Stem Cell Clinic

Stem-cell therapy for cancer comes closer home – The New Indian Express

By Stell Cell Research

BENGALURU:Full-fledged treatment for cancer and bone-related ailments using stem-cell within the state could soon be a possibility if a plan of a world renowned surgeon from the state succeeds.

Dr A A Shetty is a highly decorated orthopedic surgeon and professor based in the UK who won the Nobel equivalent of surgery called the Hunterian Medal, this year. In his aim to bring about next level cancer and orthopedic treatment, he has already set up two big stem cell research labs - one in Dharwad and another in Mangaluru, a few years back at a cost of around 20 to 25 crore. A hospital that will treat stem-related ailments has also been envisaged at a total cost of around Rs 200 to 250 crore.

Setting up the labs is part of a three-step goal. After setting up the labs, the next step will be producing the stem cells, whether it be for bone ailments, treatment for cervical cancer etc. Then the third step will be the application of these stem cells through our hospital or through tie-ups with other hospitals. I have already received the funding for setting up the hospital, says Dr Shetty in an interaction with CE in Bengaluru. He is originally from a small village called Asode in Udupi district.

The lab in Dharwad is located at SDM College and is being backed by Shri Dharmasthala Manjunatheshwara and will be primarily working on blood cancer and thalassemia treatment. The one in Mangaluru is located at K.S. Hegde Medical Academy (KSHEMA) and is backed by the NITTE group. It will work on cartilage and bone fracture treatments.The effort is no doubt for profit. We will charge the rich but the poor will be treated for free at our hospital, he says.

Already, Shetty has recruited a number of top stem cell researchers from the state who are presently abroad. I have recruited researchers who were doing their postdoc studies in Japan, South Korea. Presently there are four of them working at the two labs, he says. Shetty ultimately wants to settle in Karnataka and hopes to achieve his goal by 2020. The third stage of his plan also requires expertise in various cutting edge technologies such as robotics, computing and he will also be recruiting people who specialize in these fields.

Cancer Vaccination

Shetty also hopes to make cancer vaccination a possibility. Giving an example of cervical cancer, Shetty says, Few cancers can be vaccinated. Cervical cancer, one of the most rampant cancers, is one of them. We will use stems derived from iPS cell. In the UK, the vaccine cost 60 pounds. Our aim is to develop it and sell it at a very low cost, as low as Rs 100, he adds. Induced Pluripotent Stem Cells or iPS Cells are derived from the blood and skiwwn cells and can be reprogrammed to provide an unlimited source of any type of human cell.

Stem cells for Arthritis In 2013, Shetty devised a minimally invasive procedure to treat arthritis using stem cells. When the cartilage between the bones begin to erode, the bones rub against each other and cause severe pain. Shetty treated a patient suffering from knee arthritis. He drilled a hole into the patients knee bone and released stem cells that could grow into the cartilage. In all, the procedure lasted just 30 minutes. Shetty has already done as many as two dozen such procedures in India.

Trauma Center Shetty also says that he wants to develop and provide integrated trauma services. If a patient survives the golden hour then he/she can be saved. Majority die in the first hour of trauma. My integrated services will have specialized suits that will help reduce blood loss and will have other know-how. I am negotiating with the International Rotary on this, he adds. This may be established either in Mangalore or Bangalore.

Dr Vishal Rao, head and neck oncology surgeon at HCG Hospitals says that stem cells research is in the mid-stage of development and has great potential to grow in India. The IT and BT ministry is already taking great steps by encouraging startups on these lines, starting various schemes, he says. Vishal also pointed out that a number of private organizations, hospitals and individuals like those like Dr Shetty are also investing in the field.

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Stem-cell therapy for cancer comes closer home - The New Indian Express

Growing an entire baby from skin cells could happen in a decade, scientists say – The San Diego Union-Tribune

By Embryonic Stem Cells

Nearly 40 years after the world was jolted by the birth of the first test-tube baby, a new revolution in reproductive technology is on the horizon and it promises to be far more controversial than in vitro fertilization ever was.

Within a decade or two, researchers say, scientists will likely be able to create a baby from human skin cells that have been coaxed to grow into eggs and sperm and used to create embryos to implant in a womb.

The process, in vitro gametogenesis, or I.V.G., so far has been used only in mice. But stem cell biologists say it is only a matter of time before it could be used in human reproduction opening up mind-boggling possibilities.

With I.V.G., two men could have a baby that was biologically related to both of them, by using skin cells from one to make an egg that would be fertilized by sperm from the other. Women with fertility problems could have eggs made from their skin cells, rather than go through the lengthy and expensive process of stimulating their ovaries to retrieve their eggs.

It gives me an unsettled feeling because we dont know what this could lead to, said Paul Knoepfler, a stem cell researcher at UC Davis. You can imagine one man providing both the eggs and the sperm, almost like cloning himself. You can imagine that eggs becoming so easily available would lead to designer babies.

