Two patients possibly HIV free after bone marrow stem cell therapy
- Thread starter Orphia Nay
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The_Fire
Unimpressed Female
Well, not a scientist, but this seems promising.
If I recall correctly, HIV infects the immunesystem through RNA replication of the bloodcells and T-cells (Please correct me if I'm wrong) already in thebonemarrow (which, if I recall correctly, is the cell-fabricator of both T-cells and bloodcells). This treatment basically nukes both the existing immunesystem and the "factory", then the transplant reestablishes the "factory" using healthy cells.
A "reset" of sorts.
Have I understood it correctly?
If so, and its replicable, its a possible, if expensive and hard for the patient, cure in the HIV stage of the disease.
As the article states though, it would most likely only be available in the richer countries as the procedure would involve massive amounts of Chemo, sterile rooms for the patient untill the immunesystem have been rebooted and finding compatible marrow donors (this due to the fact that "ordinary" patients going through this procedure would, AFAIR, donate part of their own marrow before the nuking, but a HIV patient would need "clean" marrow from someone else or risk re-infection).
If I recall correctly, HIV infects the immunesystem through RNA replication of the bloodcells and T-cells (Please correct me if I'm wrong) already in the
A "reset" of sorts.
Have I understood it correctly?
If so, and its replicable, its a possible, if expensive and hard for the patient, cure in the HIV stage of the disease.
As the article states though, it would most likely only be available in the richer countries as the procedure would involve massive amounts of Chemo, sterile rooms for the patient untill the immunesystem have been rebooted and finding compatible marrow donors (this due to the fact that "ordinary" patients going through this procedure would, AFAIR, donate part of their own marrow before the nuking, but a HIV patient would need "clean" marrow from someone else or risk re-infection).
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arthwollipot
Observer of Phenomena, Pronouns: he/him
Yeah, it's promising, but it's not exactly going to resolve the HIV epidemic in Africa.
Pretty much, yes.
Hard for the patient is an understatement par excellence. You need to almost kill the patient to do it, and you risk a great deal of secondary diseases. I imagine a good deal of HIV positive people would actually be better off on drugs than undergoing a bone marrow transplant.
McHrozni
Skeptic Ginger
Nasty Woman
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Even if cured, this poses a great dilemma for patients. They need to decide to trade their now chronic disease of HIV (because properly managed it is no longer a death sentence) and the chronic disease of immunosuppression and/or graft vs host disease problems that come after bone marrow transplant.
Long-term physiological side effects after allogeneic bone marrow transplantation.
And that's not even delving into the economic issues related to the cost of both options, treating with anti-retrovirals va bone marrow transplant.
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rjh01
Gentleman of leisure
There could be variations of this treatment that might not be so expensive that might also work.
Ian Osborne
JREF Kid
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That's the real hope in all of this. Bone marrow transplants aren't practical for most sufferers, but perhaps it could lead to a more realistic cure being discovered.
Long term immunosuppression is thankfully not needed for most bone marrow transplants. As the article states the main dangers are improper reconstitution of the immune system, leading to inadequate immune response.
McHrozni
pakeha
Penultimate Amazing
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This. Let's see where the investigation goes.
Capsid
Graduate Poster
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HIV infects the blood cells (CD4+ T lymphocytes) then reverse transcribes its RNA into DNA which then integrates into the cellular DNA and is called a provirus. It's there for good then unless the cells can be destroyed which is what happened in these transplants where the grafted cells destroy the host cells (graft versus host disease) which as Skeptic Ginger has pointed out has chronic health implications.
The_Fire
Unimpressed Female
Wasn't this due to the fact that they found a way to "cleanse" a portion of the patients own bone marrow of the cancer cells,thus being able to minimize rejection by re-introducing the bonemarrow to the orginal body thou? (I vaguely remember reading something about a sort of "wash" in a centrifuge).
Unless they have found a way to do the same with HIV-cells, we are back to locating suitable donors outside the patient her/him-self and we are back to immunosuppressants to prevent rejection of a potential graft.
The_Fire
Unimpressed Female
Sorry. Didn't intent to sound flippant about the agony this treatment is for the patients going through it either for HIV or cancer.
I had a sibling donor Stem Cell Transplant 46 months ago for Acute Myeloid Leukemia. I'm alive but my quality of life took a big hit. Graft versus host disease has gone after my liver, skin, gut, eyes and nerves. I had no choice because I wanted to live. Unless you can't control HIV any other way then a transplant might be indicated. Being strong enough to take the chemo regimen would disqualify anyone with full blown AIDS I would guess. I'm still on immune suppressants because every time we try to taper off them my liver enzymes start spiking. Transplant patients are also more susceptible to skin cancer. No more sun for me so I have to live like a vampire and avoid the sun. No alcohol either. I have had so many squamous cell tumors removed from my face and scalp I'm beginning to look like the Frankenstein monster. I'm lucky to be alive because my prognosis was only a 20% survival after transplant. After 40 months the mortality curve has leveled out for patients with my cytogenetics but that dark cloud of a leukemia relapse still hangs over me. My case is different from everyone else and some people don't develop GVHD after transplant.
My point is that a blood transplant will buy time in some cases but it's a desperate measure that has many risks.
My point is that a blood transplant will buy time in some cases but it's a desperate measure that has many risks.
Gawdzilla Sama
121.92-meter mutant fire-breathing lizard-thingy
Are your results typical?
Like I said, every case is different but GVHD is common with transplant cases. With my particular prognostic indicators (FLT3 ITD, NPM1)a more "typical" case would be death either by the treatment, relapse, opportunistic infections, acute GVHD or chronic GVHD. Leukemia has many manifestations and some actually have a very high cure rate like promyelocytic leukemia.