Skin Cell Discovery Could Lead to Possible Treatments for Balding, Hair Graying – Sci-News.com

A team of scientists at the University of Texas Southwestern Medical Center has identified the cells that directly give rise to hair as well as the mechanism that causes hair to turn gray. The research is published in the journal Genes & Development.

Layers of the skin. Image credit: M.Komorniczak / Madhero / CC BY-SA 3.0.

With this knowledge, we hope in the future to create a topical compound or to safely deliver the necessary gene to hair follicles to correct these cosmetic problems, said senior author Dr. Lu Le, an associate professor of dermatology with the Harold C. Simmons Comprehensive Cancer Center at the University of Texas Southwestern Medical Center.

Dr. Le and colleagues found that a protein called KROX20 (also termed EGR2), more commonly associated with nerve development, turns on in skin cells that become the hair shaft.

These hair precursor cells then produce a protein called stem cell factor (SCF) that the researchers showed is essential for hair pigmentation.

When the authors deleted the SCF gene (KITLG gene) in the hair progenitor cells in mouse models, the animals hair turned white.

When they deleted the KROX20-producing cells, no hair grew and the mice became bald.

We uncovered this explanation for balding and hair graying while studying a disorder called Neurofibromatosis Type 1, a rare genetic disease that causes tumors to grow on nerves, Dr. Le said.

Scientists already knew that stem cells contained in a bulge area of hair follicles are involved in making hair and that SCF is important for pigmented cells.

What they did not know in detail is what happens after those stem cells move down to the base, or bulb, of hair follicles and which cells in the hair follicles produce SCF or that cells involved in hair shaft creation make the KROX20 protein.

If cells with functioning KROX20 and SCF are present, they move up from the bulb, interact with pigment-producing melanocyte cells, and grow into pigmented hairs.

But without SCF, the hair in mouse models was gray, and then turned white with age. Without KROX20-producing cells, no hair grew.

We will now try to find out if the KROX20 in cells and the SCF gene stop working properly as people age, leading to the graying and hair thinning seen in older people as well as in male pattern baldness, Dr. Le said.

_____

Chung-Ping Liao et al. Identification of hair shaft progenitors that create a niche for hair pigmentation. Genes & Development, published online May 2, 2017; doi: 10.1101/gad.298703.117

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New lung ‘organoids’ in a dish mimic features of full-size lung – Phys.Org

May 12, 2017 Bright-field images of day 50 LBO-derived Matrigel colonies from RUES2 cells. Representative of six independent experiments. Scale bars, 500?m. Credit: Snoeck lab/Columbia University Medical Center

New lung "organoids"tiny 3-D structures that mimic features of a full-sized lunghave been created from human pluripotent stem cells by researchers at Columbia University Medical Center (CUMC). The team used the organoids to generate models of human lung diseases in a lab dish, which could be used to advance our understanding of a variety of respiratory diseases.

A paper detailing the discovery was published in the April 24 online issue of Nature Cell Biology.

Organoids are 3-D structures containing multiple cell types that look and function like a full-sized organ. By reproducing an organ in a dish, researchers hope to develop better models of human diseases, and find new ways of testing drugs and regenerating damaged tissue.

"Researchers have taken up the challenge of creating organoids to help us understand and treat a variety of diseases," said Hans-Willem Snoeck, PhD, professor of medicine (in Microbiology & Immunology) at CUMC and lead investigator of the study. "But we have been tested by our limited ability to create organoids that can replicate key features of human disease."

The lung organoids created in Dr. Snoeck's lab are the first to include branching airway and alveolar structures, similar to human lungs.

To demonstrate their functionality, the researchers showed that the organoids reacted in much the same way as a real lung does when infected with respiratory syncytial virus (RSV). Additional experiments revealed that the organoids also responded as a human lung would when carrying a gene mutation linked to pulmonary fibrosis.

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RSV is a major cause of lower respiratory tract infection in infants and has no vaccine or effective antiviral therapy. Idiopathic pulmonary fibrosis, a condition that causes scarring in the lungs, causes 30,000 to 40,000 deaths in the U.S. each year. A lung transplant is the only cure for this condition.

