Posts tagged ‘leukemia’


Adoptive T cell therapy: Harnessing the immune system to fight cancer

August 15, 2014 | by

Immunotherapy — using one’s immune system to treat a disease — has been long lauded as the “magic bullet” of cancer treatments, one that can be more effective than the conventional therapies of surgery, radiation or chemotherapy. One specific type of immunotherapy, called adoptive T cell therapy, is demonstrating promising results for blood cancers and may have potential against other types of cancers, too.

In adoptive T cell therapy, T cells (in blue, above) are extracted from the patient and re-engineered to recognize and attack cancer cells. They are then re-infused back into the patient, where it can then target and kill cancer cells throughout the body. (Photo credit: Lawrence Berkeley Laboratory)

In adoptive T cell therapy, T cells (in blue, above) are extracted from the patient and modified to recognize unique cancer markers and attack the cells carrying those markers. They are then reinfused back into the patient, where they can kill cancer cells throughout the body. (Photo credit: Lawrence Berkeley Laboratory)

Here, Leslie Popplewell, M.D., associate clinical professor and staff physician in City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation, explains what this treatment entails.

What is adoptive T cell therapy and how does it work to treat cancer?

Every day, our immune system works to recognize and destroy abnormal, mutated cells. But the abnormal cells that eventually become cancer are the ones that slip past this defense system. The idea behind this therapy is to make immune cells (specifically, T lymphocytes) sensitive to cancer-specific abnormalities so that malignant cells can be targeted and attacked throughout the body.

Who would be good candidates for this type of therapy? » Continue Reading


In acute myeloid leukemia treatment, infighting just might be positive

July 18, 2014 | by

Elizabeth Budde, M.D., Ph.D., wants to encourage infighting. She aims to turn the immune system on itself — to the benefit of patients with acute myeloid leukemia, or AML.

Budde recieves grant to support her study on T cells and AML.

In a new treatment for acute myeloid leukemia, Elizabeth Budde is using modified white blood cells to attack their malignant cousins.

AML arises when abnormal white blood cells grow out of control, amassing in the bone marrow and interfering with normal blood cell development. Blood stem cell transplants are the only hope of cure for most patients with AML; however, many patients eventually see their cancer return.

Budde wants to give patients with relapsed AML a fighting chance by giving them modified white blood cells that attack their malignant cousins.

Her work is garnering increased attention. Budde, an assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, has been chosen as The Jake Wetchler Foundation for Innovative Pediatric Cancer Research-Damon Runyon Cancer Research Foundation Clinical Investigator. The accompanying $450,000 grant will support her studies for the next three years.

» Continue Reading


A bone marrow transplant on an outpatient basis? For some patients, yes

July 17, 2014 | by

Six, to date; more soon. Outpatient bone marrow transplants, that is.

City of Hope is expanding the transplant services to more patients by delivering care on an outpatient basis.

City of Hope is now providing bone marrow transplant services to some patients on an outpatient basis.

Finding new ways to deliver quality care with the greatest benefit is a priority for a patient-centered institution like City of Hope. For example, not every bone marrow transplant patient needs to check into the hospital for treatment. In fact, some might even benefit from remaining outpatients.

City of Hope’s new day hospital is designed to address their needs.

Studies have shown that day hospitals can meet clinical standards for bone marrow transplants without compromising patient quality of care. They allow patients to be treated as outpatients rather than inpatients, which lets them go home after their treatment. The result can be greater patient satisfaction and an improved patient experience. » Continue Reading


Children with cancer, Part 3: Transitioning from patient to survivor

July 7, 2014 | by

John Cloer was three months shy of his third birthday in 2004 when he was diagnosed with acute lymphoblastic leukemia. For the next three and a half years, he received chemotherapy at City of Hope, finally obtaining long-term remission.

childhood cancer survivor John Cloer

The challenges of a cancer diagnosis don’t stop with treatment. Survivorship brings its own challenges, as John Cloer, a former leukemia patient at City of Hope, knows well.

His parents Bill and Gina, along with John and his younger brother Steve, recently sat down to reflect on that experience, sharing tips for family members and friends of children with cancer, as well as advice for parents of children with cancer. Here, they and City of Hope pediatric nurse Karla Wilson, R.N., M.S.N., discuss the sometimes difficult transition from treatment to survivorship.

In this third of a three-part series, they describe the transition from patient to survivor.

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Some of the cancer treatments that save children’s lives also may produce life-altering side effects that don’t materialize for years.

During the Cloers’ annual visit to City of Hope’s Childhood Cancer Survivorship Program, Wilson reviews John’s medical progress, and reminds his parents about conditions they’ll need to monitor.

When alerting patients that they may be prone to future therapy-related conditions, Wilson said she always tries to drive home one message above all: Just because survivors are at risk for a condition doesn’t mean they’ll necessarily develop it. » Continue Reading


Children with cancer, Part 2: How parents can help their kids

June 30, 2014 | by

John Cloer was three months shy of his third birthday in 2004 when he was diagnosed with acute lymphoblastic leukemia. For the next three and a half years, he received chemotherapy at City of Hope, finally obtaining long-term remission.