Some scientists even talk about what they call the Brad Pitt scenario when someone retrieves a celebritys skin cells from a hotel bed or bathtub. Or a baby might have what one law professor called multiplex parents.

There are groups out there that want to reproduce among themselves, said Sonia Suter, a George Washington University law professor who began writing about I.V.G. even before it had been achieved in mice. You could have two pairs who would each create an embryo, and then take an egg from one embryo and sperm from the other, and create a baby with four parents.

Three prominent academics in medicine and law sounded an alarm about the possible consequences in a paper published this year.

I.V.G. may raise the specter of embryo farming on a scale currently unimagined, which might exacerbate concerns about the devaluation of human life, Dr. Eli Y. Adashi, a medical science professor at Brown; I. Glenn Cohen, a Harvard Law School professor; and Dr. George Q. Daley, dean of Harvard Medical School, wrote in the journal Science Translational Medicine.

Still, how soon I.V.G. might become a reality in human reproduction is open to debate.

I wouldnt be surprised if it was five years, and I wouldnt be surprised if it was 25 years, said Jeanne Loring, a researcher at The Scripps Research Institute in La Jolla who, with the San Diego Zoo, hopes to use I.V.G. to increase the population of the nearly extinct northern white rhino.

Loring said that when she discussed I.V.G. with colleagues who initially said it would never be used with humans, their skepticism often melted away as the talk continued. But not everyone is convinced that I.V.G. will ever become a regularly used process in human reproduction even if the ethical issues are resolved.

People are a lot more complicated than mice, said Susan Solomon, chief executive of the New York Stem Cell Foundation. And weve often seen that the closer you get to something, the more obstacles you discover.

I.V.G. is not the first reproductive technology to challenge the basic paradigm of baby-making. Back when in vitro fertilization was beginning, many people were horrified by the idea of creating babies outside the human body. And yet, I.V.F. and related procedures have become so commonplace that they now account for about 70,000, or almost 2 percent, of the babies born in the United States each year. According to the latest estimate, there have been more than 6.5 million babies born worldwide through I.V.F. and related technologies.

Of course, even I.V.F. is not universally accepted. The Catholic Church remains firm in its opposition to in vitro fertilization, in part because it so often leads to the creation of extra embryos that are frozen or discarded.

I.V.G. requires layers of complicated bioengineering. Scientists must first take adult skin cells other cells would work as well or better, but skin cells are the easiest to get and reprogram them to become embryonic stem cells capable of growing into different kinds of cells.

Then, the same kind of signaling factors that occur in nature are used to guide those stem cells to become eggs or sperm. (Cells taken from women could be made to produce sperm, the researchers say, but the sperm, lacking a Y chromosome, would produce only female babies.)

Last year, researchers in Japan, led by Katsuhiko Hayashi, used I.V.G. to make viable eggs from the skin cells of adult female mice, and produced embryos that were implanted into female mice, who then gave birth to healthy babies.

The process strikes some people as inherently repugnant.

There is a yuck factor here, said Arthur Caplan, a bioethicist at New York University. It strikes many people as intuitively yucky to have three parents, or to make a baby without starting from an egg and sperm. But then again, it used to be that people thought blood transfusions were yucky, or putting pig valves in human hearts.

Whatever the social norms, there are questions about the wisdom of tinkering with basic biological processes. And there is general agreement that reproductive technology is progressing faster than consideration of the legal and ethical questions it raises.

We have come to realize that scientific developments are outpacing our ability to think them through, Adashi said. Its a challenge for which we are not fully prepared. It would be good to be having the conversation before we are actually confronting the challenges.

Some bioethicists take the position that while research on early stages of human life can deepen the understanding of our genetic code, tinkering with biological mechanisms that have evolved over thousands of years is inherently wrongheaded.

Basic research is paramount, but its not clear that we need new methods for creating viable embryos, said David Lemberg, a bioethicist at National University in California. Attempting to apply what weve learned to create a human zygote is dangerous, because we have no idea what were doing, we have no idea what the outcomes are going to be.

Lewin writes for The New York Times.

