Stem Cell Clinic

Erica Keane – High School Stem Cell Research Intern June 2013 – Video

Erica Keane - High School Stem Cell Research Intern June 2013
The CIRM Creativity Awards support summer internship programs that introduce high school students to stem cell science and foster the next generation of scie...

By: California Institute for Regenerative Medicine

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Erica Keane - High School Stem Cell Research Intern June 2013 - Video

Ariana Gonzalez- High School Stem Cell Research Intern June 2013 – Video

Ariana Gonzalez- High School Stem Cell Research Intern June 2013
The CIRM Creativity Awards support summer internship programs that introduce high school students to stem cell science and foster the next generation of scie...

By: California Institute for Regenerative Medicine

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Ariana Gonzalez- High School Stem Cell Research Intern June 2013 - Video

No trace of HIV after stem-cell transplants, researchers say

By Dennis Thompson HealthDay Reporter

WEDNESDAY, July 2 (HealthDay News) -- Two HIV-positive patients show no trace of virus after receiving chemotherapy and stem-cell transplants as treatment for lymphoma, according to new research.

These patients have become the second and third known cases of a "sterilizing cure," in which medical treatment removes all traces of HIV -- the virus that causes AIDS -- from the body. They have remained virus-free even though doctors months ago took them off their HIV-targeted medications.

"We have been unable to detect virus in either the blood cells or the plasma of these patients," said lead researcher Dr. Timothy Henrich, of Harvard Medical School and Brigham and Women's Hospital in Boston. "We also biopsied gut tissue from one of our patients, and we were unable to detect HIV in the cells of the gut. Essentially, we do not have any evidence of viral rebound."

The findings are scheduled for presentation Wednesday at the International AIDS Society Conference in Kuala Lumpur, Malaysia.

The patients had been receiving long-term antiretroviral therapy for HIV when they developed lymphoma, a type of blood cancer involving white blood cells, Henrich said.

Both underwent chemotherapy followed by bone marrow transplants to cure their lymphoma. Afterward, Henrich could not detect any HIV infection in their bodies.

Henrich presented preliminary findings on the research at the International AIDS Conference last July. Since then, he and his research team withdrew the patients' antiretroviral therapy to see how completely the cancer treatment had rid them of HIV. One patient has been off treatment with no detectable virus for about 15 weeks, and the second patient for seven weeks.

Henrich warned that it is too soon to declare the patients completely cured of HIV. "Although we cannot detect HIV, it's possible it's there but in extremely low amounts," he said. "We're going to watch and wait, and see where it goes with these patients."

Unfortunately, this type of cure is not something that can be put into widespread practice for all people infected with HIV. "Transplantation is not a scalable, affordable or even safe treatment for HIV patients," Henrich said.

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No trace of HIV after stem-cell transplants, researchers say

Two stem cell transplant recipients now controlling HIV off treatment

Two people with HIV who received stem cell transplants for the treatment of lymphoma are now controlling HIV replication without medication in the early weeks of treatment interruption, following the discovery that both had experienced loss of detectable HIV DNA, researchers from Boston reported on Wednesday at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.

Although the treatment patterns of the two patients bear some similarities to the 'Berlin patient' who experienced a 'functional cure' of HIV infection after aggressive chemotherapy, immunosuppressive treatment and a bone marrow transplant from a donor with genetic resistance to HIV the 'Boston patients' also differ in several respects, which could provide important clues about how remission from active HIV infection could be achieved in other people with longstanding HIV infection.

The findings were reported by Timothy Henrich of Brigham and Womens Hospital, Boston, who has led the team conducting extensive tests on the patients. They concern a small group of people with HIV who were evaluated after hematopoietic stem cell transplants for lymphoma at hospitals in Boston (transfer of stem cells that will replace all blood cells, derived the from genetically matched donors). Three patients were originally evaluated but one died of recurrent Hodgkin's lymphoma six months after the transplant.

Both the surviving patients had been receiving prolonged antiretroviral therapy and received stem cell transplants with a reduced-intensity conditioning regimen of chemotherapy designed to eradicate the cancer and eliminate the existing bone marrow. In the case of the two patients under investigation, the conditioning regimen did not include radiotherapy and it did not eliminate the residual lymphocyte population. In contrast, the 'Berlin patient' received a much more aggressive regimen which eliminated existing bone marrow cells.

