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Finding a better (mis)match

New way to pair blood stem cell donors with recipients promises to lower risk of potentially devastating transplant side effect

Aug. 28, 2015 | By Susan Keown / Fred Hutch News Service

Effie Petersdorf speaks at a meeting of the transplant team at Seattle Cancer Care Alliance

Dr. Effie Petersdorf discusses how to implement her recent findings in a meeting of members of the transplant team at Seattle Cancer Care Alliance.

Photo by Robert Hood / Fred Hutch News Service

Sometimes the treatment that is supposed to save your life comes with life-threatening risks itself.

This is the reality of blood stem cell transplantation, a lifesaving therapy developed at Fred Hutchinson Cancer Research Center that can cure blood diseases like leukemia, but which comes with a serious risk of a dangerous complication called graft-vs.-host disease.

Soon, many patients coming to Seattle for transplants will have a lower risk of this outcome thanks to additional genetic testing, which will be built on findings published this month in the New England Journal of Medicine by a team of researchers based at Fred Hutch.

“We’re extremely enthusiastic and excited because it’s something that we feel we should be able to translate” into patient care, said Dr. Effie Wang Petersdorf, the Fred Hutch clinical scientist who led the research. 

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‘A reminder of this journey’: One gift linking three lives

How a ceramic mouse gave an oncology nurse inspiration – and a grieving daughter hope

Aug. 27, 2015 | By Megan Herndon / Fred Hutch News Service

Kathleen Shannon Dorcy and Jessica Mann embrace

Kathleen Shannon Dorcy, left, hugs Jessica Mann on July 24, 2015 at Fred Hutchinson Cancer Research Center in Seattle. Two decades ago, Shannon Dorcy cared for Mann's mother, then a leukemia patient at Fred Hutch.

Photo by Bo Jungmayer / Fred Hutch News Service

In the simple exchange of a big hug and a little mouse figurine, a nurse felt the deep purpose of her work, and a daughter felt hope for a future when kids don’t their lose moms to cancer.

Their solemn gift swap all began with the same woman, Sally Mann, who had traveled with her family from Los Angeles to Fred Hutchinson Cancer Research Center in 1993, seeking to cure her acute myeloid leukemia.

Here in Seattle, Mann underwent a blood stem cell transplant but, unfortunately, relapsed. At that time, Dr. Fred Appelbaum, who today is the deputy director and executive vice president of Fred Hutch, was leading an early-phase clinical trial for which Mann might have qualified, but it was on hold for analysis. Kathleen Shannon Dorcy, a nurse with Seattle Cancer Care Alliance, Fred Hutch’s treatment arm, who cared for Mann during her relapse, recalled that the trial team felt the wait for the study to reopen would be too long for Mann. So she returned to her home in California for treatment.

In 1995, Mann passed away. But before her death, she and her husband gave Shannon Dorcy a tiny mouse figurine as a tribute to Appelbaum’s mouse-derived study – and with hopes of motivating Shannon Dorcy to keep pursuing cures. 

“He’s been on my desk for 20 years,” Shannon Dorcy said of the figurine. “They gave it to me and said, ‘We want you to continue ... finding hope for patients with leukemia, and we want this little mouse to be there as a reminder of us and this journey.’”

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Good News at Fred Hutch

Dr. Roland Walter receives two grant awards for acute leukemia research; Dr. Jonathan Bricker to keynote behavioral therapy conference; Dr. Benjamin Anderson chairs NCCN committee that publishes clinical-practice guidelines for cervical cancer

Aug. 27, 2015 | By Fred Hutch staff

Dr. Roland Walter

Dr. Roland Walter

Fred Hutch file photo

Dr. Roland Walter receives grants from Alex's Lemonade Stand Foundation and Leukemia & Lymphoma Society for acute leukemia research

Dr. Roland Walter, a clinical researcher at Fred Hutch, has received two awards to develop new treatments for acute leukemia: one from Alex’s Lemonade Stand Foundation, or ALSF, and another from the Leukemia & Lymphoma Society, or LLS.

From the ALSF, Walter received a 2015 Innovation Award Grant. He is among 22 investigators to receive such funding, which will provide him with $250,000 over the next two years.

From the LLS, he received a Translational Research Program Award for $600,000 over the next three years.

Both awards will support Walter’s research on developing new antibody-based treatments for acute leukemia, which are blood cancers from which many children and adults will eventually die despite aggressive therapies. There is thus a critical need for new drugs for these tumors.

For more than 30 years, proteins (so-called "antibodies") that recognize tumor cells have been envisioned as “magic bullets” for cancer patients but so far have been largely ineffective against acute leukemias. One strategy to render antibodies more active is to modify them so that they recognize leukemia cells and, simultaneously, normal immune cells (typically T-cell lymphocytes), which then selectively kill the attached cancer cell.