"Organoids, created with human pluripotent or genome-edited embryonic stem cells, may be the best, and perhaps only, way to gain insight into the pathogenesis of these diseases," Dr. Snoeck says.

Explore further: New study makes strides towards generating lung tissue

More information: Ya-Wen Chen et al, A three-dimensional model of human lung development and disease from pluripotent stem cells, Nature Cell Biology (2017). DOI: 10.1038/ncb3510

Using Induced pluripotent stem cells (iPSCs), researchers have for the first time profiled the complete genetic programs of early lung progenitors identifying genes that control lung formation and have created mini-lung organoids ...

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Human lungs, like all organs, begin their existence as clumps of undifferentiated stem cells. But in a matter of months, the cells get organized. They gather together, branch and bud, some forming airways and others alveoli, ...

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An ancient sink hole in eastern Tennessee holds the clues to an important transitional time in the evolutionary history of snakes. Among the fossilized creatures found there, according to a new paper co-authored by a University ...

New lung "organoids"tiny 3-D structures that mimic features of a full-sized lunghave been created from human pluripotent stem cells by researchers at Columbia University Medical Center (CUMC). The team used the organoids ...

University of Dundee scientists have solved a mystery concerning one of the most fundamental processes in cell biology, in a new discovery that they hope may help to tackle cancer one day.

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Adult stem cells have the ability to transform into many types of cells, but tracing the path individual stem cells follow as they mature and identifying the molecules that trigger these fateful decisions are difficult in ...

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New lung 'organoids' in a dish mimic features of full-size lung - Phys.Org

Sniffing out stem cell fates in the nose – UC Berkeley

Adult stem cells have the ability to transform into many types of cells, but tracing the path individual stem cells follow as they mature and identifying the molecules that trigger these fateful decisions are difficult in a living animal.

Neurons (green) derived from a single stem cell in the olfactory epithelium of the nose. The magenta cells are support cells called sustentacular cells. (Russell Fletcher image)

UC Berkeley neuroscientists have now combined new techniques for sequencing the RNA in single cells with detailed statistical analysis to more easily track individual stem cells in the nose, uncovering clues that someday could help restore smell to those who have lost it.

The results are published this week in the journal Cell Stem Cell.

A stem cells job is twofold: to replace or recreate mature cells that are lost over time, both through normal aging and after injury, and to replace themselves so that the process can continue over the life of the animal, said senior author John Ngai, the Coates Family Professor of Neuroscience and a member of UC Berkeleys Helen Wills Neuroscience Institute and the Berkeley Stem Cell Center. We are getting closer to understanding how mature sensory neurons are generated from olfactory stem cells, an understanding thats key for an eventual stem cell therapy to restore function.

Ngai noted that perhaps one-quarter of all people over the age of 50 have some loss of smell, yet doctors have little understanding why, and no treatments for most cases. Theres not even a standardized test for loss of smell, as there is for vision or hearing loss, in spite of widespread reports of suffering by patients who have lost their sense of smell.

Some cases of anosmia the loss of the sense of smell are due to traumatic injury, and there is generally not a whole lot you can do about that, he said. But some are age-related, or occur for reasons we dont quite know. In the case of age-related anosmias, it could be because the stem cells are just not doing their job replacing the cells that are naturally lost over time. One idea is that if we could harness the very stem cells that are in the noses of people who are losing smell, maybe we can figure out a way to restore function, by getting them to regenerate the cells that are lost.

Tracking cell fate Ngai, who directs the Functional Genomics Laboratory in UC Berkeleys California Institute for Quantitative Biosciences, focuses on the cells and regulatory molecules involved in our sense of smell. Olfactory cells in the nose are unusual in that they are part of the bodys outer layer, or epithelium, but also part of the nervous system, incorporating neurons that connect directly with the smell centers in the brain.