The transplants also differed from the 'Berlin patient' because they did not come from donors with genetic resistance to HIV infection (a CCR5 delta 32 mutation), so the cells were susceptible to HIV infection.

Measurements of HIV DNA showed that, around 200 days after transplant, HIV DNA levels had declined below 50 log copies per million PBMCs (peripheral blood mononuclear cells, part of the immune system) in one patient, while HIV DNA fell below this level around 280 days after transplant in the other patient. In both cases, HIV DNA levels have continued to decline after this point. After transplantation, the two patients have been followed for 21 (patient A) and 42 months (patient B), respectively.

More sensitive HIV DNA testing using larger samples of blood obtained by leukapheresis and rectal tissue biopsy showed that HIV DNA was below the limit of detection in both patients. Patient A provided a sample of 25 million PBMCs, and testing with a limit of detection of 0.07 copies per million PBMCs failed to detect HIV DNA. Patient B provided a sample of 50 million PBMCs, and testing with a limit of detection of 0.01 international units per million PBMCs similarly failed to detect HIV DNA.

Viral co-culture from CD4 lymphocytes failed to detect HIV in either patient. A rectal biopsy in patient B failed to detect HIV DNA in rectal cells that would be expected to provide a reservoir for HIV (limit of detection 2 copies per million cells).

After establishing that HIV DNA could not be detected, the researchers conducted extensive discussions with the patients and healthcare providers over a six-month period about the acceptability of an experimental treatment interruption in order to test viral control off medication.

Both patients consented after review of the study protocol by an internal review board. The patients are now being intensively monitored with weekly viral load (RNA) tests and bi-weekly testing of HIV DNA in PBMCs and, after six to eight weeks, the patients gave large volumes of blood for more sensitive analysis of HIV DNA. Leukapheresis will be repeated every three months.

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Two stem cell transplant recipients now controlling HIV off treatment

Stem Cell Transplants Clear HIV in Two Patients in Study

Two cancer patients in Boston who were also infected with HIV have no trace of the virus after receiving stem-cell transplants, suggesting they may have been cured of the AIDS-causing infection.

The two patients, treated at Brigham and Womens Hospital, stopped HIV treatment after the transplants, which in other patients has opened the door for the virus to come roaring back. In one patient there was no sign of the virus 15 weeks after stopping treatment, while the other has gone seven weeks without HIV rebounding, according to results presented today at the International AIDS Societys meeting in Kuala Lumpur.

The researchers led by Timothy Henrich of Harvard Medical School and Brigham and Womens Hospital said its too early to conclude the two men have been cured and the virus may be lingering in their brains or gut. Still, their cases are similar to that of Timothy Brown, the so-called Berlin patient, who was the first person to be cured of HIV after getting a bone marrow transplant for leukemia in 2007.

While stem-cell transplantation is not a viable option for people with HIV on a broad scale because of its costs and complexity, these new cases could lead us to new approaches to treating, and ultimately even eradicating, HIV, Kevin Robert Frost, the chief executive officer of amfAR, The Foundation for AIDS Research, which funded the study, said in a statement.

There was one main difference between Brown and the two Boston men: the cells he received contained a rare genetic mutation called CCR5 that made him resistant to HIV infection. The donors in the new cases lacked that mutation, and the Boston patients didnt undergo the intensive chemotherapy Brown did.

Scientists had believed the CCR5 mutation was key to Brown being cured. Theyll be searching through the new results for clues to whether other genes may hold promise against HIV, Rowena Johnston, amfARs director of research, said in an e-mail.

This stuff is really very exciting scientifically, and it really captures the imagination of the patients, said Paul E. Sax, a professor of medicine at Harvard Medical School and a clinician at Brigham and Womens. All of us get asked by our patients about these cases, even to the point of people actually requesting bone marrow transplants.

While AIDS drugs such as Gilead Sciences Inc. (GILD)s Atripla reduce HIV to undetectable levels in the body, making it a chronic disease, they dont completely clear it. The virus hides in certain immune cells, where it switches off the normal process of replication. That enables HIV to avoid detection by the medicines, which are designed to block steps in its reproduction.

Studies have shown that when patients who have the virus under control stop treatment, latent HIV reactivates and comes roaring back, forcing victims to resume daily pill therapy.

