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News Archive: Michigan Oncology Journal Summer 99

Advancements in Clinical and Basic Science Research from the University of Michigan Comprehensive Cancer Center

Contents:

From the Editor

The Separation of Graft-Versus Leukemia and Graft-Versus-Host Disease Through Cytokine "Shields"

Low-Intensity Preparative Regimen and Allogeneic Peripheral Blood Stem Cell Transplantation

Stem Cell Transplantation for Multiple Myeloma

New Approaches for Neuroblastoma

Of Interest





Editor
Laurence H. Baker, D.O.
Deputy Director and
Director for Clinical Research
U-M Comprehensive Cancer Center

Assistant Editor
Maria McKinney White
Director
Marketing and Public Relations

Home Page:
http://www.med.umich.edu/cancer

Michigan Oncology Journal
Copyright ©1999
University of Michigan
Comprehensive Cancer Center



From the Editor

This issue of the Michigan Oncology Journal introduces Jamie Ferrara. Jamie joined our faculty last fall after an intensive (and I would add highly successful) search for the directorship of our Blood and Marrow Transplantation Program. Sam Silver, who had initially organized our transplant group, became the director of the Cancer Center's outreach program. Jamie brings to Michigan a highly successful investigative program on the pathophysiology of graft vs. host disease (GVHD). He is also a trained pediatrician, and that fact allowed us to combine the medical and pediatric transplant efforts into a single program under his direction.

The first article, "The Separation of Graft vs. Leukemia and Graft vs. Host Disease through Cytokine Shields," describes the latest understanding of the underlying pathophysiology of GVHD. It lays the groundwork for why biologic response modifiers such as keratinocyte growth factor and interleukin-11, which have direct protective effects on the GI tract, offer an attractive new approach to GVHD and its prophylaxis. Much of the background investigation for this approach was done by Dr. Ferrara and his colleagues at Children's Hospital in Boston and the Dana Farber Cancer Center.

Dr. Voravit Ratanatharathorn describes the latest new clinical approach to the limitations associated with allogeneic stem cell transplantation. The primary limitations are regimen-related toxicity and graft vs. host disease. It has been shown that both complications can be reduced by decreasing the intensity of the preparative regimen, but the preparative regimen is still sufficiently immunosuppressive to allow engraftment of allogeneic hematopoiesis. A "mini-allo" approach to myelodysplastic syndrome for patients older than 55 years is described in some detail. A standard allogeneic transplant could not be done in this older age group. Indeed, Voravit's initial results are impressive.

Chris Reynolds and Joe Uberti describe the role stem cell transplant plays in patients with multiple myeloma. Their article describes the success (or lack thereof) of standard chemotherapy. There still is not a standard therapy superior to melphalan and prednisone. The article then describes the current data supporting high dose chemotherapy with autologous stem cell support, as well as the data supporting an allogeneic approach. Our results using allogeneic BMT from sibling donors in multiple myeloma (60% long-term, disease-free survival) lead the country. In the future, this group plans to use the "mini-allo" approach described by Voravit.

Ray Hutchinson reviews several new approaches for metastatic neuroblastoma including: stem cell transplants; system radiotherapy with a tumor-targeted agent, MIGB; and a dendritic cell vaccine approach. The optimism of our pediatricians is clear. Every success in treating adult cancer patients has followed the success of treating children.

Laurence H. Baker, D.O.

 

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Please note: The articles listed in the Cancer Center's News Archive are here for historical purposes. The information and links may no longer be up-to-date.