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Growing an entire baby from skin cells could happen in a decade, scientists say - The San Diego Union-Tribune

Regenerative medicine: holy grail within grasp? – Gulf Times

By Uncategorized

With gene-editing techniques such as CRISPR-Cas9, offending genes could one day be snipped out of hematopoietic stem cells, then be returned to their owners to generate new lines of disease-free blood cells

New research has nudged scientists closer to one of regenerative medicines holy grails: the ability to create customised human stem cells capable of forming blood that would be safe for patients. Advances reported in the journal Nature could not only give scientists a window on what goes wrong in such blood cancers as leukaemia, lymphoma and myeloma, but they could also improve the treatment of those cancers, which affect some 1.2 million Americans. The stem cells that give rise to our blood are a mysterious wellspring of life. In principle, just one of these primitive cells can create much of a human beings immune system, not to mention the complex slurry of cells that courses through a persons arteries, veins and organs. While the use of blood-making stem cells in medicine has been common since the 1950s, it remains pretty crude. After patients with blood cancers have undergone powerful radiation and chemotherapy treatments to kill their cancer cells, they often need a bone-marrow transplant to rebuild their white blood cells, which are destroyed by that treatment. The blood-making stem cells that reside in a donors bone marrow and in umbilical cord blood that is sometimes harvested after a babys birth are called hematopoietic, and they can be life-saving. But even these stem cells can bear the distinctive immune system signatures of the person from whom they were harvested. As a result, they can provoke an attack if the transplant recipients body registers the cells as foreign. This response, called graft-versus-host disease, affects as many as 70 percent of bone-marrow transplant recipients in the months following the treatment, and 40 percent develop a chronic version of the affliction later. It can overwhelm the benefit of a stem cell transplant. And it kills many patients. Rather than hunt for a donor whos a perfect match for a patient in need of a transplant a process that can be lengthy, ethically fraught and ultimately unsuccessful doctors would like to use a patients own cells to engineer the hematopoietic stem cells. The patients mature cells would be reprogrammed to their most primitive form: stem cells capable of becoming virtually any kind of human cell. Then factors in their environment would coax them to become the specific type of stem cells capable of giving rise to blood. Once reintroduced into the patient, the cells would take up residence without prompting rejection and set up a lifelong factory of healthy new blood cells. If the risk of deadly rejection episodes could be eliminated, physicians might also feel more confident treating blood diseases that are painful and difficult but not immediately deadly diseases such as sickle cell disease and immunological disorders with stem cell transplants. The two studies published on Wednesday demonstrate that scientists may soon be capable of pulling off the sequence of operations necessary for such treatments to move ahead. One of two research teams, led by stem cell pioneer Dr George Q. Daley of Harvard Medical School and the Dana Farber Cancer Institute in Boston, started their experiment with human pluripotent stem cells primitive cells capable of becoming virtually any type of mature cell in the body. Some of them were embryonic stem cells and others were induced pluripotent stem cells, or iPS cells, which are made by converting mature cells back to a flexible state. The scientists then programmed those pluripotent stem cells to become endothelial cells, which line the inside of certain blood vessels. Past research had established that those cells are where blood-making stem cells are born. Here, the process needed a nudge. Using suppositions gleaned from experiments with mice, Daley said his team confected a special sauce of proteins that sit on a cells DNA and programme its function. When they incubated the endothelial cells in the sauce, they began producing hematopioetic stem cells in their earliest form. Daleys team then transferred the resulting blood-making stem cells into the bone marrow of mice to see if they would take. In two out of five mice who got the most promising cell types, they did. Not only did the stem cells establish themselves, they continued to renew themselves while giving rise to a wide range of blood cells. A second research team, led by researchers from Weill Cornell Medicines Ansary Stem Cell Institute in New York, achieved a similar result using stem cells from the blood-vessel lining of adult mice. After programming those cells to revert to a more primitive form, the scientists also incubated those stem cells in a concoction of specialised proteins. When the team, led by Raphael Lis and Dr Shahin Rafii, transferred the resulting stem cells back into the tissue lining the blood vessels of the mice from which they came, that graft also took. For at least 40 weeks after the incubated stem cells were returned to their mouse owners, the stem cells continued to regenerate themselves and give rise to many blood-cell types without provoking immune reactions. In addition to making a workhorse treatment for blood cancers safer, the new advances may afford scientists a unique window on the mechanisms by which blood diseases take hold and progress, said Lee Greenberger, chief scientific officer for the Leukemia and Lymphoma Society. From a research point of view you could now actually begin to model diseases, said Greenberger. If you were to take the cell thats defective and make it revert to a stem cell, you could effectively reproduce the disease and watch its progression from the earliest stages. That, in turn, would make it easier to narrow the search for drugs that could disrupt that disease process early. And it would speed the process of discovering which genes are implicated in causing diseases. With gene-editing techniques such as CRISPR-Cas9, those offending genes could one day be snipped out of hematopoietic stem cells, then be returned to their owners to generate new lines of disease-free blood cells. But Daley cautioned that significant hurdles remain before studies like these will transform the treatment of blood diseases. We do know the resulting cells function like blood stem cells, but they still are at some distance, molecularly, from native stem cells, he said. By tinkering with the processes by which pluripotent stem cells mature into blood-producing stem cells, Daley said his team hopes to make these lab-grown cells a better match for the real things. Los Angeles Times/TNS

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Regenerative medicine: holy grail within grasp? - Gulf Times

Cancer Therapy May Work in Unexpected Way – Technology Networks

By Uncategorized

An antibody to the cell receptor PD-1 may launch a two-pronged assault on cancer by initiating attacks by both T cells and macrophages, a Stanford study has found.

