Bone Marrow Cancer
Understanding bone marrow cancer first requires an understanding of what, exactly, bone marrow is and its importance within our bodies. Bone marrow refers to the soft and spongy tissue that can be found in the centre of most bones. This spongy marrow contains “immature” blood forming cells called “stem cells” – a commonly heard name as of late in the nears. Blood stem cells, being very much in a nascent form, can develop in one of three ways – into white blood cells which go on to fight infections, red blood cells that will carry oxygen through the body, or platelets which aid the blood clotting process. Bone marrow cancer occurs when uncontrolled mutations occur within cells located in these blood production areas of our bodies, causing uncontrolled growths known as tumors to develop.
There are also different types of marrow cancer, with most cases originating from cancer that has spread to the bone from some other organ. This type is called “secondary bone cancer”, and when this type of cancer is viewed under a microscope it will resemble the tissue from whence it came – whether this be lung, prostate, or some other cancerous growth. Primary bone cancer occurs when the cancer forms in the very cells of the bone itself. This includes such types of cancer as as osteosarcoma and Ewing’s sarcoma.
Other types of cancer that originate in the blood forming sections of bone marrow are lymphomas that tend to originate in the lymph nodes, leukaemia which occurs when the bone marrow develops abnormal or mutated white blood cells, and multiple myeloma – a cancer that spreads from the plasma of the marrow.
The principle symptoms of bone cancer might include fever, loss of appetite, tiredness and weight loss, although actual symptoms may well vary from person to person. Symptoms can be very subtle, and as a result the patient may well not present to a health care professional until the cancer itself has spread. Other associated symptoms might include a hard lump situated on the bone, pain, bone tenderness, stiffness or swelling, restricted movement and wheezing breath as well as a general lowered resistance to other infections. It is also important to remember that any symptoms may well vary depending on where exactly the cancer is located and how big it is. Also, the aforementioned symptoms may not necessarily mean that a patient presenting some of them actually has cancer and a thorough examination from a specialist should be sought by a concerned patient.
With regards to treatments for bone cancer several things should be kept in mind. Among them are the age of the patient, the stage the cancer is at and the patient’s overall health during the beginning of the treatment. All of these factors will help to decide which treatment will be best for the patient. Options might include surgery, a bone marrow transplant, IMRT and chemotherapy. Complementary therapies including nutrition therapy and spiritual counseling are also common practices today. Each specific type of treatment should generally be determined by a healthcare professional as appropriate.
Subscribe to the comments for this postBone Marrow Transplant Procedure
A bone marrow transplant is one of the treatment options available to a patient suffering from bone marrow cancer, and the suitability for this type of treatment will be decided by the patient’s healthcare provider. During a bone marrow transplant the diseased bone marrow of the patient is destroyed and healthy bone marrow is inserted into the blood stream of the patient. When a bone marrow transplant is successful the newly-inserted bone marrow travels to the cavities of the larger bones, grafts, and subsequently begins the production of normal blood cells.
In the event that a donor’s bone marrow is not identical to the recipient’s the transplant is referred to as an allogeneic BMT, whereas if the donor is an identical twin of the patient the transplant is referred to as a syngenic BMT. In an allogeneic type of transplant the new bone marrow given to the patient must provide as close a match to the genetic makeup of the patient’s own bone marrow as possible.
In the first stage of compatibility testing blood tests are undertaken to ascertain whether or not the genetic types of the bone marrow match. This is crucial, as if the given bone marrow is not a good generic march it will be rejected as “foreign material” by the patient’s body and will be attacked and destroyed in what can become a life-threatening condition (known as Graft Versus Host Disease – GVHD). Also, the patient’s immune system may attack and destroy the bone marrow in what is known as “graft rejection”.
In order to be successful in most cases a transplant relies primarily upon the fact that the patient is sufficiently healthy to undergo what is a very rigorous procedure. Such factors as the patient’s age, general physical health, their actual diagnosis and the stage of the cancer will all be taken into account when determining the suitability of the transplant procedure.
At this point once a transplant has been decided upon a range of tests will be conducted to be certain that the patient will withstand the procedure, and these will include testing the lungs, kidneys, heart and other vital organ functions to establish a baseline in which to test post-transplant results against. In this way doctors can measure whether or not organ functions have been impaired as a result of the transplant.
The transplant will be undertaken by an expert team of doctors, nurses and support staff that are all experienced in bone marrow transplant procedures and will be able to react quickly to any problems that may occurs. They will also ensure that the patient and their family are given sufficient support before, during and after the procedure.
