A new study offers a potential way to help restore blood cells and the immune systems of patients who have had treatments, such as chemotherapy, that deplete normal cells along with tumor cells. The method increases the numbers of hematopoietic stem cells that can be obtained from umbilical cord blood by stimulating the Notch signaling pathway of cord blood stem/progenitor cells in the laboratory (ex vivo). These cells can then be transplanted into patients, where they give rise to new blood cells, including the white blood cells of the immune system.

A team from the Fred Hutchinson Cancer Research Center (FHCRC) tested the method in a phase I trial of patients with acute leukemias. The modified transplanted cells repopulated certain immune cell types faster than normal umbilical cord blood did, in some cases by more than a week, the researchers reported online in Nature Medicine on January 17. The results, while preliminary, suggest that this method reduces the time it takes for the patient’s immune system to recover after a transplant. Speeding this recovery is important because the lack of an immune system leaves patients vulnerable to life-threatening infections.

The Notch signaling pathway is an important regulator of development. A decade ago, Dr. Irwin D. Bernstein of FHCRC and his colleagues discovered that increased activity of the Notch1 gene was associated with expanded populations of hematopoietic stem/progenitor cells. Since then, he and others have been developing ways to translate this discovery into the clinic without having to alter the gene itself. Instead, their technique stimulates Notch signaling through molecules that interact with proteins in the pathway.

Acupuncture Reduces Joint Pain in Some Women with Breast Cancer

In a small randomized clinical trial, breast cancer patients experiencing joint pain and stiffness from aromatase inhibitor (AI) treatment reported an improvement in pain from acupuncture. Eighty percent of women receiving acupuncture reported at least a 2-point improvement on a 10-point pain scale, compared with 22 percent of women who received a sham treatment. These results were published January 25 in the Journal of Clinical Oncology.

Researchers led by Dr. Katherine D. Crew of Columbia University enrolled 51 women in the trial, 43 of who were randomly assigned and 38 of who completed the treatment. Scheduling difficulties accounted for most of the women who enrolled but did not begin or finish treatment.

All of the women were blinded to their treatment assignment, which consisted of either 12 acupuncture sessions or 12 sham treatments (in which needles were lightly inserted into the body at points thought to have no effect on pain) over the course of 6 weeks. The researchers used three different scales to measure changes in joint pain, stiffness, and knee and hand function.

At the beginning of the study, women in the acupuncture group reported a mean worst pain score of 6.7 (on a scale from 1 to 10), compared with a mean score of 5.6 in women in the sham group. After treatment, women in the acupuncture group reported a mean worst pain score of 3.0, compared to 5.5 in women in the sham group. These numbers corresponded to a 50 percent improvement in pain scores for the acupuncture group.