Antibodies to the proteins PD-1 and PD-L1 have been shown to fight cancer by unleashing the bodys T cells, a type of immune cell. Now, researchers at the Stanford University School of Medicine have shown that the therapy also fights cancer in a completely different way, by prompting immune cells called macrophages to engulf and devour cancer cells.

The finding may have important implications for improving and expanding the use of this cancer treatment, the researchers said.

A study describing the work, which was done in mice, was published online May 17 in Nature. The senior author is Irving Weissman, MD, professor of pathology and of developmental biology. The lead author is graduate student Sydney Gordon.

PD-1 is a cell receptor that plays an important role in protecting the body from an overactive immune system. T cells, which are immune cells that learn to detect and destroy damaged or diseased cells, can at times mistakenly attack healthy cells, producing autoimmune disorders like lupus or multiple sclerosis. PD-1 is whats called an immune checkpoint, a protein receptor that tamps down highly active T cells so that they are less likely to attack healthy tissue.

How cancer hijacks PD-1

About 10 years ago, researchers discovered that cancer cells learn to use this immune safeguard for their own purposes. Tumor cells crank up the production of PD-L1 proteins, which are detected by the PD-1 receptor, inhibiting T cells from attacking the tumors. In effect, the proteins are a dont kill me signal to the immune system, the Stanford researchers said. Cancer patients are now being treated with antibodies that block the PD-1 receptor or latch onto its binding partner, PD-L1, to turn off this dont kill me signal and enable the T cells attack.

Using antibodies to PD-1 or PD-L1 is one of the major advances in cancer immunotherapy, said Weissman, who is also the Virginia and D.K. Ludwig Professor for Clinical Investigation in Cancer Research, director of the Stanford Institute for Stem Cell Biology and Regenerative Medicine and director of the Ludwig Center for Cancer Stem Cell Research and Medicine at Stanford. While most investigators accept the idea that anti-PD-1 and PD-L1 antibodies work by taking the brakes off of the T-cell attack on cancer cells, we have shown that there is a second mechanism that is also involved.

What Weissman and his colleagues discovered is that PD-1 activation also inhibits the anti-cancer activity of other immune cells called macrophages. Macrophages that infiltrate tumors are induced to create the PD-1 receptor on their surface, and when PD-1 or PD-L1 is blocked with antibodies, it prompts those macrophage cells to attack the cancer, Gordon said.

Similar to anti-CD47 antibody

This mechanism is similar to that of another antibody studied in the Weissman lab: the antibody that blocks the protein CD47. Weissman and his colleagues showed that using anti-CD47 antibodies prompted macrophages to destroy cancer cells. The approach is now the subject of a small clinical trial in human patients.

As it stands, its unclear to what degree macrophages are responsible for the therapeutic success of the anti-PD-1 and anti-PD-L1 antibodies.

The practical implications of the discovery could be important, the researchers said. This could lead to novel therapies that are aimed at promoting either the T-cell component of the attack on cancer or promoting the macrophage component, Gordon said.

Another implication is that antibodies to PD-1 or PD-L1 may be more potent and broadly effective than previously thought. In order for T cells to attack cancer when you take the brakes off with antibodies, you need to start with a population of T cells that have learned to recognize specific cancer cells in the first place, Weissman said. Macrophage cells are part of the innate immune system, which means they should be able to recognize every kind of cancer in every patient.

Other Stanford co-authors of the study are associate professor of pathology Andrew Connolly, MD, PhD; visiting scholar Gregor Hutter, MD, PhD; instructor Rahul Sinha, PhD; postdoctoral scholars Roy Maute, PhD, Daniel Corey, MD, and Melissa McCracken, PhD; graduate students Benjamin Dulken, Benson George and Jonathan Tsai; and former graduate student Aaron Ring, MD, PhD.

The research was supported by the D.K. Ludwig Fund for Cancer Research, the A.P. Giannini Foundation, the Stanford Deans Fellowship, the National Institutes of Health (grant GM07365), the Swiss National Science Foundation and the National Center for Research Resources.

Weissman is a founder of the company Forty Seven Inc., which is sponsoring the clinical trial of the anti-CD47 antibody.

This article has been republished frommaterialsprovided by Stanford University Medical Center. Note: material may have been edited for length and content. For further information, please contact the cited source.

Reference

Gordon, S. R., Maute, R. L., Dulken, B. W., Hutter, G., George, B. M., McCracken, M. N., ... & Ring, A. M. (2017). PD-1 expression by tumour-associated macrophages inhibits phagocytosis and tumour immunity. Nature.

