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St. Jude clinicians used immune system cells called natural killer (NK) cells from a father to save the life of his 3-month-old infant daughter who wasn’t expected to survive her battle with acute lymphoblastic leukemia (ALL).
While hematopoietic-cell transplantation (HCT) improves outcome in older children, efforts to improve the outcome of infants with ALL have failed, according to Wing Leung, MD, PhD, Hematology-Oncology. HCT, the infusion of stem cells from a donor to a patient, is used in order to rebuild the patient’s blood system after chemotherapy is used to eliminate all the cells, including leukemic ones.
Following treatment, however, a few surviving leukemic cells can restart ALL and threaten the patient with relapse. But Leung and his colleagues at St. Jude previously found that immune system cells called NK cells from donors can sometimes attack and kill those few remaining leukemic cells. The secret to NK cells killing leukemic cells is the presence of certain proteins called KIRs (killer-cell immunoglobulin-like receptors) on the surface of the NK cells.
Leung and his colleagues have done pioneering work in identifying donor NK cells that are likely to work well in recipients based on their KIRs.
The young patient had suffered a relapse after two series of treatments, including one HCT. So the team gave her a transfusion of stem cells and NK cells from her father after a check of the KIRs suggested the transplant would work. The St. Jude researchers report in the February 1 issue of Blood that, after 16 months, the young girl is still in remission.
“This is in marked contrast to the invariably fatal outcome we see in infants with ALL who receive a hematopoietic cell transplant after they relapse following an initial treatment,” Leung said.
Other St. Jude authors are Brandon Triplett, MD, Hematology-Oncology; Rupert Handgretinger, MD, PhD, now at University of Tübingen, Germany; and Ching-Hon Pui, MD, Hematology-Oncology.
Last update: March 2006