Doctors in March said they had cured an infant born with HIV for the first time by treating her with AIDS drugs about 30 hours after she was born at a rural Mississippi hospital. At 18 months the mother took the child off medication, and when the virus had not returned 10 months later, she was deemed functionally cured.

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Stem Cell Transplants Clear HIV in Two Patients in Study

Italian stem-cell trial based on flawed data

The controversial stem cell therapy has garnered fervent public support, while many scientists decry it as unproven.

MMaurizio D'Avanzo/Milestone/Empics Entertainment

Davide Vannoni, a psychologist turned medical entrepreneur, has polarized Italian society in the past year with a bid to get his special brand of stem-cell therapy authorized. He has gained fervent public support with his claims to cure fatal illnesses and equally fervent opposition from many scientists who say that his treatment is unproven.

Now those scientists want the Italian government to pull out of a 3-million (US$3.9-million) clinical trial of the therapy that it promised to support in May, after bowing to patient pressure. They allege that Vannoni's method of preparing stem cells is based on flawed data.

And Nature's own investigation suggests that images used in the 2010 patent application, on which Vannoni says his method is based, are duplicated from previous, unrelated papers.

The trial is a waste of money and gives false hope to desperate families, says Paolo Bianco, a stem-cell researcher at the University of Rome and one of the scientists who says that Vannonis 2010 application to the US patent office does not stand up to scrutiny.

I am not surprised to learn this, says Luca Pani, director-general of the Italian Medicines Agency (AIFA), which suspended operations at the Brescia-based laboratories of Vannoni's Stamina Foundation in May 2012, after inspectors concluded that the labs would not be able to guarantee contamination-free preparations of stem cells. Inspectors were not shown systematic methodologies or protocols. We saw such chaos there, I knew that a formal method wouldnt exist, he says.

But questions raised over the patent that underpins the methodology needed for the trial could be political dynamite.

Well over 100 people with conditions ranging from Parkinson's to motor neuron disease to coma nearly half of them children have already signed up to participate in the government-sponsored trial, despite there being no published evidence that the therapy could be effective.

The Stamina Foundation has been given permission to treat more than 80 people on compassionate grounds since 2007, and Vannoni who has not published follow-up data on patients says that hundreds more were lined up waiting for treatment when the lab's operations were suspended. Supporters held angry demonstrations up and down Italy earlier this year.

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Italian stem-cell trial based on flawed data

Stem-cell therapy wipes out HIV in two patients

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Stem-cell therapy wipes out HIV in two patients

2 stem cell patients stop HIV treatment, no virus seen

Two HIV-positive patients in the United States who underwent bone marrow transplants for cancer have stopped anti-retroviral therapy and still show no detectable sign of the HIV virus, researchers said Wednesday.

The Harvard University researchers stressed it was too early to say the men have been cured, but said it was an encouraging sign that the virus hasn't rebounded in their blood months after drug treatment ended.

The first person reported to be cured of HIV, American Timothy Ray Brown, underwent a stem cell transplant in 2007 to treat his leukemia. He was reported by his German doctors to have been cured of HIV two years later.

Brown's doctors used a donor who had a rare genetic mutation that provides resistance against HIV. So far, no one has observed similar results using ordinary donor cells such as those given to the two patients by the Harvard University researchers.

The researchers, Timothy Henrich and Daniel Kuritzkes of the Harvard-affiliated Brigham and Women's Hospital in Boston, announced last year that blood samples taken from the men - who both had blood cancers - showed no traces of the HIV virus eight months after they received bone marrow transplants to replace cancerous blood cells with healthy donor cells. The men were still on anti-HIV drugs at the time.

The men have both since stopped anti-retroviral therapy - one 15 weeks ago and the other seven weeks ago - and show no signs of the virus, Henrich told an international AIDS conference in Malaysia on Wednesday.

"They are doing very well," Henrich said. "While these results are exciting, they do not yet indicate that the men have been cured. Only time will tell."

The HIV virus may be hiding in other organs such as the liver, spleen or brain and could return months later, he warned.

Further testing of the men's cells, plasma and tissue for at least a year will help give a clearer picture on the full impact of the transplant on HIV persistence, he said.

Kuritzkes said the patients will be put back on the drugs if there is a viral rebound.

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2 stem cell patients stop HIV treatment, no virus seen