The nose is lined with sensory tissue, the olfactory epithelium, that contains various types of cells, all of which arise from olfactory stem cells (green). Among these are smell-sensing neurons (orange), progenitor cells (cyan) and support cells (magenta sustentacular cells and blue microvillous cells). (Russell Fletcher image)

His group has been working with adult olfactory stem cells that give rise to the neurons that sense odors and other cells, such as sustentacular cells, that support the neurons. A new technique for sequencing the RNA in a single cell has been revolutionary, Ngai said, allowing researchers to trace which stem cells in a densely packed tissue become specialized, based on the mRNA present in the cell, which indicates which genes are being expressed. Nevertheless, it is difficult to follow stem cells that can potentially differentiate into different types of cells.

Ngais group teamed up with UC Berkeley statisticians and computer scientists led by Sandrine Dudoit, a professor of biotstatistics and statistics, Elizabeth Purdom, a professor of statistics, and Nir Yosef, a professor of electrical engineering and computer sciences to develop a way to analyze the experimental data and identify cells with similar RNA profiles, indicative of specific cell types and developmental states.

As a result, the team was able to trace the paths that cells take as they turn into sustentacular cells which seems to be the default fate for olfactory stem cells and into neurons and other types of cells. They also were able to identify a signaling pathway known as Wnt that triggers the olfactory stem cell to become a sensory neuron.

Ngai cautions that the immediate implications of the work are limited to animal models, which provide the necessary foundation for eventually addressing human anosmias. But with this information, we now have a window into what controls the process and therefore a window into manipulating or coopting that process to stimulate regeneration he said. There has been a lot of work on Wnt signaling pathways, for example, so there are a lot of small-molecule drugs that could be tested to trigger a stem cell to mature into a neuron.

The sequencing and statistical techniques the team developed can also be used by others studying regulation of stem cells in other tissues, organ systems or organisms, he said.

The work was spearheaded by senior postdoctoral researcher Russell Fletcher and graduate student Diya Das, and was funded by the National Institute on Deafness and Other Communications Disorders, the National Institute of Mental health, the National Institute on Aging, National Human Genome Research Institute, the National Center for Research Resources, the National Institute of General Medical Sciences, the California Institute of Regenerative Medicine and the Berkeley Siebel Stem Cell Center.

Other co-authors include Levi Gadye, Kelly Street, Ariane Baudhuin, Allon Wagner, Michael Cole, Quetzal Flores, Yoon Gi Choi and Davide Risso.

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Sniffing out stem cell fates in the nose - UC Berkeley

Stem cell therapy holds promise for treating most severe cases of … – Medical Xpress

May 11, 2017

An analysis of data from the entire development program consisting of three trials assessing the feasibility of using a stem cell therapy (CD34+ cells) to treat patients with the most severe cases of angina, refractory angina (RA), showed a statistically significant improvement in exercise time as well as a reduction in mortality. Results from "CD34+ Stem Cell Therapy Improves Exercise Time and Mortality in Refractory Angina: A Patient Level Meta-Analysis" were presented today as a late-breaking clinical trial at the Society for Cardiovascular Angiography and Interventions (SCAI) 2017 Scientific Sessions in New Orleans.

One of the warning signs of coronary artery disease is angina, or chest pain, which occurs when the heart muscle does not receive enough blood. Unlike angina pectoris or "stable angina," which can often be treated with medication, RA can be incapacitating, impacting quality of life. In the most severe cases, those with class III or IV angina, treatment options are exhausted, and patients remain severely debilitated. Unfortunately, one of the untoward consequences of the improved survival of patients with chronic ischemic heart disease is more patients with refractory angina.

A meta-analysis of three trials that each showed promising results looked at injecting RA patients with autologous CD34+ cellswhich have been shown to increase blood flowand the therapy's effect on mortality and total exercise time (TET), an important predictor of long-term mortality.

Data from 304 patients was extracted and analyzed from phase 1 (24 patients), ACT-34 and ACT-34 extension studies (168 patients), and RENEW (112 patients), which was prematurely terminated by the sponsor due to financial considerations.

"The goal of this meta-analysis was to combine patient level data from three very similar trials to try understand what it would tell us," said lead investigator Tom Povsic, MD, FSCAI, associate professor at the Duke Clinical Research Institute (DCRI) and an interventional cardiologist at Duke University School of Medicine.

