Posts Tagged ‘research’

Winship Central to New Study Evaluating Bone Marrow vs. Blood Stem Cell Transplant

Patients with leukemia or blood-related cancers are typically treated with one of two techniques, either a bone marrow transplant, or a blood stem cell transplants. Currently, there are many studies are currently being conducted to determine which option is right for each patient type.

Past studies have shown that when blood stem cell (as opposed to bone marrow) transplants are used between HumanLeukocyte Antigen (HLA)-identical siblings, or siblings whose tissue is immunologically compatible,  the engraftment process is accelerated. Engraftment is when the donated cells, in this case, blood stem cells, begin to grow and produce their own new blood cells. However, with this benefit, there can be some risk. Studies have also shown that when blood stem cell transplants are used, the risk of acute and chronic graft-versus-host-diseaese (GVHD) is increased when compared to GVHD rates experienced by patients who receive bone marrow transplants. Other studies have demonstrated that patients with high-risk leukemia experience a decreased rate of relapse and improved survival rates from of blood stem cell transplant. Because these two treatment options have varying benefits and risks depending on unique patient circumstances, ongoing research is being conducted to better understand those potential benefits and  risks.

Edmund K. Waller, MD, Winship Cancer Institute

Edmund K. Waller, MD
Director of Bone Marrow & Stem Cell Transplant
Winship Cancer Institute

Edmund K. Waller, MD, Director of the Bone Marrow and Stem Cell Transplantation Center at Winship Cancer Institute, was a key author and researcher in a study published on October 18, 2012, in the New England Journal of Medicine that could influence whether leukemia and blood-related cancer patients receive transplants from blood stem cells or bone marrow.

The study reported on the first randomized trial comparing bone marrow with peripheral blood stem cells (PBSC) for unrelated-donor transplantation. The trial involved 48 centers enrolling 551 patients as part of the Bone Marrow and Clinical Trials Network (BMT CTN). Dr. Waller helped design the study, and his lab at Winship analyzed the cells in each type of graft as the central core lab for the trial.

The study found no significant difference in the overall survival rate at two years, and no difference in relapse rates or in acute graft-versus-host-disease (GVHD). It did, however, find a significantly higher rate of chronic GVHD among patients receiving blood stem cell transplants.

Because GVHD can be a difficult and sometimes life-threatening complication from transplants, this finding could result in patients and their physicians choosing different treatments. At the very least, this finding will generate serious discussion among leaders in the transplant field about whether bone marrow or PBSC transplantation is a better treatment option.

Chronic GVHD starts more than three months after a transplant and can severely diminish a patient’s quality of life over his or her lifetime. Dr. Waller says the study leads him to believe that since the survival rates are the same, bone marrow should be the standard for the majority of unrelated-donor transplants. Exceptions to this would be patients with life-threatening infections and patients at high risk for graft rejection.

Winship played a key role in this study and, according to Waller, is part of on-going BMT CTN studies that will help shape transplant protocols and outcomes.

“This is an outstanding example of Winship investigators leading in the resolution of major questions in cancer care,” said Fadlo R. Khuri, MD, Deputy Director of the Winship Cancer Institute, and Chair of the Department of Hematology and Medical Oncology at Emory University. “Dr. Waller and his colleagues have helped define a major question, namely, whether patients who receive grafts from unrelated donors should receive peripheral stem cells or cells from the bone marrow harvest of others. This is paradigm shifting work, and Dr. Waller and his colleagues are to be congratulated for their foresight and persistence in answering this important question.”

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Join Us for the 32nd Annual Charles Harris Run for Leukemia

Charles Harris Run for LeukemiaThe annual Charles Harris Run for Leukemia, which benefits leukemia research at Winship Cancer Institute of Emory University, is scheduled for Saturday, February 25. The 10K run kicks off at 7:45 am at Tucker High School; the one-mile run/walk starts at Druid Hills Middle School.

The run honors the late Dr. Charles E. Harris — former teacher, coach and beloved principal of Shamrock High School. Dr. Harris passed away more than three decades ago from leukemia at the age of 49. Dr. Harris was an un-sung All-American football player at the University of Georgia and a Marine who volunteered for the Korean War. Playing on the Camp Pendleton football team, Pete Rozelle, father of the modern day NFL, attempted to draft Dr. Harris to the Los Angeles Rams football team before he graduated from UGA. He played one year with the New York Titans (now Jets) and made it to the last cut with the Cleveland Browns during the Jim Brown and Coach Paul Brown era. An avid runner, Dr. Harris ran in the inaugural Peachtree Road Race. He left behind a wife and three children.

Dr. Harris’ children, led by son Chuck Harris, began the Charles Harris Run for Leukemia 32 years ago this year, and they have dedicated all race proceeds to Winship Cancer Institute of Emory University. In celebration of this special 32nd anniversary, please consider joining us this year as a walker, runner or race day volunteer.