Irrespective of who provides the bone marrow that is used in the transplant the harvest procedure is the same – conducted in an operating room under a general anesthetic a needle is inserted into the cavity of the iliac crest (rear hip bone), as a large amount of bone marrow can be found here. This is then extracted with the needle for infusion into the patient.
Upon admission for the procedure the recipient will initially undergo a few days of chemotherapy or radiation treatments that will destroy both bone marrow and cancerous cells in order to provide room for the new bone marrow. This is known as the “preparative regime”, and after the chemotherapy or radiation treatment the transplant will take place in which the marrow is infused intravenously into the patient. The transplant does not take place in an operating room as it is not a surgical procedure.
During bone marrow infusion the patient will be continually checked for chills, hives and chest pains. In the two-to-four week period after the transplant the patient and healthcare team will wait for the new bone marrow to migrate to the cavity of the large bones to begin grafting and the subsequent production of normal blood cells. At this time the patient must be carefully monitored, as the initial conditioning prior to the graft and its chemotherapy treatments will have crippled their immune system as well as make them susceptible to excessive bleeding and infection.
Blood samples and tests will be taken in order to monitor functions and general health regularly as well. The patient will spend anywhere up to eight weeks in hospital post-transplant and will also receive antibiotics and blood transfusions in order to prevent and fight any infections. They will also receive platelet transfusions in order to prevent bleeding. The patient will also be protected from bacteria and viruses during this stage, including the preclusion of plants, flowers and fruits from the patient’s room as these often carry bacteria and fungi. Afterwards, should the transplant be successful, the patient will most likely be discharged from the hospital’s care and allowed to return home slowly and have their new immune system re-introduced to the world.
34 Most Important Stem Cell Research Facts
The research into stem cells is an ongoing concern among scientists and researchers, as well as those suffering from a range of currently untreatable conditions. Currently, stem cell research has provided a number of successes, as well as serving to confront a range of medical and wider ethical issues. Because stem cells are such a sensitive topic in many circles many times the facts can be misconstrued, however when examining stem cells and their research consider the following points:
1. Stem cells can be found in the majority of multi-cellular organisms, and they can self-regenerate by both mitosis and differentiation.
2. The stem cells that are found in mammals can be classified as embryonic stem cells found in blastocysts.
3. Cell culture can be utilized in order to grow and develop stem cells into specialist cells
4. Besides having the ability to self-renew, stem cells can differentiate into specialist cell types. This is referred to as “potency”.
5. Embryonic stem cells are cell cultures that are typically around four or five days old. In general, embryonic stem cells are largely untested.
6. An adult stem cell is the type that is found in a fully developed living organism. Adult stem cells are multipotent, and they can create cells similar to themselves as well as differentiated cells. These types of cells have provided reasonable success in the treatment of both blood and bone cancers.
7. Research has indicated that stem cells hold on to their ability to self-regenerate by cellular division. These cells act as the body’s wear and tear mechanism.
8. Due to the fact that stem cells are capable of repairing damaged tissues they are extremely useful in curing some diseases related to heart and brain damage, as well as the spinal cord injuries.
9. Stem cells also potentially have a part to play in gene therapy and the treatment of inherited diseases and conditions. Embryonic cells are reportedly of excellent use in treatments for disorders of the nervous system.
10. The earliest research into stem cells can be traced back to the 1960s, and work done by Joseph Altman and Gopa Das.
11. Joseph Altman and Gopal Das discovered the evidence of neurogenesis in adults, which is basically a form of stem cell activity in the human brain.
12. Altman and Das’ work was followed by the 1978 discovery of haematopoietic stem cells in human cord blood.
13. The first groundbreaking success that underscored the first true success in the field of research into stem cells was the bone marrow transplant that was carried out between two siblings in order to correct severe combined immunodeficiency.
14. 1997 saw research into cancer stem cells validated, when it was shown that leukaemia evolves from haematopoietic stem cells
15. In 2006 a team of English scientists created the first artificial liver cells thanks to the use of blood stem cells from the umbilical cord.
16. The first embryonic stem cells in mice were discovered by Martin Evans, Gail Martin and Matthew Kauffman.
17. Gail Martin is known to have pioneered the phrase “embryonic stem cell”.
18. In 1998 James Thompson created the first-ever human embryonic stem cell line.
19. The injection of stem cells into the human body is not without risk and can cause tumours in certain circumstances.
20. There are currently no proven treatments in the field of embryonic cell research, despite ongoing work.
21. January 2008 saw researchers finally able to develop human embryonic stem cells without killing the embryo.
22. In order to produce embryonic cells an embryo must first be destroyed. This can be difficult, ethically, as an embryo holds the possibility of human life.
