receive stem cell transplants no matter what age group they are in- 60 to 64, 65 to 69 or 70 to 75. Patients in all three age groups had comparable survival rates, suggesting  age played a limited role in how patients tolerate the mini-transplant, a "kinder, gentler" form of allogeneic (donor cell) stem cell transplantation developed at Fred Hutchinson Cancer Research Center.

"Age is no longer a barrier to allogeneic transplant," Mohamed Sorror, M.D., M.Sc., an assistant member of the Hutchinson Center's Clinical Research Division was quoted as saying.

The mini-transplant, known in medical circles as nonmyeloablative transplantation, was developed by researchers at the Hutchinson Center for older and medically sicker patients who otherwise could not tolerate the standard, more-toxic, high-dose regimens used to prepare patients for transplantation. Conventional transplants, which are generally not performed on people over age 60 or others who are medically unfit, use high doses of total-body irradiation and potent chemotherapy to eliminate leukemic cells. The intense treatment destroys the blood and immune system and is fatal unless the patient is rescued by infusion of donor bone marrow or stem cells isolated from peripheral blood. The mini-transplant, in contrast, relies on the ability of donor immune cells to target and destroy the cancer - without the need for high-dose chemotherapy and radiation. Instead, low-dose radiation and chemotherapy is used to suppress the immune system rather than destroy it. This helps the body accept the donor stem cells, which then go to work to attack cancer cells - called the graft-vs.-leukemia effect - and rebuild the immune system.

The study involved 372 patients ages 60 to 75 who were enrolled in prospective clinical trials between 1998 and 2008 at 18 collaborating U.S. and European cancer centers known as the "Seattle Consortium." All patients at these centers were treated with the same regimen, which was developed in Seattle. The patients in the study were treated for acute and chronic leukemia, lymphoma, multiple myeloma, myelodysplastic syndromes (which can progress to acute myeloid leukemia if not treated) and myeloproliferative diseases such as chronic myelogenous leukemia.

"These findings, together with the normal to near-normal performance status of surviving patients, should help allay reluctance in entering older patients with hematologic cancers on nonmyeloablative transplantation protocols. The lack of a matched sibling donor also should no longer be a limitation given that transplants with matched unrelated donor grafts had comparable outcomes," Sorror was quoted saying.

20 percent of the U.S. population will be 65 or older by 2030, and that increases of up to 77 percent in the number of newly diagnosed blood cancers among this population are expected to occur in the next two decades. Such malignancies are mainly diseases of the elderly. Yet, only 12 percent of patients who were treated with a transplant between 2004 and 2008 in U.S. institutions were over age 60 and a previous study suggested that only 26 percent of patients with acute myeloid leukemia were treated with a transplant, according to results reported by the Center of International Blood and Marrow Transplantation Research.

"These statistics clearly highlight the reluctance of providers in offering allogeneic stem cell transplantation to the elderly. Little is known about the reasons behind the low referral rate of older patients to transplant or how mini-transplant outcomes compare to those of conventional therapies. We are initiating a multicenter study designed to follow patients from the time of diagnosis to answer both questions," Sorror was quoted saying.

Clearly, there is a hope for older patients to receive a blood cancer treatment with less side effects and with more willing providers to accept older patients for a treatment.

Source: JAMA, published November 2011

TAMPA (American Health Newswire)--Your grandparents or parents probably had them and you could to. We're talking about the sagging, swollen skin that spans from under the eye to the top of the cheekbone a condition called festoons. They make you look tired and older. Now a new laser treatment promises to turn back the hands of time and reveal a younger looking you.

Hairstylist Donna Mart was tired of looking tired. Eye bags and swollen, puffy, skin weredragging her down.

 "I would get that comment frequently. Did you not rest, are you tired? Which isn't good. You don't want your clients thinking you're working on them tired," Donna Mart, a woman who suffered with festoons told American Health.

Her festoons were primarily caused by sun damage. The swelling in the eyelids and upper cheek can make you look years older than you are. Dr. Adam Scheiner has perfected a laser technique that can literally wipe away unsightly bags and festoons. It worked for Donna.

 "The results since and the comments from my clients and everybody have just been phenomenal," Mart said.

Now it's Mindy Walley Dietterick's turn. She invited us along for her surgery.

"I can't wait to get this done and then look in the mirror and not have these things staring back at me," Mindy Walley Dietterick told American Health.

"So what we can do is take swollen, sun damaged skin and make it smooth, tight and younger looking," Dr. Adam Scheiner from Tampa Eye Clinic told American Health.

The laser zaps away the top layer of Mindy's skin, a second pass tightens it.

"This is like a reset button on the skin, they're actually going to grow their skin all over again and they are going to get brand new skin, almost like baby skin," Dr. Scheiner explained.

Two weeks later Mindy saw results. Results Dr. Scheiner says will last as long as you stay out of the sun.

Dr. Scheiner is one of the only plastic surgeons in the country doing this procedure for festoons and has patients fly in from all over the world. The laser treatment costs start at $5,000.

New Ways to Save Hearts

"I just really couldn't do anything. I couldn't much more than walk across the floor, and then I just had to labor to do that," Will said..

Duke cardiologists replaced his old valve with a new pig valve delivered on the end of a catheter through a groin artery to the heart. 

"Rather than removing the valve this catheter-based system is a stent that opens and pushes the old scarred valve out of the way," Kevin Harrison,

M.D., a cardiologist at Duke UniversityMedical Center, told Iexplained.

Studies show 50% of patients who used drugs to help their stenosis died within a year. Compare that to just 30% who had their valve replaced without open heart surgery. 

"It looks like a child's aortic valve," Dr. Siegal said.

Just one week after another life-saving heart surgery, Brian Bennett enjoys playing hoops with his son. Several of Brian's arteries around his heart were clogged with a buildup of fat and cholesterol. 

"I was a walking time bomb," Brian said..
 

into the blocked arteries. Traditionally, cardiologists access the heart by threading a catheter through an artery in the leg. Now they've changed their approach, starting at the wrist. 

"Because the artery in your wrist is right on the surface, it's very visible. It's right next to ta bone. You can easily stop any bleeding," Adam Greenbaum, M.D,  a Director of the Cardiac Catheterization Laboratory at Henry Ford Hospital, said.

The risk of bleeding is less and patients can go home the same day. Brian was out of the hospital in six hours. And for some, stents are life-savers to keep arteries open.  Now, a new stent could do the job, and then dissolve away.

"The vessel needs to be supported for three to four months, after that it heals to the point where it's no longer at risk for the collapse," Stephen Ellis, M.D., an interventional cardiologist  at the Cleveland Clinic, said.

On traditional stents, there's a high risk of blood clots forming on the stent setting off a heart attack. At just 41 years old, Willi Hampton knows the danger. 

"It started to feel heavy like someone was sitting on my chest," Willi told American Health.
 

"The goal is to make this sort of stent the gold standard," Dr.Ellis said.

Another game changer, we've known for some time that statins lower bad cholesterol. Now doctors are using drugs like Zocor, Lipitor and Crestor for people who do not have high cholesterol, but still have increased inflammation in the body. It can also lead to heart disease.  If heart disease runs in your family, but your HDL is normal, ask your doctor for a blood test to check your inflammation level.