If you would like register for the race please follow the registration link at www.charlesharrisrun.com.

Volunteers are also needed during the race to hand out t-shirts, pass out water at various water stations, cover intersecting points, help out in the finish shoot and help with bag check. Please go to http://charlesharrisrun.com/contactus.html to register to volunteer. All volunteers should report to Shamrock Middle School between 6:15 and 6:30 am. Volunteers will receive a free t-shirt, philanthropic points and the opportunity to watch world class runners compete!

Directions to Shamrock Middle School from Emory University:

  1. Head Southeast on OXFORD RD NE toward N. Decatur Rd.
  2. Stay on N. DECATUR RD for 2.1 miles
  3. Turn left on SCOTT BLVD (also called US29, US-78 E, and GA-8) Follow US-29 for 2.1 miles.
  4. Turn left on HARCOURT DR.
  5. HARCOURT dead ends on MT. OLIVE DR. – turn right
  6. SHAMROCK MIDDLE SCHOOL is on the left.

If you have questions about volunteer opportunities, please contact Melissa Harris at (770) 495-8557 or email Melissa_h@bellsouth.net.

Myths About Tobacco-Related (Bladder) Cancer Go Up in Smoke

Smoking Bladder Cancer RiskMany people think that cigarette smoking causes only lung cancer. If you are one of them, think again.

A study published just this week in the Journal of the American Medical Association (JAMA) finds that risk of developing bladder cancer – for men and women – is higher among smokers than previously believed.

Doctors such as Dr. Viraj Master, associate professor of urology, Emory School of Medicine and director of clinical urology research at the Winship Cancer Institute of Emory University, see patients every week whose cancers likely were caused by smoking.

“Patients are often surprised to hear of the link between smoking and bladder cancer, but it’s there and it’s real,” says Dr. Master. “Smoking’s effects on the body are both pervasive and lethal.”

How could it be that cigarette smoke gets into your bladder? As it turns out, the actual smoke does not, but the carcinogens in tobacco smoke do get into your blood stream and thus into other parts of your body. The study, authored by researchers at the National Cancer Institute, suggests that an apparent increase in the concentration of carcinogens has occurred in the past 50 years, even as tar and nicotine concentrations have been reduced.

Other cancers caused from smoking include: throat, mouth, nasal cavity, esophagus, stomach, pancreas, kidney, bladder, cervix, and acute myeloid leukemia. If you or a loved one would like help to quit smoking, you can call the Georgia Tobacco Quit Line at 877-270-STOP (7867).

Also, if you are a heavy smoker between 55 and 74, you may be interested in having a CT screening of your lungs. Emory University Hospital began offering such scans in early August. A study published this summer in the New England Journal of Medicine showed that low-dose spiral CT scans of heavy smokers aged 55 to 74 reduced mortality by 20 percent. People who are screened need to be aware that false positives may occur and that further testing may be required.

Cancer Patient Rescues Dog and Is Rescued in Return

Carol Witcher & Floyd Henry

Carol Witcher, breast cancer patient & her dog Floyd

Carol Witcher rescued her dog when he was seven months old, but never imagined that he would rescue her in return. Over two years ago, her dog, Floyd Henry displayed some curious behavior that made Carol worry that something may be seriously wrong.

“When he sniffed me, he kind of turned back and really pushed into my right breast, real hard,” Carol recalls. “He started sniffing, sniffing, sniffing.” Carol adds, “He pushed real hard for one shot…Then he looked at me straight in the face, and began to paw my right breast. And I thought, ‘This is not good.’” After four days of continuous sniffing, nudging and pawing from her 8-year-old boxer, Carol made plans to see a doctor at the Winship Cancer Institute of Emory University.

It turned out that Carol did in fact have breast cancer that would require treatment with chemotherapy, surgery and then radiation. According to breast surgical oncologist at Winship, Dr. Sheryl Gabram, “Her type of cancer presented as an indistinct  asymmetry in her breast…I absolutely believe the dog saved Miss Witcher’s life.”

Dr. Gabram and Charlene Bayer PhD, a chemist at Georgia Institute of Technology, are no strangers to this type of phenomena. They have been  investigating  cancer patients’ breath in a pilot study involving 20 volunteers with normal mammograms compared to 20 newly diagnosed breast cancer patients. They have found that cancer causes the body to release certain organic compounds and the patterns of these compounds can be detected with mass spectrometry, a device that separates out compounds for analysis. It is possible that dogs can smell these compounds but people cannot. Ultimately, Drs. Gabram and Bayer hope that this simple breath test could lead to a means to alert physicians in the office that a patient may have an underlying breast cancer. And in Carol Witcher’s case, quite possibly it did.

As Gabram notes, in the study that Miss Witcher was involved in prior to her treatment, “Our model predicted  more than 75 percent of the time correctly which patients did have breast cancer and which ones did not.” This study will be published in early June in the American Surgeon.

