Posted by rob on November 28, 2004 under Uncategorized | 
Story last updated at 7:28 a.m. Sunday, November 28, 2004
Minority marrow donors in short supply
Matches are usually dictated by race, leaving many who need transplants at a disadvantage
BY HOLLY AUER
Of The Post and Courier Staff
If you’re white and need a bone marrow transplant, your chances of finding a nonrelated donor who’s a perfect genetic match are about one in a million. It may sound unlikely, but you’ll probably get one, since there are more than 5 million people enrolled as potential donors in the National Bone Marrow Donor Program.
If you’re black, Asian or Native American, though, the odds plummet, because there aren’t enough people in those groups in the national registry. The genes that correlate to donor matches are usually tied to race, so minorities are at a disadvantage when awaiting a transplant.
Siblings offer the greatest chance for a genetic match, but only 30 percent of people who need transplants, most of whom have leukemia, are able to find a donor in their family. As family size continues to decrease — the average number of children per family is now 1.86 according to the 2000 Census — doctors expect more people will need to tap into the registry.
Each year, about 35,000 people in the United States are diagnosed with diseases for which a marrow or blood cell transplant could be a cure.
“A bone marrow transplant used to be a treatment of last resort,” said Dr. George Geils Jr., medical director of Roper Hospital’s blood and marrow transplant program. “But improving technologies and improving mortality rates have really made it the best option for a lot of patients.”
When Janie Goodin, a 62-year-old Awendaw resident who is black, learned she had chronic myelogenous leukemia in 2002, her doctor put her on Gleevec, what many called a leukemia wonder drug. For her, though, the side effects were almost worse than the disease itself, and it became clear that she would need a bone marrow transplant.
She hoped one of her four sisters would be a match, but weeks went by before she found out. The whole time, she worried that she’d have to seek out that perfect match from the donor registry.
“The doctor told me my chances wouldn’t be as good that way,” she said. “The anxiety is unbelievable. Day by day, you don’t know what’s going to happen.”
One of her sisters did prove to be a match, and Goodin had her transplant in late September.
Today, she’s back on her feet and encouraging everyone who will listen to get on the marrow donor registry.
“If you get this disease, what are you going to do if you don’t have a donor?” she said. “You can die while you wait.”
Seventy-eight people turned out at Roper Hospital’s bone marrow donor registration drive last week, and 30 percent of those were minorities, which is more than the national average of 25 percent, noted Sarah Hathcock, a registered nurse who organized the drive.
Getting the word out to black churches has been a crucial way to draw more minority donors, she said.
“They have a lot of questions, but if we can get them in here, we can give them all the information,” Hathcock said. “The more people we have on the registry, the better chance somebody has … of matching.”
Goodin said she believes the minority donor shortage stems from a lack of education about the process. Two of her four sisters were afraid even to be tested, because they believed donating marrow is like donating a kidney, with many risks and a long recovery time.
“One sister said, ‘What’s gonna happen to my hip?’ One said, ‘Are they going to take all my blood?’” I couldn’t convince them,” Goodin said. “They didn’t believe that you can do this and not be sick.”
Doctors need blood stem cells, the tiniest building blocks of blood, from the bone marrow to conduct a transplant, which then leads to regeneration of healthy marrow in sick patients. Although donating marrow once required a procedure under general anesthesia, people now may donate stem cells through an IV catheter during a short, painless outpatient procedure.
Goodin said her sister went right back to work after her donation.
“It was so easy, she didn’t even have an ache or a pain,” she said. “It’s a shame that black people don’t realize that this thing is nothing that’s going to destroy them. It’s not a big deal.”
Free registration drives are offered several times a year throughout the Lowcountry. For more information about bone marrow donation, call the Red Cross at 744-8021, ext. 371, or visit www.marrow.org.
Holly Auer covers health and medicine. Reach her at (843) 937-5560 or hauer@postandcourier.com.