Results showed that patients treated with CD34+ cell therapy (n=187) improved TET by 80.5 12.1, 101.8 13.7, and 90.5 14.7 seconds at three months, six months, and 12 months compared with 28.1 15.7, 48.8 18.2, and 39.5 20.3 seconds for the placebo group (n=89), resulting in treatment effects of 52.5 (p=0.002), 52.9 (p=0.009) and 50.9 (p=0.027) seconds.

The relative risk of angina was 0.90 (p=0.40), 0.81 (p=0.14), and 0.79 (p=0.17) at three months, six months, and 12 months in CD34+ treated patients.

CD34+ treatment decreased mortality by 24 months (2.6 percent vs. 11.8 percent, p=0.003). In addition, major adverse cardiac events were less frequent (29.8 percent for CD34+ patients vs. 40.0 percent for the placebo group, p=0.08).

"Therapies for these patients are direly needed," said Povsic, "and results from our meta-analysis are very compelling. Most importantly, the number of patients in our meta-analysis approximates those who were targetedfor enrollment in RENEW, the prematurely terminated phase III study. These results suggest that had RENEW been completed, a regenerative therapy for these patients might meet criteria for approval. I still think this therapy has a lot of promise."

Timothy Henry, MD, chief of cardiology at Cedars-Sinai Medical Center in Los Angeles, agrees "CD34+ cell therapy appears to be an extremely safe and effective therapy for this growing and challenging patient population with limited options."

Explore further: Stem cell therapy shows potential for difficult-to-treat RA patient population

More information: Povsic presented "CD34+ Stem Cell Therapy Improves Exercise Time and Mortality in Refractory Angina: A Patient Level Meta-Analysis" on Thursday, May 11, 2017 11:30 a.m. CDT

A study using a stem cell therapy to treat challenging refractory angina (RA) patients demonstrated promising results, including improved exercise time, reduced angina and reduced mortality. The RENEW results were presented ...

A two-year, multi-center clinical study with 167 patients with class III-IV refractory angina randomized to low and high dose CD34+ cells or placebo has revealed that patients who received either a high or low dose of CD34a ...

The absolute cumulative probability of death at 12 months was 5 percent lower for patients who received routine invasive coronary angiography and revascularization as indicated during an unstable angina admission compared ...

An injection of stem cells into the heart could offer hope to many of the 850,000 Americans whose chest pain doesn't subside even with medicine, angioplasty or surgery, according to a study in Circulation Research: Journal ...

(HealthDay)Reduced baseline levels of circulating CD34+ stem cells predict adverse cardiovascular outcomes for patients with type 2 diabetes, according to a study published online Nov. 4 in Diabetes Care.

A non-surgical treatment that uses a patient's own bone marrow stem cells to treat chest pain or angina improved both symptoms and the length of time treated patients could be physically active, according to preliminary research ...

(HealthDay)When someone goes into cardiac arrest, quick action from bystanders can have a long-lasting impact, researchers say.

Cholesterol-lowering statin drugs may have been wrongly blamed for muscle pain and weakness, said a study Wednesday that pointed the finger at a psychological phenomenon called the "nocebo" effect.

A new pilot study reports that Mexican-American stroke survivors are less likely to receive inpatient rehabilitation than non-Hispanic whites.

Less than half of individuals with peripheral artery disease, which is a narrowing of arteries to the limbs, stomach and head, are treated with appropriate medications and lifestyle counseling. These findings highlight the ...

Using two simple blood tests, Western University researchers were able to drastically improve treatment for resistant hypertension across three sites in Nigeria, Kenya and South Africa.

Two immune responses are important for recovery after a heart attackan acute inflammatory response that attracts leukocyte immune cells to remove dead tissue, followed by a resolving response that allows healing.

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New Lung "Organoids" in a Dish Mimic Features of Full-Size Lung – Newswise (press release)

Newswise (press release)

New Lung "Organoids" in a Dish Mimic Features of Full-Size Lung Newswise (press release) Newswise New York, NY (May 11, 2017)New lung organoidstiny 3-D structures that mimic features of a full-sized lunghave been created from human pluripotent stem cells by researchers at Columbia University Medical Center (CUMC). The team ... and more »

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New Lung "Organoids" in a Dish Mimic Features of Full-Size Lung - Newswise (press release)

Study Identifies Root Cause of Gray, Balding Hair – NBC 10 Philadelphia

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Scientists in North Texas have identified the cells that cause hair to turn gray and to go bald findings that could one day help identify possible treatments.