John Cloer

Now 13, John Cloer, right with younger brother Steve, was only 3 when he was diagnosed with acute lymphoblastic leukemia. His parents learned the hard way how to cope with a new array of parenting challenges. Shown here: John (right) with his brother, Steve.

His parents Bill and Gina, along with John and his younger brother Steve, recently sat down to reflect on that experience, sharing tips for family members and friends of children with cancer and now, their advice for parents facing a similar challenge.

In this second of a three-part series, they answer the question:

How can parents help their children with cancer? 

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1. Numb the pain. Perhaps because he still remembers caregivers frantically trying to start an IV in him the day he was diagnosed, John still dreads IVs and injections. The Cloers now ask nurses to use lidocaine to numb a site before the needle goes in. (They pay for this off-protocol request, but find it worth the costs.)

In the early days of John’s illness, the tense toddler used to “rub the rubber right off his pacifier,” said Bill. “I wish we had had a better tool set to manage his anxiety,” he added. Gina regrets they didn’t get John into the habit of meditating before procedures, “a coping skill I wish he’d have now.” » Continue Reading


Children with cancer, Part 1: How family members and friends can help

June 23, 2014 | by

John Cloer became a teenager in May, an ordinary rite of passage made extraordinary because he is a cancer survivor – one of an estimated 370,000 pediatric cancer survivors in the U.S.

Childhood cancer patient John Cloer

The parents of John Cloer, now a childhood cancer survivor, learned many lessons during his treatment for leukemia. Photo courtesy of the Cloer family.

He was three months shy of his third birthday in 2004 when what his parents Bill and Gina Cloer assumed was the flu was diagnosed as acute lymphoblastic leukemia. For the next three and a half years, John received chemotherapy – eventually leading to his long-term remission.

John finally became well enough to attend kindergarten and enjoy normal pursuits like T-ball. In fact, his perseverance (from staying late to practice, to reveling in teammates’ progress) earned the 6-year-old an invitation to play T-ball on the White House lawn and meet President George Bush. He has long raised awareness for City of Hope, from presenting an award to singer Miley Cyrus to riding on the hospital’s 2014 Tournament of Roses float as his sister Heather, a City of Hope nurse, walked alongside.

When John was embarking on cancer treatment, Bill and Gina were given well-tested roadmaps from oncologists adept at keeping children alive. On the comparatively uncharted path of cancer survivorship, they have longed for a similar roadmap. Along with regular follow-up visits with doctors such as Clarke Anderson, M.D., the Cloers are being helped in their survivorship journey by City of Hope’s Childhood Cancer Survivorship Program, led by Smita Bhatia, M.D., M.P.H., the Ruth Ziegler Chair in Populations Sciences, and nurse practitioner Karla Wilson, M.S.N., R.N.

In this program, John and his family receive a comprehensive medical summary of his diagnosis and treatment, as well as an individualized review of his potential late-effects from treatment.

Bill, Gina, John and his younger brother, Steve, recently sat down around their dining room table and offered some advice to parents of children with cancer, along with well-meaning family and friends.

In this first of a three-part series, they answer the question:

What can family/friends do to help parents whose children have cancer?

» Continue Reading


Kids with leukemia at relapse risk due to forgetfulness about their pills

June 5, 2014 | by

A quarter of children in remission from acute lymphoblastic leukemia, or ALL, are tripling their risk of a relapse because they are missing too many doses of an essential maintenance medication, according to findings from a recent City of Hope study .

bottle with tablets

A City of Hope study found that a quarter of kids with acute lymphoblastic leukemia are at a tripled risk of relapse because they are missing doses of an oral chemotherapy. The No. 1 reason why: they forget.

The research, published in the journal Blood, also reports maintenance medication adherence was lower in minority groups. About 46 percent of African-American children and 28 percent of Asian children are not taking enough doses to prevent relapse, compared with 14 percent of white children.

Acute lymphoblastic leukemia, a cancer of the white blood cells, is the most common form of childhood cancer. While more than 95 percent of children with ALL enter remission within a month of receiving initial cancer therapy, one in five will relapse. Additionally, relapsed disease is often harder to treat and may involve costlier, most toxic therapies.

In order to remain cancer-free, children in ALL remission must take a form of oral chemotherapy, called 6-mercaptopurine(6MP), every day for two years to protect against the disease coming back.

Despite 6MP’s proven benefit, previous studies have suggested pediatric ALL patients have difficulty taking it consistently. Other studies reported survival rates vary greatly among racial groups – prompting investigators to begin studying race-specific patterns of adherence in children with ALL.

“While we don’t yet know why children of different races have significantly different survival rates for ALL, we know that their adherence to their maintenance medication is a critical factor in their survival,” said first author Smita Bhatia, M.D., M.P.H. “With this in mind, we sought to explore the potential linkages that may exist between several key race-specific sociodemographics of these children and their adherence to 6MP.”