23. When in the womb an embryo can develop into a human being, and hence a new life. Therefore, the creation of a many stem cell lines requires that a human embryo must first be destroyed, thereby potentially depriving the right to life.
24. Supporters of stem cell research claim that the sacrifice of an embryo is outweighed by the fact that such embryos are used for the greater good as stem cells in cell therapies and treatments for the suffering.
25. Many stem cell research supports also claim that the argument is not wholly conclusive, as embryos are not technically developed life.
26. Adult stem cells can be obtained from a variety of pregnancy-related tissues, including amniotic fluid, the umbilical cord and the placenta.
27. Stem cells are present in both adults and children from the moment of birth in almost all organs and tissues.
28. Stems cells are very hardy, and there have been cases of neural stem cells being taken from particular areas of the post-mortem human brain as long as 20 hours after death.
29. Stem cells, being a natural “wear and tear” mechanism, are argued by some to be the most natural repair mechanism for many of our bodily tissues.
30. Stem cell usage must be fully differentiated, and adult stem cells only belong in the micro-environment of an adult body while embryonic cells belonging in an early embryo micro-environment rather than in an adult body where they are liable to cause tumours and reactions from the adult body’s immune system.
31. Stem cells are already being successfully used in the treatment and cures of a wide range of different medical conditions, including a range of different cancers, auto-immune diseases, cardiovascular disease, corneal regeneration, immunodeficiencies, degenerative conditions such as Parkinson’s Disease, stroke and spinal cord damage, certain blood conditions, wounds and injuries such as skull bone repair, gangrene and jawbone replacement as well as liver failure, cirrhosis and chronic bladder diseases.
32. Stem cell research has also produced treatments for a number of birth defect related conditions, as well as the potential to treat long-term nerve damage.
33. Studies indicate that stem cell research could also lead to the possibility of being able to grow and harvest replacement organs, thereby negating the need for agonizing waits on the transplant list for many patients. Some are also opposed to the harvesting organs on ethical and religious grounds.
34. Concerns have also been raised that stem cell research could lead to the possibility of one day cloning humans, or lead to the rise of so-called “designer babies”.
Stem Cell Research Ethics
Stem cell research has become a pioneering practice in recent medical history as a means of providing treatment to diseases such as Alzheimer’s, Parkinson’s and Diabetes. This treatment often involves the taking of embryos that are a few days old, although it can also involve the extraction of cells from human embryos that have been discarded during fertility treatment. All adults and children have stem cells, however embryonic stem cells are thought to be more flexible to work with and more effective in the curing of chronic disease.
The carrying out of stem cell research has been thought to be effective because the introduction of new cells into damaged tissue can both treat disease or injury, and also alleviate human suffering. Currently a few countries such as the US, UK and Japan have either allowed or are considering legislation on allowing stem cell research to occur, however wide criticism has come of the practice with many objectors to the process deeming it unnecessary, immoral and technically illegal.
The government policy currently for countries such as Austria, France, Germany and Ireland is that stem cell research is illegal and that the production of embryonic stem cells should not be permitted. Further criticism has largely come from anti-abortion and ethics groups, as well as the Catholic Church, because it involves the destruction of living human embryos. Using these for scientific and medical research is wrong, these groups argue, because in the case of taking young embryos from a human body this is killing what is effectively a human being that might otherwise have a chance at living.
This is open to debate as supporters of stem cell research argue that at the stage of embryonic development where embryos are extracted we cannot recognize an embryo as a living human being. The argument made is to recognize instead how stem cell research can alleviate suffering in existing human beings, and therefore the end justifies the means.
Further criticism has been made, because there is some call currently in countries such as the US for therapeutic cloning, which involves the creation of human embryos solely for stem cell research in laboratories. Whilst this might serve to remove the unethical suggestion that a human being could ever come of the embryos used in stem cell research there has been much outcry to the suggestion of therapeutic cloning in practice, as it suggests human life becoming devalued and made no different to using rats or any other animal in laboratorial research. There are those who further argue that human tissue used solely for the purpose of laboratory research is wrong because the embryonic tissue could be exploited and ill-used.
Many argue that there are more suitable alternatives to using embryonic life as a means of repairing damaged human tissue such as by using organ and blood donors or by using existing adult stem cells, the technology for which is becoming increasingly advanced and can provide some benefits to treating certain conditions which embryonic stem cells cannot.