Researchers from the University of Texas Southewestern Medical Center accidentally stumbled upon the discovery while studying a rare genetic disease that causes tumors to grow on nerves.

"When we saw the mice that we were expecting to form a tumor turned gray, we were really excited!" said Dr. Lu Le, an associate professor of dermatology at UT Southwestern.

The researchers found that a protein called KROX20, more commonly associated with nerve development, switches on in skin cells that become the hair shaft.

These hair cells then produce another protein called stem cell factor (SCF).In mice, these two proteins turned out to be important for baldness and graying.

When researchers deleted theSCF gene in mice,the animals' hair turned white; when they deleted the cells that produce KROX20, the mice stopped growing hair and eventually went bald, according to the study.

"We were really excited because as a dermatologist, I treat patients with hair disease, so when we found the root cause of why hair turns gray and hair loss, we just cannot let it go," Le said.

More research is needed to understand if the process works similarly in humans, and Le and his colleagues plan to start studying it in people.

Le hopes that, armed with this knowledge, scientists can develop a topical compound or transplant the necessary gene to hair follicles to correct these cosmetic problems.

Researchers say the findings could one day also provide answers about why humans age in general as hair graying and hair loss are among the first signs of aging.

At Hair Revival Studio in Dallas, clients say the possibility of a treatment for gray hair and baldness sounds remarkable.

"Everyone wants to have a good head of hair. There's a lot of confidence that comes with that," said Brandon Stewart.

Published at 8:55 AM EDT on May 11, 2017 | Updated at 9:54 AM EDT on May 11, 2017

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Study Identifies Root Cause of Gray, Balding Hair - NBC 10 Philadelphia

Stem Cell Vaccine Found to Increase Immune Responses, Inhibit Tumors – University of Cincinnati

Stem Cell Vaccine Found to Increase Immune Responses, Inhibit Tumors

CINCINNATIResearchers at the University of Cincinnati (UC) have found that a cancer stem cell vaccine, engineered to express a pro-inflammatory protein called interleukin-15 (IL-15) and its receptor (IL-15Ralpha), caused T cell production in animal models and enhanced immune responses against tumors.

This T cell production showed a cellular immune response that could lead to new immunotherapy treatments for cancer with improved side effects.

These findings are being presented via poster abstract at the American Society of Gene and Cell Therapys annual meeting in Washington, D.C., May 10-13.

"IL-15 is a powerful stimulator of the maturation and activation of T cells and natural killer cells that recognize and attack tumor cells. Human IL-15 was first used in Phase I clinical trials to test its efficacy for treatment of a number of cancers, including melanoma and kidney cancer, but caused a number of side effects that made high doses difficult for patients to tolerate, says John Morris, MD, co-author of this study, clinical co-leader of the Molecular Therapeutics and Diagnosis Program for the Cincinnati Cancer Consortium, co-leader of the UC Cancer Institute's Comprehensive Lung Cancer Program, professor in the Division of Hematology Oncology at the UC College of Medicine and UC Health medical oncologist.

"In this work, we showed that transferring the genes for both IL-15 with its receptor into cancer cells increased the cell-surface presentation of IL-15 to T cells, and in turn, stopped the tumor cells from reproducing with little evidence of side effects in animal models.

"In an effort to enhance antitumor activity and reduce side effects, we studied a vaccine targeting cancer stem cells, the cells in a tumor thought to be resistant that give rise to recurrent tumors after treatment, by genetically altering them to express IL-15 and IL-15Ralpha to see if lung cancers implanted in animal models shrunk.

Using animal models and their lung cancer cell lines, researchers introduced the IL-15/IL-15Ralpha-modified lung cancer stem cells as a vaccine and saw dramatically inhibited tumor growth.

"Animal lung cancer stem cells expressing IL-15 and IL-15Ralpha stimulated proliferation of T cells suggesting the ability to enhance immune responses, he says. "These findings further support evidence of IL-15s ability as a cancer treatment. We are continuing vaccination studies in animal models with hopes of moving this research to a Phase I trial in humans to see if side effects are reduced.