Promising results with one "bispecific" antibody, blinatumomab, were recently reported in some patients with acute leukemia who had failed intensive chemotherapy. However, because of their small size, these antibodies are quickly eliminated by the kidneys and need to be given via infusion pump over several weeks. Also, for unknown reasons, about half of the patients still do not benefit from these antibodies.

“Recognizing these limitations, our goal is to develop novel, highly active bispecific antibodies that have longer half-lives and can be given in a simple and safe fashion in the clinic,” Walter said.

Through studying how exactly these bispecific antibodies kill leukemia cells, Walter and colleagues will not only better understand which patients are most appropriate for these agents but also be able to develop combination treatments that may overcome resistance so that more patients can benefit from them.

“Together, by optimizing bispecific antibodies, our investigations have the potential to significantly improve the treatment options and outcomes for patients with acute leukemia,” he said.

Fred Hutch research collaborators will include Drs. Jim Olson, Christopher Mehlin and Colin Correnti from the Olson Lab (Clinical Research Division), Dr. Roland Strong (Basic Sciences Division) and Dr. Benjamin Hoffstrom of the antibody-development facility in Shared Resources.

Initial funding for this work was made possible by a pilot award from the Bezos family (sic) Immunotherapy Initiative.

"Especially at times when federal research funding is very limited, our work depends on support from philanthropic sources and foundations," Walter said.

Dr. Jonathan Bricker

Dr. Jonathan Bricker

Photo by Robert Hood / Fred Hutch News Service

Dr. Jonathan Bricker to keynote Washington Innovators in Behavioral Therapy conference

Dr. Jonathan Bricker, a psychologist and scientist in Fred Hutch’s Public Health Sciences Division, will be the keynote speaker at the upcoming Washington Innovators in Behavioral Therapy conference, which will take place Sept. 11-12 at the Talaris Conference Center in Seattle.

Bricker, president of the Washington Association for Contextual Behavioral Science, the event sponsor, will speak about the future of the science and practice of behavioral therapy.

The event is geared toward professionals in human resources, mental health and patient care who are interested in learning about the latest behavioral approaches for helping clients make positive changes.

At the all-inclusive conference, which will be held at an 18-acre retreat near downtown Seattle, attendees will have an opportunity to build and sharpen their clinical skills in leading approaches to behavioral therapies such as Bricker’s specialty, acceptance and commitment therapy, or ACT.

At Fred Hutch, Bricker is evaluating the effectiveness of such therapy to help people quit smoking and other behaviors. ACT focuses on increasing the willingness to experience physical cravings, emotions and thoughts that trigger such behaviors – to accept one’s cravings and just let them dissipate rather than viewing them as enemies to be conquered.

The conference will also explore the latest innovations in other treatment modalities, including mindfulness and compassion-focused therapy.

Note: For $100 off the registration cost, enter promo code UWASH-2015.

Dr. Benjamin Anderson

Dr. Benjamin Anderson

Photo by Bo Jungmayer / Fred Hutch News Service

Dr. Benjamin Anderson chairs NCCN committee that publishes clinical-practice guidelines for cervical cancer

The National Comprehensive Cancer Network, or NCCN, has published the NCCN Framework for Resource Stratification of NCCN Guidelines for Cervical Cancer. The NCCN Framework guides evidence-based adaptation to available clinical treatment resources.

The NCCN Guidelines are used widely around the world, including in a number of low- and middle-income countries where certain diagnostic tests and/or treatment approaches may be unavailable. The goal of the NCCN Framework is to define appropriate treatment pathways at four resource levels — basic limited, enhanced and maximal — and deliver a tool for health care providers to identify treatment options that will provide the best possible outcomes given specific resource constraints.

“NCCN is presenting a framework to help health care planners prioritize their use of cancer treatment resources in limited-resource settings and assist policymakers in outlining cancer-control plans that are data-driven, evidence-based blueprints for action,” said Dr. Benjamin O. Anderson, a global oncology implementation researcher in the Public Health Sciences Division at Fred Hutch and a professor of surgery and global health medicine at the University of Washington who chairs the NCCN International Program Committee. “As such, the NCCN Framework furthers NCCN’s mission to improve the lives of people with cancer around the globe,” he said.

The NCCN Framework outlines a rational approach for building cancer-management systems to provide the highest achievable level of care for stage-specific cancers by applying available or attainable tests and treatments. In addition, the NCCN Framework can be used to define strategic pathways for growth by illustrating how new resources or tools introduced in a stepwise fashion can optimally improve on current best-practice models and cancer outcomes.

The four levels of NCCN Framework resources are defined as:

Basic: Essential services needed to provide a basic, minimal standard of care.