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Leukemia. 2004 Dec; 18(12): 1951-63
Weisberg E, Catley L, Kujawa J, Atadja P, Remiszewski S, Fuerst P, Cavazza C, Anderson K, Griffin JD
NVP-LAQ824 is a novel potent hydroxamic acid-derived histone deacetylase inhibitor that induces apoptosis in nanomolar concentrations in myeloid leukemia cell lines and patient samples. Here we show the activity of NVP-LAQ824 in acute myeloid leukemia cells and BCR/ABL-expressing cells of mouse and human origin, both sensitive and resistant to imatinib mesylate (Gleevec, STI-571). Whereas imatinib inhibited overall cellular tyrosine phosphorylation in Ba/F3.p210 cells, NVP-LAQ824 did not inhibit tyrosine phosphorylation, and did not affect BCR/ABL or ABL protein expression. Neither compound was able to inhibit cellular tyrosine phosphorylation in the imatinib-resistant Ba/F3.p210-T315I cell line. These data taken together suggest that BCR/ABL kinase activity is not a direct target of NVP-LAQ824. Synergy between NVP-LAQ824 and imatinib was demonstrated against BCR/ABL-expressing K562 myeloid leukemia cell lines. In addition, we show that NVP-LAQ824 was well tolerated in vivo in a pre-clinical murine leukemia model, with antileukemia activity resulting in significant prolongation of the survival of mice when treated with NVP-LAQ824 compared to control mice. Taken together, these findings provide the framework for NVP-LAQ824 as a novel therapeutic in myeloid malignancies.Leukemia (2004) 18, 1951-1963. doi:10.1038/sj.leu.2403519 Published online 21 October 2004.
http://www.hubmed.org/display.cgi?issn=08876924;uids=15496979
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Acta Haematol. 2004; 112(4): 217-218
Arimura K, Arima N, Ohtsubo H, Matsushita K, Kukita T, Ayukawa T, Kuroki T, Tei C
Interferon (IFN)-alpha is a leukocyte-derived cytokine and is used to treat several hematopoietic malignancies. The most common adverse effects of IFN-alpha are flu-like symptoms and usually insignificant. However, adverse effects due to autoimmune mechanisms are often hazardous and irreversible, although their frequency is low. In the present report, we describe a 55-year-old female with chronic myelogenous leukemia who developed severe autoimmune thrombocytopenia during IFN-alpha therapy. The lowest platelet count was 6 x 10(9)/l with severe hemorrhagic tendency. The present report strongly suggests the clinical importance of autoimmune thrombocytopenia as an adverse effect of IFN-alpha. Copyright (c) 2004 S. Karger AG, Basel.
http://www.hubmed.org/display.cgi?issn=00015792;uids=15564735
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Hematology (Am Soc Hematol Educ Program). 2004; 146-62
O’brien S, Tefferi A, Valent P
In Section I, Dr. Stephen O’Brien reviews the latest data on the clinical use of imatinib (STI571, Gleevec, Glivec) in CML. His review focuses on the use of imatinib in newly diagnosed chronic phase patients and summarizes cytogenetic and molecular response data, as well as use of the agent at high doses and in combination with other drugs. A brief summary of the prospective international Phase III studies that are currently ongoing is also provided, and the issues of resistance and definition of suboptimal therapeutic response are also covered. Finally, therapeutic decision-making and treatment strategy are considered. In Section II, Dr. Ayalew Tefferi considers the latest developments in the biology and therapy of myeloid metaplasia/myelofibrosis. Dr. Tefferi covers what is currently understood of the biology of the disease and reviews established therapies for the condition as well as novel agents that are being used in clinical trials. The development of optimal management strategies for the disease is considered. In Section III, Dr. Peter Valent reviews the classification of mast cell proliferative disorders and covers the clinical and pathological presentation of this group of neoplasms. He reviews the state-of-the-art regarding the molecular biology of mastocytosis along with diagnostic criteria and novel treatment concepts.
http://www.hubmed.org/display.cgi?issn=15204391;uids=15561681
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Chloroma, or granulocytic sarcoma, is a rare extramedullary solid hematologic cancer that affects many sites, usually in concert with acute myeloid leukemia. It is infrequently associated with other myeloproliferative disorders or chronic myelogenous leukemia. Chloroma of the testis after allogeneic bone marrow transplantation is particularly sparsely represented in the literature. It is often incorrectly diagnosed as malignant lymphoma, especially large-cell lymphoma, owing to the similarity of the histologic morphology, scanty eosinophilic myelocytes, and no or overlooked history of leukemia. Although erroneous diagnosis is decreasing with the advent of ancillary studies, the diagnosis of chloroma continues to be a nightmare for pathologists. It is thus suggested that an appropriate panel of marker studies be performed in conjunction with clinical correlation and circumspection to avoid reaching a misleading conclusion and improper treatment of patients. We report an interesting case of a 35-year-old male with a clinical history of chronic myelogenous leukemia post allogeneic peripheral blood stem cell transplantation and complete molecular remission, who was found to have chloroma of the left testis.
http://www.hubmed.org/display.cgi?issn=1607551X;uids=15553811