SpineSmith at the 5th Annual Stem Cell Summit
All the leading medical, scientific and financial pioneers in the regenerative science applications will meet at the 5th Annual Stem Cell Summit that is going to be held in New York on February 16, 2010. The Summit meeting has become a prominent forum on the advances in stem cell science and technology with aim to develop effective and safe stem cell therapies both for prevention and treatment of series of diseases.
SpineSmith Partners, LP has been sponsoring and attending the Summit meeting for many years and has become one of the leading companies in the field of regenerative science and medicine. The company is best known for its innovations in the treatment of spinal disorders with a focus on medical devices and biologic therapies offering implants and technology for surgical attachment, alignment and spinal tissue regeneration. SpineSmith has also founded the company Celling Technologies focusing on study and development of stem cell therapies in close collaboration with scientists and health care providers such as Dr. Robert Johnson of Neurosurgical Associates of San Antonio. At the Summit, Dr. Johnson will present new newest results concerning application of stem cell therapy for spinal treatment and showing the potentials of regenerative science with emphasis on the application of autologous cells in spinal treatment.
Celling Technologies is focused on development of new technologies in the field of regenerative science and medicine which has advanced tremendously in recent years. Dr. James Poser who is vice president of regenerative medicine at the company has emphasized the potentials of the regenerative medicine, stem cell therapy, application of autologous cells as well as the importance of close collaboration with experts in the field of regenerative science. He also said he is looking forward to participate the 5th Annual Stem Cell Summit as well as the future meetings. Celling’s research and products encompass devices and autologous cell therapies for many conditions including spine, injury, cardiovascular disease and orthopedics.
Vitro Announces Co-Sponsoring of Keystone Symposium on Stem Cells
Vitro Diagnostics, Inc. (dba Vitro Biopharma) announced co-sponsoring of the Keystone Symposium on cell stems that is going to be held at the Keystone Resort Conference Center from February 15- February 20, 2010. The company is best known for adult stem cell applications, US patents for adult stem cells production and pending US patents for iPS cell generation. At the meeting, Vitro Biopharma will present more information about the research concerning its pending patent for alternative technology for iPS cell generation.
The iPS cells are believed to have the same abilities as human embryonic stem cells including development into any type of cells in the body. Scientists all over the world intensively work on the technology for iPS cell generation with aim to develop an effective generation of stem cells without the use of controversial human embryonic stem cells.
The first technology for production of iPS cells was reported to be developed in 2007 and involved genetic engineering of fibroblast cells and increased expression of four genes. Vitro’s patent pending technology is notable for increased expression of one gene (POU5-F1) only which is believed to be the main regulator of pluripotency. Thus iPS cell generation would not require genetic engineering which is the main obstacle for the use of iPS cells for commercial and therapeutic purposes.
Vitro’s chief executive officer Dr. Jim Musick has stated that his company is proud to be the co-sponsor of the symposium on stem cells where scientists from all over the world will present the progress that was made in the research of iPS cells. He also said that Vitro has completed its first studies concerning the technology for generation of iPS cells involving expression of the gene known as POU5-F1 and that the results will be presented at the Keystone Symposium.
Vitamin C and Generation of Induced Pluripotent Stem Cell
The exciting news that scientists developed stem cells from the human adult cells in 2007 was followed by frustrating reality that the scientists are they are still trying to increase its efficiency. Typically, only 0,01 percent of fibroblast cells are successfully transformed into induced pluripotent stem cells. The iPS cells can develop into any kind of cell type promising the repair or replacement of damaged tissues and organs as well as treatment of various diseases in the future.
The researchers at the Guangzhou Institutes of Biomedicine and Health in China have managed to increase the efficiency of iPS cell production by using vitamin C. Generation of iPS cells is triggered by introduction of genes or proteins to adult cells commonly involving a virus. The Chinese researchers led by Duanqing Pei have discovered that the same factors that are used for transformation of non-pluripotent cells into pluripotent ones also create the free radicals or reactive oxygen species which are known to increase cell death. In order to block the free radicals Pei and his team added different antioxidants including vitamin C to the medium used for growth of mouse cells. They discovered that the medium containing vitamin C had 30% more cells than the one that did not. In addition, vitamin C increased the pluripotency of the cell population. 10 to 20 percent of cells grown with vitamin C expressed pluripotency genes after 14 days, while only 0,1 to 0,2 of cell population grown without vitamin C expressed pluripotency genes in the same period of time.
