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When Dr. Gero Hütter gave Timothy Ray Brown a bone marrow transplant at a Berlin hospital on Feb. 7, 2007, he knew he could be making history. If, that is, Brown survived long enough to see whether the grueling transplant cured not only his leukemia but also his infection with HIV, the virus that causes AIDS.

Brown did survive, and eight years later, is free of both cancer and HIV. On Thursday, the German doctor reunited with his Seattle-born patient for a rare joint public appearance to talk about how the world’s first -- and so far only -- HIV cure came about and what it means for the future.

“At the time we were doing the transplant, we knew we were doing something very special that could change the whole medical world if it worked,” Hütter told a standing-room-only crowd of more than 200 people - including Brown’s mother – at the downtown Seattle Public Library. “We weren’t clear what would happen. It was a big and good surprise that it worked.”

Added Brown: “I didn’t really believe I was cured until he published the paper [in the New England Journal of Medicine in 2009].”

Identified only as “the Berlin patient” in that first paper and in subsequent media reports, Brown, 48, went public in 2010, around the time he returned from Berlin to live in the United States.

Most people know about common chemotherapy side effects like hair loss and nausea. But another common side effect is neutropenia, an abnormally low white cell count that can lead to fever and infection and land cancer patients in the hospital or even result in their death. 

To fend off neutropenia, oncologists will often prescribe a biologic known as a primary prophylactic colony-stimulating factor, or PP-CSF, that helps boost a patient’s white cell count. But not all doctors use the same criteria to evaluate which patients get this drug and which don’t.

As a result, some cancer patients receive this medication when they don’t really require it and suffer needless side effects like severe bone pain. Other patients don’t receive it at all and endure far more serious consequences: fever, infection, hospitalization and the associated financial burden.

Thanks to a new $7.75 million research award, however, we will have an improved understanding of the neutropenia puzzle and better ways to reduce complications and improve the quality of patient care.

The funding, announced Tuesday, will be used by the Hutchinson Institute for Cancer Outcomes Research (HICOR), a research institute of Fred Hutchinson Cancer Research Center, to conduct a pragmatic clinical trial evaluating the use of colony stimulating factors to reduce the risk of serious neutropenia-driven infections in patients undergoing chemotherapy for breast, colorectal or lung cancer.

“This is something that is not just science fiction. This is real world,” Dr. Stan Riddell said on Thursday when he described the immunotherapies currently being developed and tested as treatments for cancer. “We are entering, I think, a new era where immunotherapy is going to become as established as surgery, radiation and chemotherapy, and I’m hoping that it’s going to be a lot safer for patients and a lot more effective.”

Riddell, a world-renowned immunotherapy researcher and oncologist at Fred Hutchinson Cancer Research Center, made the comments to the nearly 200 members of the public who packed the Hutch’s Pelton Auditorium to hear his presentation, “Cancer Immunotherapy — Is the Cure Inside of You?” The Hutch-hosted Science for Life event enabled community members to hear about one of the hottest topics in medical research from one of the pioneers of the field.

Timothy Ray Brown became an icon the day he came out as the previously anonymous “Berlin patient” — the first and still only person in the world to be cured of the virus that causes AIDS. But the path to becoming the personification of hope for the 35 million people worldwide infected with HIV has been more challenging — and more convoluted — than many people realize.

The Seattle-born Brown was not trying to cure his HIV infection when he reluctantly agreed to a stem-cell transplant in a Berlin hospital eight years ago this month. The immediate threat to his life was leukemia. Chemotherapy had failed, and the grueling transplant — assuming he survived it — was a last-ditch attempt to cure his rapidly progressing cancer.

Brown will talk about how he came to be cured and why he wants an easier cure for others at a free community event Feb. 26 at 6 p.m. at the downtown Seattle Public Library. He will share the stage with Dr. Gero Hϋtter, the German blood cancer specialist who had the idea of curing both Brown’s leukemia and his HIV infection by finding a stem-cell donor who carried a rare genetic mutation that protects against HIV.

For cancer patients who’ve undergone bone marrow transplantation, graft-vs.-host disease can seem like a cruel irony. The donor immune cells that fought off their cancer now attack other body parts, leading to painful skin rashes, digestive troubles and sometimes liver problems.

Up to 70 percent of transplant recipients develop acute GVHD, which crops up within the first few months of transplantation. And 40 percent get chronic GVHD, which can evolve from acute GVHD or appear on its own and is often more severe and can last for years.

As if the double whammy of a treatment-induced disease after cancer wasn’t enough, the standard medication for GVHD – the steroid prednisone – carries its own host of potentially serious side effects, including an increased risk of dangerous infections in patients whose immune systems have already taken a major hit from the transplant procedure.

So doctors have to balance the risk of out-of-control GVHD with minimizing prednisone’s side effects, said Dr. Marco Mielcarek, a clinical researcher at Fred Hutchinson Cancer Research Center who led a new study testing lower doses of prednisone in patients with acute GVHD.

A much-anticipated clinical trial has begun in South Africa to test a modified version of the so-called Thai vaccine, the only experimental vaccine regimen so far to show modest protection against HIV/AIDS.

In the Thai study, published in 2009, vaccine recipients had a 31 percent lower risk of becoming infected with HIV, the virus that causes AIDS, compared to placebo recipients. That was not enough protection to warrant licensing, but it was the first evidence that a vaccine could protect people from HIV and was widely hailed as a breakthrough in the decades-long struggle to develop one.

For the South Africa study, the Thai vaccine regimen has been altered with the aim of making it more protective as well as longer-lasting. The trial, called HVTN 100, will start out small, with 252 volunteers, to test for safety and to see if the regimen induces the predicted immune system response.

If all goes as hoped, the next phase will be a larger trial beginning in late 2016 or early 2017 to test for efficacy, or whether the vaccine actually protects those who receive it from being infected with HIV. That trial could lead to the first licensed HIV vaccine.

“This is what the next few years are all about. Can we build on [the Thai vaccine] and get as good results or better and make it more durable?” said Dr. Linda-Gail Bekker, who is leading the trial. She is deputy director of the Desmond Tutu HIV Centre at the University of Cape Town and chief operating officer of the Desmond Tutu HIV Foundation in South Africa.