ABC News recently covered Carol’s story and discussed previous situations in which the combination of a person’s breath and a dog’s sense of smell led to accurate cancer diagnoses. According to the ABC News story, “In January, a study published in the British journal Gut said that a specially-trained 8-year-old black Labrador retriever named Marine had detected colorectal cancer 91 percent of the time when sniffing patients’ breath, and 97 percent of the time when sniffing stool.” They add that “Dogs have also reportedly sniffed out skin, bladder, lung and ovarian cancers.”
While they might not be able to pinpoint or vocalize what are wrong, canines have demonstrated that they are able to determine that something is wrong.

We will keep you posted on the latest developments in the breath diagnostic work of the team at the Winship Cancer Institute of Emory University, Georgia’s only NCI-designated cancer center, and the Georgia Institute of Technology.  In the meantime, you can learn more about Carol’s story by checking out the ABC News video here.

New Blood Test Aids in Early Cancer Detection

Winship at Emory’s Dr. Suresh Ramalingam explains the test and what it means for cancer detection and treatment.

Suresh Ramalingam, MDYou may have heard in news headlines this week about the ability to detect a single cancer cell among billions of healthy cells. This may be possible via a new blood test (under development) that may someday help detect cancer earlier.

For tumors located in organs such as the lung, prostate, colon and breast, access to tumor tissue is only possible with a biopsy. This requires an invasive procedure, which in certain situations involves surgical intervention. It has been known for sometime that tumors shed their cancer cells that can be found in the circulating blood stream. However, the tumor cells are a significant minority in number compared to normal blood cells. Identifying the tumor cells among billions of normal cells has been a major challenge. Currently, it is possible with sophisticated techniques to identify such cells and count them. The number of circulating tumor cells has been linked to survival outcomes in some studies. Now researchers are trying to not only count, but collect these tumor cells and then conduct molecular testing.

Such an advance would have tremendous implications for cancer research and treatment. First of all, it may not be necessary to obtain tumor biopsies if adequate number of cells can be identified in the peripheral blood. It will be possible then, to administer this test during the course of a patient’s treatment to learn how a tumor is changing, because they do change as treatment progresses. It would also be possible to diagnose cancer early as part of screening strategies for patients at risk for developing certain cancers.

So how does this test work and what does it do? The test uses a microchip resembling a lab slide covered in 78,000 tiny posts. Those posts are coated with antibodies that attract and bind to tumor cells like glue. A patient’s blood sample, about a teaspoon full, is forced across the chip. The cancer cells stick, and a stain makes them glow so researchers can capture them for study.

For patients, care-givers and researchers this is very exciting news. However, this technology is just entering the early stages of testing and will have to go through several studies before it can be applied in routine practice. A number of important research questions will still have to be answered regarding the utility of circulating tumor cells, even if the test proves to be successful.

It is important to emphasize that while the new technology is exciting, it is possibly years away from practical application. If you have questions on this new blood test, please leave them in the comments below.

Could Space Travel Cause Lung Cancer in Astronauts?

Researchers are launching a new cancer research initiative – literally. NASA partners with Emory & MCG

NASA has awarded a team of investigators from both the Winship Cancer Institute of Emory University and the Medical College of Georgia $7.6 million over five years to study how a component of space radiation may induce lung cancer.

The award establishes a NASA Specialized Center of Research (NSCOR), consisting of a team of scientists with complementary skills who work closely together to solve a set of research questions. Ya Wang, PhD, professor of radiation oncology at Emory University School of Medicine and Winship Cancer Institute, is director of the NSCOR at Emory.

Interplanetary space travel could expose astronauts to conditions where they are chronically subject to types of radiation not normally encountered on earth. One of these radiation types is high energy charged particles (HZE), which results in complex damage to DNA and a broader stress response by the affected cells and tissues.

There is no epidemiological data for human exposure to HZE particles, although some estimates have been made studying uranium miners and Japanese atomic bomb survivors. Animal experiments show that HZE particle exposure induces more tumors than other forms of radiation such as X-rays or gamma rays.

Because it is a leading form of cancer, lung cancer can be expected to be prominent among increased risks from radiation even though astronauts do not smoke. However, the risk for astronauts remains unclear because the dose of HZE astronauts are expected to receive is very low.

The Emory-MCG researchers will probe whether the broader stress response induced by HZE particles amplifies cancer risk. Investigators will collaborate with physicists at Brookhaven National Laboratory to gather information on HZE’s effects. Individual projects include the study of how cells repair DNA damage induced by HZE particles, how HZE particles generate oxidative stress, and how they trigger regulatory changes in DNA known as methylation.

“The information generated by this project will be critical for estimating risks and establishing countermeasures for cancers associated with long term space travel. In addition, new insights into cancer resulting from all types of radiation exposure, including those found on earth, are likely to emerge from this project,” concludes Dr. Paul Doetsch, PhD, professor of radiation oncology and biochemistry, and associate director of Emory’s NSCOR.