Pei and his team also tried with other types of antioxidants but they were less efficient in compare to vitamin C. The results of the study which were published in Cell Stem Cell in December 2009 imply that a yet unidentified factor may play an important role in the development of pluripotency.
Software Program Foresees Stem Cell Behavior
Stem cells are crucial for human development and play an essential role in tissue and organ repair due to injury or disease. The progress in stem cell science has achieved a tremendous progress but the scientists and biologists still do not have all the necessary means to control the differentiation of stem cells that is required for the use of stem cell therapies for therapeutic purposes. Andrew Cohen who is an assistant professor of electrical engineering at the University of Wisconsin-Milwaukee has developed a software program foretelling which specialized cells will be developed by a stem cell and their future behavior even before the division of stem cell takes place. The software program bases on analyzing of time-lapse behavior of live stem cells.
Cohen’s software will help the scientists in search for methods to control the specialization of stem cells which is the leading obstacle in furthering the use of stem cells for treatment of diseases. His software predicts the production of specialized cells with 87% accuracy and foresees when self-renewal will result in specialization with 99% accuracy which may make the software very useful for research of cancer cells characterized by continuous self-renewal.
The problem of unpredictability of the outcome of cell division is perhaps best best expressed in stem cell treatment of age related macular degeneration. In order to treat the eye disease with stem cells these would need to develop a larger amount of photoreceptive cells. However, once implanted into the retina they can produce other types of cells and potentially worsen the patient’s vision. The Cohen’s software which was designed for isolation of the genes, proteins and other factors that are responsible for control of cell specialization could enable both identification and manipulation of stem cell differentiation.
Anorexics Have Excess Fat in Bone Marrow
Excess fat and anorexia may be an oxymoron but the researchers at Children’s Hospital Boston have discovered that people who suffer from anorexia nervosa have excess fat in their bone marrow. The study which was published in the Journal of Bone and Mineral Research in February 2010 bases on MRI scans of the knees in 20 healthy girls and 20 girls with anorexia, while the images were evaluated by radiologists not knowing which scans came from girls with anorexia and which from the healthy ones.
The results of the study have shown that girls with anorexia had significantly elevated levels of fat in their knees. In comparison with healthy girls they had less than one half of the healthy marrow confirming the earlier findings in mice with symptoms similar to those in anorexia. The results of the newest study, animal researches and some previous researches shed more light on loss of bone mass in anorexics sometimes leading to development of osteoporosis and even fracture. Improper nutrition activates differentiation of stem cells in bone marrow into fat cells instead osteoblasts, cells which are responsible for bone formation. This is particularly problematic because the majority of anorexics are young women in adolescence who experience loss of bone density at the time when the bone formation should be at its height.
The research group led by Catherine Gordon MD, MSc and director of the Bone Health Program at the Children’s Hospital Boston has announced further studies to determine why stem cells differentiate into fat cell instead osteoblasts in anorexics. One theory that may explain such process is the attempt of the body to store energy and warmth. Gordon’s team also wants to determine the link between excess fat in bone marrow and bone density, and is currently testing whether MRI scans can be used to evaluate the efficacy of treatments for improvement of bone mass.
FDA Approves Clinical Study Involving Stem Cells for Cerebral Palsy in Children
Cerebral palsy is a serious condition affecting up to 3 children in 1,000. It is caused by a injury of the brain or inadequate oxygenation of the brain before, during or after birth in the first years of life. The condition can affect movement, cognitive skills, vision and hearing. At the time of writing there is no cure for cerebral palsy but the FDA has approved the first clinical study to determine the potential benefits of stem cells for children with cerebral palsy.
The study will be conducted by at Medical College of Georgia and will research the potential benefits of stem cell therapy for children will cerebral palsy. 40 children from 2 to 12 years will participate in the trial after being neurologically examined. Children that can participate in the study must meet the following conditions: inability to sit without assistance by 12 months of age or inability to walk by 18 months of age, not having seizures or having seizures that can be controlled. One half of the participants will receive a stem cell infusion from their own cord blood, while the other 20 children will receive a placebo. Both groups will be examined by physicians not knowing which children received stem cell infusion and placebo after three months. Then the children that received a placebo will be given the infusion. All will be re-examined after three and six months later.
The purpose of the study is not use of stem cells as a potential cure for cerebral palsy but the evaluation of the potential benefits of stem cell therapy for children who have cerebral palsy. The results of the animal studies are encouraging as well as the therapy involving core blood that has been used for two decades. However, the research that will be conducted at Medical College of Georgia is going to be the first controlled clinical study involving stem cells.