Harvesting own stem cells
 

Hi All,

Remission means normal blood counts and normal numbers and functions of stem cells. Many people believe that (in most persons) stem cells never return to normal in both numbers and functions. Therefore, harvesting one's own stem cells as "insurance" would be considered investigational.

Has anyone any knowledge to share on this subject?? I know of one study in progress at Shands in Gainsville, FL. No results yet. Do you know of other such studies??

Nellie and I have been discussing our next move. All comments welcome.


Eli

Hi Eli,
Yes, in fact, I did a Clinical Trial at NIH with Dr. Elaine Sloane about 1 year after stopping all meds which would have been about mid 2005. I was diagnosed in May 2003. I was in complete remission with all normal blood counts at the time. The theory is , as you say, once in complete remission, with no guarantee of how long it will last, can the bone marrow generate enough of your own stem cells to harvest in case a future transplant is needed? I raised the question when I was in NIH for my ATG. Then the clinical trial came out, so I joined up. I went up to Bethesda, got GCSF shots everyday for 5 days and then went in for blood work and set up with the Apheresis Dept. You have both arms checked (the process is just like donating stem cells). Anyway, they didn't like my arm veins, which meant I would have to be admitted for a groin catheter(ouch) and stay in a hospital bed unable to move for at least 3 days maybe more. That wasn't the problem though, since I would have done anything to harvest enough of my own stem cells, which would have been frozen and stored at NIH for life. Double insurance, since my sister is a complete match. Unfortunately, upon doing the blood work checking for the correct type (CD34) for transplant, I was not producing any of those, not one. Dr. Sloane had no explanation, since my blood counts were all normal. We thought, maybe 1 year was too soon and I should come back and try again in another year. By then, my life was pretty back to normal and that is a huge commitment to try, so I have not gone back to try again, although I still have the option to do so.I still go up, now every 2 years, for my BMB.
Anyway, the answer is yes..there are studies, although I don't know if they are still open to new patients or ones that didn't receive their ATG at NIH.

http://www.clinicaltrials.gov/ct2/sh...Anemia&rank=20

Here is a link to the study I did.

All the best to you,
Judi

Hi!

What you refer to is called autologous transplant. Judi was talking about a study that was done at NIH regarding AA patients, not MDS. That study yielded poor results.

Mobilization, collection, and immunomagnetic selection of peripheral blood CD34 cells in recovered aplastic anemia patients

Authors: Sloand, Elaine M.; Read, Elizabeth J.; Scheinberg, Phillip; Tang, Yong; More, Kenneth; Leitman, Susan F.; Maciejewski, Jaroslaw; Young, Neal S.

Source: Transfusion, Volume 47, Number 7, July 2007 , pp. 1250-1253(4)


Abstract:

BACKGROUND:
Most patients with severe aplastic anemia (sAA) respond to immunosuppression, but a significant number relapse or develop clonal abnormalities such as paroxysmal nocturnal hemoglobinuria, myelodysplasia, or leukemia. In principle, patients without matched sibling donors and older patients might benefit from transplantation of autologous hematopoietic peripheral blood progenitor cells (PBPCs) obtained during remission. Even patients who have clinically recovered from aplastic anemia have diminished hematopoietic progenitor cells, so the practicability of PBPC mobilization in these individuals is unknown.

STUDY DESIGN AND METHODS:
The feasibility of PBPC mobilization in nine patients with a history of sAA was evaluated. Granulocyte-colony-stimulating factor (10 µg/kg) was administered subcutaneously for 5 days and followed by a 12-L leukapheresis procedure.

RESULTS:
Only two of the nine patients had sufficient mobilization of CD34 cells to merit collection; in these cases sufficient CD34 cells were obtained for autologous transplantation should the need arise.

CONCLUSION:
PBPC collection is feasible only in a fraction of recovered AA patients.

I'm not very good at this subject, but in my mind, I guess the main problem (apart from the scarcity, and therefore difficulty in collecting stem cells) would be that in MDS there is a KNOWN stem cell defect (as opposed to AA, where no apparent defect is found at diagnosis).

Sandra