Giving Hematopoiesis a Hand

New York, NY -

Despite the introduction of various types of mutation-specific kinase inhibitors into the field of hematology/oncology, the only curative approach for many of the leukemias still resides in bone marrow or hematopoietic stem cell transplantation.

Drawbacks of this approach are the need for myeloablation of the recipient, followed by post transplant immune suppression to prevent graft versus host disease from T cells that are contaminating the graft.

While attempts have previously been made to utilize bone marrow stem cells that have been depleted of T cells for performing transplants, this approach failed because not only was there lower graft versus host disease observed, but also lower graft versus leukemia. The recipients of T cell depleted bone marrow grafts basically had a higher rate of leukemia relapse.

A recent paper (Zakrzewski et al. Adoptive precursor cell therapy to enhance immune reconstitution after hematopoietic stem cell transplantation. J Mol Med. 2007 Feb 28;) provides a new approach. The authors speculate that mixing T cell depleted stem cell grafts with semi-differentiated precursor cells will on the one hand avoid the graft versus host effect, but also lead to higher graft versus leukemia effects, as well as accelerate the neutropenic period.

This will be an interesting area to follow since the authors of the paper state that clinical trials using such an approach are ongoing.

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