Donatien Toukam, PhD, post-doctoral fellow in the Division of Hematology Oncology, is the lead author of this study funded in part by the Lcs Foundation. He cites no conflicts of interest.

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Stem Cell Vaccine Found to Increase Immune Responses, Inhibit Tumors - University of Cincinnati

Tucson Health and wellness events, support groups and more – Arizona Daily Star

HEALTH AND WELLNESS

All events are free unless otherwise noted.

Widowed to Widowed The Fountains at La Cholla, 2001 W. Rudasill Road. Offers group discussion and support. 10-11 a.m. Mondays. 797-2001.

Interfaith Spiritual Support Group Parlor at First Christian Church, 740 E. Speedway. An interfaith spiritual support group for adults affected by mental health disorders. 6-7:30 p.m. May 15. 624-8695.

Healthy Living with Chronic Pain Desert Harmony Hospice of Tucson, 1200 N. El Dorado Place. Six-week interactive workshop for individuals living with chronic pain and their caregivers. Ages 18 and up. 1-3:30 p.m. Tuesdays. $35. 305-3410.

Taekwondo Wellness Intuition Wellness Center, 5675 N. Oracle Road. Learn traditional Taekwondo, philosophy and core principles, self-care, stress management, coping skills, social skills and mindfulness meditation. 4:15 p.m class for ages 7-12; 5:15 p.m. for ages 12 and up. 4:15-5:15 p.m. Tuesdays and Thursdays; 5:15-6:15 p.m. Tuesdays and Thursdays. $20. 333-3320.

Right treatment, right person, right time: Progress in precision cardiovascular care at the Sarver Heart Center Banner-University Medical Center Tucson, 1501 N. Campbell Ave. Learn about human "disease in a dish," induced pluripotent stem cell (iPSC) technology that has the potential to completely change medicine in terms of understanding individual variation, underlying disease mechanisms, transforming and personalizing drug discovery and targeting treatments, sometimes at the level of correcting a single gene mutation. 6-7:15 p.m. May 17. 626-2901.

Beyond Movement: Cognition and Emotion PWR! Gym, 140 W. Fort Lowell Road. Marisa Menchola will introduce the most common cognitive and emotional changes experienced by people with Parkinson Disease. 4-5:30 p.m. May 18. 591-5346.

Experience Wellness: A day of activities and education Thrive Wellness Collective, 4737 N. First Ave. Free mini treatments, demos, lectures, snacks and door prizes. 11 a.m.-3 p.m. May 20. 477-2107.

Free Eye Exams St. Elizabeth's Health Center, 140 W. Speedway. Will screen for cataracts, glaucoma, macular degeneration, dry eyes and complications related to diabetes. Call to make an appointment. 8 a.m.-noon. May 20. 694-1471.

Depression: Share your story to help someone else get through it... Call for guests on The Depression Session The Depression Session on Downtown Radio, One E. Toole Ave. Share your story of Depression on 99.1FM Downtown Radio, and help de-stigmatize depression. Prerecorded and edited. Contact: lmilkins@gmail.com. Ages 18 and up. Noon-12:30 p.m. Sundays.

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Tucson Health and wellness events, support groups and more - Arizona Daily Star

Vail Daily column: School district has model partnership with medical center – Vail Daily News

Our school district goes out of its way to develop meaningful and impactful partnerships with all kinds of groups in our valley. We understand that we can't solve all of our community's problems on our own. That's why we've reached out to community organizations to try to develop systems of support for all of our students.

One model partnership we are very proud of is the collaboration and support we get from Vail Valley Medical Center. On top of providing quality medical care, VVMC is also very good to our kids and schools.

One major area where VVMC supports our students is through medical coverage for our athletes. Annually, VVMC provides $188,000 in support and medical care, including two certified athletic trainers who are available to our athletes.

VVMC also supports a program called ThinkFirst, which teaches students about preventable injuries. Sure, kids will be kids, but ThinkFirst is a proven program designed to help students think through the consequences of their actions before leaping.