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Cancer Therapy May Work in Unexpected Way - Technology Networks

Caution urged in using PRP or stem cells to treat young athletes’ injuries – Science Daily

By Stem Cell Treatment
Caution urged in using PRP or stem cells to treat young athletes' injuries
Science Daily
"Evidence from laboratory and veterinary research suggests that mesenchymal stem cells (MSC) may provide an alternative treatment option for conditions that affect muscle, tendons, ligaments, and cartilage," said the authors. "This evidence, however ...

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Caution urged in using PRP or stem cells to treat young athletes' injuries - Science Daily

Patient uses fat stem cells to repair his wrist – CNN

By Stell Cell Research

He was tired of the daily pain that made even shaking someone's hand almost unbearable.

Marlette lost his arm in an accident when he was a teenager, but as an active kid, he didn't this slow him down. He continued to play football and golf, running track and even wrestling.

But over time, the strain on his remaining arm and wrist took a toll.

So to relieve his pain, he traveled from Sioux Falls, South Dakota, to Munich, Germany, with the hopes that a special procedure using stem cells could make a difference.

"There's no cartilage," Marlette said of his wrist. "I'm bone-on-bone. It is constantly inflamed and very sore."

As Marlette grew older, even the simplest things, like tucking in his shirt or putting on a jacket, became incredibly painful.

Marlette developed cysts and holes in the bones of his wrist. Doctors prescribed anti-inflammatory medications, but they only managed the pain, doing nothing to actually heal the problem. One day, his doctor, Dr. Bob Van Demark at Sanford Health in South Dakota, where Marlette works in finance, saw a presentation by Dr. Eckhard Alt.

It was about a new treatment using stem cells.

"Following an infection or wound or trauma," Alt said, "there comes a call to the stem cells in the blood vessels, which are silent, and nature activates those cells."

Stem cells are located throughout our bodies, like a reserve army offering regeneration and repair. When we're injured or sick, our stem cells divide and create new cells to replace those that are damaged or killed. Depending on where the cells are in the body, they adapt, becoming specialized as blood cells, muscle cells or brain cells, for example.

Alt was the first person to use adipose tissue, or fat, as a prime source of stem cells, according to Dr. David Pearce, executive vice president for research at Sanford health.

"He observed that the simplest place to get some stem cells is really from the fat," said Pearce. "Most of us could give some fat up, and those stem cells don't have to be programmed in any way, but if you put in the right environment, they will naturally turn into what the cell type around them is."

Fat tissue has a lot of blood vessels, making it a prime source of stem cells, and Alt recognized that stem cells derived from adipose tissue are also particularly good at becoming cartilage and bone.

Bone marrow is another source of stem cells, but these easily turn into blood and immune cells. Stem cells from fat have another fate.

"Fat-derived stem cells have a different lineage they can turn into, that is really cartilage and bone and other sort of connective tissues," said Pearce.

Van Demark traveled to Alt's Munich clinic along with some doctors from Sanford, which is now partnering with Alt on clinical trials in the United States. Marlette's doctor was impressed with what he saw and recommended the treatment to his patient.

Marlette paid his own way to Munich, where he would receive an injection of stem cells from his own fat tissue.

"I had one treatment, and my wrist felt better almost within the next couple weeks," Marlette said. "Through the course of the next seven months, it continued to feel better and better."

One injection was enough for this ongoing improvement.

"We see (from an MRI scan) that those cysts are gone, the bone has restructured, the inflammation is gone, and he formed ... new cartilage," said Alt.

MRIs confirmed what he was feeling: The cartilage had begun to regenerate in his wrist. Because the procedure uses autologous cells, which are cells from the patient's own body, there's little to no chance of rejection by the body's immune system.

Though the procedure worked for Marlette, the use of stem cells as a form of treatment is not without controversy or risk. In the US, they have been mired in controversy because much of the early research and discussion has been centered around embryonic and fetal stem cells.

Marlette traveled to Germany because approved treatments like this are not available in the United States. Clinics have popped up across the country, but they lack oversight from the Food and Drug Administration.

Dr. Robin Smith, founder of the Stem for Life Foundation, first began working in this field 10 years ago. According to Smith, there were 400 clinical trials for stem cells when she first started; now, there are 4,500. She partnered with the Vatican to hold a stem cell conference last year.

"We're moving toward a new era in medicine," said Smith, who was not involved in this research. "(We are) recognizing cells in our body and immune system can be used in some way -- manipulated, redirected or changed at the DNA level -- to impact health and cure disease. It is an exciting time."

Dr. Nick Boulis is a neurosurgeon with Emory University in Atlanta. His team ran the first FDA-approved clinical trials in the US to inject stem cells in the spinal cords of patients with ALS, better known as Lou Gehrig's disease, and he isn't surprised to see procedures like the one at Alt's clinic in Germany have success.

"Joints and bones heal," Boulis said. "The nervous system is very bad at healing. It doesn't surprise me that we're seeing successes in recapitulating cartilage before we're seeing successes in rebuilding the motherboard."