Limited: Services that provide major improvements in disease outcomes, such as survival, which are not cost-prohibitive.

Enhanced: Services that provide lesser improvements in disease outcomes, or services that offer major improvements in disease outcomes but are cost-prohibitive at lower-resource levels.

Maximal: Services that do not provide improvement in disease outcomes but are desirable, or services that provide minor improvements in disease outcomes but are cost-prohibitive in lower-resource settings.

Fred Hutch and its treatment arm, Seattle Cancer Care Alliance, are member institutions of NCCN, a not-for-profit alliance of 26 of the world’s leading cancer centers devoted to patient care, research and education.

'A chance to hope’: Leukemia survivor, family reunite with favorite doctor

Ex-patient’s wife recalls how her sacred mission to save her husband led her to Fred Hutch

Aug. 26, 2015 | By Bill Briggs / Fred Hutch News Service

Hugh and Kate Fagan watch Aimee Fagan, Hugh's wife, reunite with Dr. Colleen Delaney, Aug. 13, 2015, at Fred Hutch in Seattle, Wash. Delaney helped saved Hugh six years ago with a cord blood transplant.

Photo by Robert Hood / Fred Hutch News Service

The trio locked eyes then locked arms – their first reunion since the grim days when Hugh Fagan’s survival seemed lost.

As Fagan stepped from that embrace, his wife, Aimee, held tight to her favorite scientist, Dr. Colleen Delaney. In a busy lobby at Fred Hutchinson Cancer Research Center in mid-August, Aimee kept hugging – and kept crying.

Hugh knew exactly why. Following his 2009 diagnosis of an aggressive form of leukemia, Aimee had launched a sacred mission to save her husband. She’d read medical journals. She’d questioned top oncologists across the country. She’d seen 4 a.m. come often while she scoured cancer websites.

Finally, in that same year, she’d found hope during a midnight call to Delaney, who happened to be in her Fred Hutch lab, working on solutions to improve the outcomes of patients in need of a cord blood transplant. Soon, Hugh was en route from Dallas to Seattle to receive a cord blood transplant.

“Aimee did all the research and made sure I was doing what I needed, to fight,” said Hugh Fagan, 45. “She went off on her own path, challenging people to think, looking for something outside traditional leukemia treatments. She earned her M.D. on that job.

“She said, ‘I’m not going to let him die.’ She found the solution. She found Colleen. And I am here. It’s unbelievable,” he added.

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Stress-lowering heart drug may boost ovarian cancer survival

Findings move to clinical trials, but cancer patients can use yoga and other relaxation techniques now to lower stress

Aug. 25, 2015 | By Mary Engel / Fred Hutch News Service

Yoga, mindfulness meditation and relaxation exercise are natural techniques shown to reduce stress.

Stock photo by iStock

Women with ovarian cancer who took a certain type of beta-blocker drug for heart problems unrelated to their cancer lived more than four years on average longer than those who did not take the drug, according to a retrospective study published online Monday in the journal Cancer.

Prescribed to treat heart disease, high-blood pressure, glaucoma and migraines, beta-blockers target a receptor protein in heart muscles that causes the heart to beat harder and faster when activated by “fight or flight” stress hormones, said Dr. Anil Sood of the University of Texas MD Anderson Cancer Research Center in Houston, the principal investigator of the study.

“Our research has shown that the same stress mechanisms [targeted by beta-blockers] impact ovarian cancer progression, so these drugs could play a new role in cancer treatment,” Sood said in a statement.

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The microbiome’s murky role in pregnancy loss and complication

The same vaginal bacteria linked to promotion — and prevention — of various pregnancy complications, studies find

Aug. 21, 2015 | By Dr. Rachel Tompa / Fred Hutch News Service

Pregnant woman's torso

The microbiome's role in pregnancy is not always clear. Researchers have recently found that the same vaginal bacteria can have opposite effects on different pregnancy complications, even among the same population of women.

Stock photo by FeaturePics

It could take more than two to make a healthy baby — many, many more.

Researchers are beginning to better understand how the millions of bacteria that make up the vaginal microbiome help shape a normal pregnancy — as well as the devastating complications that may arise when that microbial community is off balance.

A study published recently by scientists at Temple University and Fred Hutchinson Cancer Research Center found that the very same bacteria can have entirely different effects on women’s risk of premature delivery or miscarriage. And that dichotomy — one bacteria causing help and harm — has researchers both baffled and intrigued.

It’s long been understood that the wrong mix of vaginal bacteria can increase the risk of premature delivery, when a baby is born earlier than 37 weeks gestation. More than 450,000 babies are born premature every year in the U.S., according to the Centers for Disease Control and Prevention. Preterm birth contributed to 35 percent of all infant deaths in 2010, more than any other single cause.

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