Bhatia, who is also the Ruth Ziegler Chair in Population Sciences, and her team began their research studying differences in medication adherence among different racial groups of children in remission from ALL in 2012, reporting that Hispanic children did not follow their prescribed maintenance regimen as consistently as non-Hispanic whites. » Continue Reading


ASCO 2014: For kids taking medication, fewer adults is sometimes better

May 28, 2014 | by

Missing an occasional dose of medicine may not seem like a big deal, but for kids with acute lymphoblastic leukemia (ALL), it can have dire consequences. Now City of Hope researchers have assessed the factors that can contribute to so-called medication non-adherence. One of their more surprising discoveries: Having multiple adults involved with administering medication actually lowers the likelihood that kids will take the drugs as they should.

medication adherence

For children with acute lymphoblastic leukemia, it is crucial to take oral chemotherapy regularly after remission. In a new study, City of Hope researchers found factors linked to medication non-adherence, which can be used to identify at-risk groups.

The results will be presented at the American Society of Clinical Oncology annual meeting on June 1.

“ALL is a highly treatable cancer, but patients need to take ongoing oral chemotherapy for two years after the initial remission to reduce likelihood of relapses,” said Smita Bhatia, M.D., M.P.H., senior author of the study and the Ruth Ziegler Chair in Population Sciences at City of Hope. “By identifying factors linked to non-adherence, we can identify at-risk patients and intervene to ensure that they stay on track with the medication schedule.”

City of Hope researchers had already found that not non-adherence to medication regimens can triple a patient’s risk of relapse. They also knew that almost half of pediatric ALL patients don’t take their medication as they should. Understanding the reasons for such non-adherence is a first step in reducing the risk of relapse.

In their new analysis, Bhatia, Wendy Landier, Ph.D., R.N., assistant professor in the Department of Population Sciences, and their colleagues studied 462 pediatric ALL patients taking maintenance oral chemotherapy. Using a combination of questionnaires, demographic data and devices that track when the drug bottles were opened, the researchers found that the following factors are associated with non-adherence: » Continue Reading


This celebration (Bone Marrow Transplant Reunion) includes reflection

May 7, 2014 | by

At City of Hope’s upcoming Bone Marrow Transplant Reunion on Friday, May 9, hundreds of patients and the doctors and nurses who cared for them through their battles with cancer and other hematologic diseases will celebrate life and second chances.

Survivors and family at the City of Hope "Celebration of Life" Bone Marrow Transplant Reunion

Survivors and family members at the City of Hope “Celebration of Life” Bone Marrow Transplant Reunion.

The annual reunion, formally known as the Celebration of Life and now in its 38th year, has grown from a single patient and his brother who donated lifesaving bone marrow to hundreds of patients and thousands in attendance.

The reunion is an opportunity to reflect on the personal connection between caregivers at City of Hope and patients. That connection matters. It’s one reason that City of Hope has the best outcomes in the nation for hematopoietic cell transplants.

» Continue Reading


Meet our doctors: Ravi Bhatia on better survival for leukemia patients

May 3, 2014 | by

Every four minutes, someone is diagnosed with a blood cancer. More than 156,000 new cases in the U.S. are expected this year alone, with more than 52,000 of those diagnosed as leukemias. Causes of these cancers remain relatively unknown, but advances in treatment, some of which resulted from research at City of Hope, are increasing survival rates.

Dr. Ravi Bhatia

Advances in leukemia treatment are improving survival rates, says Ravi Bhatia, co-leader of the Hematologic Malignancies Program at City of Hope. (Photo by Walter Urie)

Recognized internationally for its breakthrough treatments for leukemia and other blood disorders, City of Hope is one of the most successful treatment centers for leukemia in the country and has had some of the consistently best survival outcomes. Here, Ravi Bhatia, M.D., director of the Division of Hematopoietic Stem Cell and Leukemia Research and co-leader of the Hematologic Malignancies Program, explains that the focus of doctors and others at City of Hope is not just cancer remission, but to cure patients altogether.

What is leukemia, and are there any symptoms?

Leukemia is a cancer of the blood cells. It usually begins in the bone marrow – the soft material in the center of most bones where blood cells are formed. Normally, blood cells are made in an orderly, controlled way. In a person with leukemia, the bone marrow makes abnormal white blood cells, called leukemia cells. As more leukemia cells are produced, they crowd out the healthy blood cells, making it hard for normal blood cells to do their work, which is to fight infections, carry oxygen and prevent bleeding.

Common symptoms of leukemia include headache, anemia, weight loss, pain in the bones or joints, swelling or discomfort in the abdomen (from an enlarged spleen) and swollen lymph nodes, especially in the neck or armpit. Some of the symptoms of leukemia are similar to those caused by the flu or other common diseases, so it is important to see a doctor if you have these symptoms. Only a doctor can diagnose and treat leukemia. » Continue Reading