Smith also cautioned patients to do their research, especially about the types of cells being used. "When you have a health problem, and you need a solution, sometimes you don't have three five, seven years to get there," she said, referencing the slow progression of regulations in places like the United States.

"So really ,look for places that have the regulatory approval of the country they're in. Safety has to be number one," she said.

Alt's Munich clinic was approved by the European equivalent of the FDA, the European Medicines Agency. Through the partnership with Sanford, the health group is now launching clinical trials in America, focusing on rotator cuff injuries, a common shoulder injury. This is the first FDA-approved trial of its kind.

Further down the line, Alt hopes to see stem cells used for such issues as heart procedures and treating the pancreas to help diabetics. For him, the growth is limitless.

"I think it will be exponential," he said. "It will be the same thing (we saw) with deciphering the human genome. The knowledge will go up exponentially, and the cost will go exponentially down. For me, the most exciting thing is to see how you can help patients that have been desperate for which there was no other option, no hope, and how well they do."

For Marlette, it has meant a wrist free from pain and a life free from pain medication.

Since the procedure in August, he hasn't taken any of the anti-inflammatory drugs. "I have more range of motion with my wrist, shaking hands didn't hurt anymore," he said. "My wrist seems to continue to improve, and there's less and less pain all the time."

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Patient uses fat stem cells to repair his wrist - CNN

‘Stem cell therapy offers me a glimmer of hope, but my date with … – Herald Scotland

By Stem Cell Treatment

Well, unfortunately I am still alive.

Dying can become unexpectedly complicated.

The TV crew filming the story of my final journey to Switzerland completed the initial shoot this week in my home town of Inverness.

The producer, cameraman and lighting technician were accompanied by Alexander - he is a 63-year-old man diagnosed with dementia who is also considering voluntary assisted suicide in Switzerland.

Along with us enjoying liquid highland hospitality many thoughts on death were discussed.

I was asked what I expected would happen after I died. I said oblivion is my expectation although I respect that many believe in an afterlife. And whilst being greeted by more than twenty beautiful virgins is the expectation of some it is definitely not something I believe will happen to me..

Inevitably the opposers of voluntary assisted suicide continue to seek to deny a change in the law. Their argument is care not killing which from my experience is meaningless. I have been offered no support in obtaining ground floor accommodation - I am an MS suffer who lives in an upstairs flat. Similarly, outwith the hospital I have been offered no care. I recall my recent discharge from hospital at the height of the flu season. For that reason I was in a single room rather than a ward. The nurse tied on a face mask to me then helped me into a wheelchair which she pushed down to the taxi rank on the ground floor. There were no ambulances available so a nervous looking taxi driver would have to take me back to my flat.

The fact that I am in a second floor flat which is in a listed building without permission to instal a lift offered me the chance for some humorous scenarios with the film makers. Whilst the film makers were at the foot of the stairs I told them this was their base camp.

They would film me bravely making a solo and hazardous attempt to reach the summit - in imagined deteriorating weather conditions. They filmed my uncertain efforts to climb ahead until I vanished from sight into a snowstorm. Eventually they met me seated in a chair at the summit and we regretted we did not have a flag with us to mark the achievement.

Back to grim reality, and I remain very much the condemned man alone in his cell on death row.

Each day continues with the challenge of holding onto a zimmer frame as I try to get dressed without falling over. Then it is through to the bathroom for a quick shower before my legs time out.

Now seated safely in a chair I use my electric shaver as leg tremor makes razor blade shaves unsafe.

For the moment, I do not require assistance with toileting and I do not yet have any difficulties with swallowing liquids. I am, though, aware that eventually choking whilst trying to swallow liquids is a likely outcome.

As I do not have any carers I survive on microwave meals.

I try not to watch too much TV and when I do watch TV it is mostly news and documentaries and some comedies. And listening to all types of music is a great joy for me. I am attempting not to add any more songs to my iTunes purchased collection which is now at 502 songs.

And a peaceful conclusion to my day is 10 minutes of improvised melodic acoustic guitar.

Bed time for me is strictly at 10pm as it requires about 15 minutes preparation to safely get into bed. I then read for about 15 minutes before falling asleep.

As an former IT specialist, much of this week has been taken up emailing old IT colleagues to lament the failings of IT staff in having not been proactive in countering the WannaCry ransom ware computer virus that hit the NHS. Incredibly it seems that the failure of regular patching of now unsupported Microsoft operating systems has made things worse. Microsoft always give plenty advance notice of withdrawing support for its older operating systems. Ten years since release date is usually the end of support for older software.

The cyber attack inevitably inspired me to update my website hosted by the excellent Go Daddy.com where I talk and write about the things I love: friends, music, blues guitar, and beer. It is much more relevant to me than Facebook.

Unsurprisingly my website is named seekingoblivion.com ...