VVMC also hosts field trips from schools to the hospital and research labs on a regular basis. Students get to see the medical profession in action, as well as see some of the cutting-edge research VVMC is doing around sports medicine and stem-cell work. These tours give our students an understanding of what a career in medicine might look like and what kinds of jobs might be available for their futures.

VVMC sponsors a program aimed at reducing skin cancer and premature aging through its Sun Safety program. This program introduces elementary school children to the dangers of overexposure to sun and provides sunscreen free to the students and their families.

VVMC is also a big supporter of our community education foundation, the Education Foundation of Eagle County. By supporting the foundation and events such as Project Funway and Wild West Day, VVMC provides classroom and instructional supports that go directly to students.

Looking ahead, we're excited about working with VVMC to also add career/technical pathways for our students into the medical profession. Through experience-based learning opportunities such as apprenticeships and internships, as well as high school credit courses in the medical field, our partnership with VVMC can help us provide a great on-ramp to a career in the medical field.

It really does "take a village" to raise a child, and we're proud of our partnership with VVMC as a model example of how the community school system and the community health care system can work together for the betterment of kids in Eagle County.

Jason E. Glass is the superintendent of Eagle County Schools. He can be reached at jason.glass@eagleschools.net.

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Vail Daily column: School district has model partnership with medical center - Vail Daily News

Survival in MDS Equivalent With Reduced-Intensity Conditioning – Cancer Network

Patients with myelodysplastic syndrome (MDS) undergoing a reducedintensity conditioning (RIC) regimen prior to allogeneic stem-cell transplantation had similar 2-year relapse-free and overall survival as patients who underwent myeloablative conditioning (MAC), according to the results of the RICMAC trial.

The role of conditioning regimen intensity before allogeneic stem-cell transplantation for MDS has not been studied prospectively and recommendations are based on retrospective single-center or registry studies, wrote Nicolaus Krger, MD, department of stem cell transplantation, University Medical Center Hamburg-Eppendorf, and colleagues in a study published in the Journal of Clinical Oncology. The rationale for using RIC before allogeneic stem-cell transplantation is to shift from high-dose chemotherapy that is aimed at maximizing cytotoxic leukemia killing to a more immune-mediated effect by harvesting the graft-vs-tumor effect to eradicate the disease.

In this study, the researchers enrolled 129 patients with MDS or secondary acute myeloid leukemia and randomly assigned them 1:1 to a busulfan-based RIC or MAC.

At 1 year, the non-relapse mortality was 17% in patients assigned RIC compared with 25% in patients assigned MAC (P = .29). The cumulative incidence of relapse at 2 years was 17% for RIC and 14.8% for MAC. This resulted in a 2-year relapse-free survival of 62.4% for RIC and 58.3% for MAC.

In a multivariate analysis for overall survival, RIC resulted in a significant survival benefit at 2 years, the researchers wrote. The 2-year overall survival was 76% for RIC and 63% for MAC.

Improved survival after RIC might be a result of lower mortality after relapse, they added. Whereas after MAC six of nine patients who experienced relapse died, in the RIC arm, only two of 11 patients who experienced relapse died.

In the low-risk group, treatment with RIC resulted in a lower non-relapse mortality (HR, 0.30). However, in patients with intermediate- and high-risk disease, treatment with RIC resulted in a higher non-relapse mortality (HR, 1.17; and HR, 2.14). The researchers noted that conclusive answer for this observation cannot be given, but a possible explanation would be that low-risk patients are protected from relapse and are thus more at risk for death without relapse.

Acute grade 2 to grade 4 and grade 3 and 4 graft-vs-host disease occurred in 32.3% and 15% of patients in the RIC arm and 37.5% and 14% of patients in the MAC arm, respectively. The cumulative incidence of chronic graft-vs-host disease was 61.6% after RIC and 64.7% after MAC.

The researchers concluded by writing, our study shows that RIC and MAC followed by allogeneic stem-cell transplantation resulted in at least an equivalent survival trend for a better 2-year overall survival, especially in the cytogenetic low-risk group, suggesting that RIC can be offered as an alternative to a myeloablative regimen.

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Survival in MDS Equivalent With Reduced-Intensity Conditioning - Cancer Network