Towards the end of this week my landlord considerately persuaded me to seek stem cell treatment with Swiss Medica. They say they presently cannot cure multiple sclerosis but the stem cell treatment will improve mobility and halt progression. I have now chosen to defer but not cancel my plan for assisted suicide in Switzerland.

My treatment with Swiss Medica will probably involve several weeks at their Belgrade clinic.

Depending on the outcome of the treatment I will decide whether or not to complete my original intention of voluntary assisted suicide with Lifecircle in Switzerland on June 15.

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'Stem cell therapy offers me a glimmer of hope, but my date with ... - Herald Scotland

Stem-cell transplants show limited benefit for double-hit lymphoma patients in remission – Science Daily

By Stem Cell Medical Center

Patients with double hit lymphoma (DHL) who undergo autologous stem-cell transplantation (autoSCT) after achieving remission are not more likely to remain in remission or live longer than patients who do not undergo autoSCT, according to a new analysis from the Perelman School of Medicine and the Abramson Cancer Center of the University of Pennsylvania. The study looked at long term outcomes for patients who achieved remission and, in most cases, found no clear benefit to the transplant, except potentially in patients who received standard front-line chemotherapy, who were less likely to remain in remission than those patients receiving intensive front-line chemotherapy. The findings are published this month in the Journal of Clinical Oncology.

DHL is a form of aggressive B cell non-Hodgkin lymphoma characterized by genetic alterations that drive the lymphoma's growth. This variant is associated with a poor prognosis as compared to other forms of aggressive B cell lymphomas, as patients with this disease survive only an average of two years after diagnosis. Relapses of this disease are almost always fatal, meaning that keeping patients in remission is crucial.

"A major dilemma for oncologists who treat this disease was whether or not to recommend the potentially harmful therapy of autoSCT to patients with this disease a strategy to help keep them in remission," said Daniel J. Landsburg, MD, an assistant professor of Hematology Oncology at Penn and the study's lead author.

Landsburg and his team looked at data on 159 patients from 19 different academic medical centers across the United States. Patients were diagnosed between 2006 and 2015, and all achieved remission following intensive front-line chemotherapy or the standard chemotherapy regimen containing rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Of the total patients, 62 underwent an autoSCT, while 97 did not. Landsburg noted that there were no significant differences between the patient groups at baseline.

"Our result is not explained by differences in patients' overall health or disease features," Landsburg said. "The transplant and non-transplant arms of this study were very well-matched."

Overall, 80 percent of the patients were still in remission three years later, and 87 percent were still alive. When researchers broke the patients into two groups, autoSCT and no autoSCT, they found 89 percent of autoSCT patients were still in remission at three years, as were 75 percent of patients who did not receive an autoSCT. Also at three years, 91 percent of autoSCT patients were still alive, compared to 85 percent of non-autoSCT patients. None of these differences were found to be statistically significant.

"Once these patients achieve remission, the data show they are likely to stay in remission," Landsburg said. "In the absence of a large randomized controlled trial, which would be very challenging to carry out in this case, this is the best evidence we have, and it shows there's no clear benefit to these patients undergoing autoSCT."

Landsburg did point to one exception in the data, and that was in patients who underwent RCHOP, the standard front-line chemotherapy regimen. Just 56 percent of them were still in remission at three years, far lower than patients who received the more intensive front-line therapies.

"Even if patients do go into remission with RCHOP, it appears to be less durable, so in these cases, going forward with autoSCT may still make sense," Landsburg said.

Landsburg says the next step will be to study features of patients who don't go into remission in order to understand why their disease is resistant to therapy and if that can be overcome with different treatment strategies. He says it's also important to try to find more effective therapies for DHL patients who relapse.

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Stem-cell transplants show limited benefit for double-hit lymphoma patients in remission - Science Daily

Rosario: Once a migrant worker, he’s revolutionizing brain surgery, cancer fight – TwinCities.com-Pioneer Press

By Stem Cell Clinic

Dr. Qs eyes widen and the hands that once picked grapes and now perform surgeries spring into action. He explains in laymans terms how he and a plastic surgeon teamed up to perform anterior brain tumor removals through an incision on the eyelid.

The way traditional surgery has been done is to remove the scalp forward, and then you do the removal of the bone, and then you take the tumor out, Dr. Alfredo Quiones-Hinojosa explained during a chat Thursday at a hotel in downtown Rochester, Minn.

Now, he explained, the plastic surgeon teammate makes the same incision used for movie stars when their eyelids get droopy. And tumors as large as three centimeters have been excised through this eyebrow-raising technique.

The method reduces, if not eliminates, cranial trauma and retraction of the brain. He has done 60 to 70 such operations in the past five years.

Supremely impressive. The same could be said of Quiones-Hinojosa, who now serves as chair of Neurologic Surgery at the Mayo Clinic complex in Jacksonville, Fla. Colleagues tagged him with that catchy Dr. Q monikeryears ago.

On New Years Day 1987, Quiones-Hinojosa, in pursuit of a dream he felt he could not realize in his native Mexico, scaled an 18-foot barbed wire fence at the U.S.-Mexico border.He was 19.

He began work picking grapes, cotton, cantaloupe, tomatoes and other crops. Twelve years later, he graduated with honors from Harvard Medical School.

Hard work, resiliency, perseverance, never giving up on your dreams are the same principles then that keep me going today as a brain surgeon, scientist, professor, philanthropist and entrepreneur, he said.

As a migrant worker, I worked with my hands and brains, he added. The difference is that the stakes are much higher, because back then I only had my life in my hands. I now have the lives of patients in my hands

The oldest of six children, the 49-year old father of three grew up dirt poor in a small village outside Mexicali in Baja California. The family plunged into further poverty after his father lost his gas station.

Alfredo went to school barefoot at times.

Wanting to help his family, Quiones-Hinojosa was barely 15 when he went to work for an uncle at a migrant farm in Mendota, Calif. He spent the summer months weeding fields and picking cotton and produce. He would return home to Mexico with $1,000, most of which he gave to his parents to make ends meet.

He obtained a teaching license when he was 19 years old. But he had a dream of becoming a doctor a goal inspired by his maternal grandmother, a curandera, Spanish for village healer. He realized America gave him the better shot to achieve it.

Border agents had confiscated his Mexican passport at a checkpoint after learning that he had illegally worked in the U.S. with only a tourist visa.

As he described in his memoir, Becoming Dr. Q: My Journey from Migrant Farm Worker to Brain Surgeon (University of California Press, 2011), Quiones-Hinojosa scaled the fence separating Mexicali from Calexico, Calif. But he was caught by border agents and sent back.

He waited a few hours and climbed over the fence again. A cousin drove him to San Diego, where he bought an airline ticket to Los Angeles with no ID.

It was very different then, he recalled.

Broke and unable to speak a word of English, he slept inside the terminal and ate food travelers had left on tables until another cousin showed up two days later for the ride to the farms in Mendota.

Quiones-Hinojosa worked as a migrant for two years and then landed a job as a welder and cleaner with a railroad company. He nearly lost his life at age 21 when he fell 18 feet into a railroad tanker and was overcome by petroleum fumes. He was pulled up barely conscious and taken to a nearby hospital.

He juggled work and studies at a community college while homeless and living in a small camper trailer with a leaky roof. There were days he woke up drenched.

We are equipping (stem cells body fat), training them, arming them with special tools so we can put them back in humans and fight all kinds of cancer.

At the urging of a friend, Quiones-Hinojosa applied to the University of California at Berkeley. He was accepted. With the help of a scholarship, hemajored in psychology and took several calculus, physics and chemistry classes to boost his grade-point average.

He wrote an honors thesis on neuroscience and was accepted to Harvard Medical School. He married and became a U.S. citizen during his time there. He graduated with honors in 1999 and was the class valedictorian.

He had long resisted the naysayers, the ones who would say Youre not Mexican. You are too smart, or even friends who told him that schools like Harvard were only for the elite, not for Mexican migrant and manual laborers like him. His dream would not let him quit.

Following a residency in San Francisco, Quiones-Hinojosa joined the staff at Johns Hopkins in Baltimore in 2005 as a professor of neurological surgery and oncology. He has served as director of both the brain tumor surgery and pituitary surgery programs at the medical center. And he has authored several textbooks on stem-cell biology and neurosurgical techniques.

Quiones-Hinojosa joined the Mayo team eight months ago, where he teaches and also heads a team of scientists working on a potentially promising way fight to fight cancer: stem cells extracted from a persons fat.

We are equipping them, training them, arming them with special tools so we can put them back in humans and fight all kinds of cancer, said Quiones-Hinojosa, who came to Minnesota this past week to make a presentation on the research.

Lab results, in which human cancer cells have been injected into animals and then treated with the fat cells, have been unbelievably positive. We have cured cancer in animals, he said.

He believes it will take another two or three years before the procedure may be done on a human patient at the Mayo Clinic.

Quiones-Hinojosa acknowledges that individuals and groups have pressured him to speak out on the immigration debate.

I always tell people that these are complex issues, he said. I am not an expert on immigration. I know about cancer. I know about brain surgery. I know about cell migration. My responsibility is not so much to talk about immigration but to serve as a role model for all those people who have come to this country with a dream to make this world a better place.

A movie production company headed by Brad Pitt is working on a movie based on his life. The script is scheduled to be completed by this summer. Casting will follow.

I ask Quiones-Hinojosa if he would like Brad Pitt to play him.

No, he chuckled. Hes too good-looking.

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Rosario: Once a migrant worker, he's revolutionizing brain surgery, cancer fight - TwinCities.com-Pioneer Press

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