Training an Immune System To Kill Cancer 209
NotSanguine sends in a story about William Ludwig, a 65-year-old leukemia patient who underwent a new, experimental treatment that draws upon two decades of advances in molecular biology. Quoting:
"Doctors removed a billion of his T-cells — a type of white blood cell that fights viruses and tumors — and gave them new genes that would program the cells to attack his cancer. Then the altered cells were dripped back into Mr. Ludwig’s veins. At first, nothing happened. But after 10 days, hell broke loose in his hospital room. He began shaking with chills. His temperature shot up. His blood pressure shot down. He became so ill that doctors moved him into intensive care and warned that he might die. His family gathered at the hospital, fearing the worst. A few weeks later, the fevers were gone. And so was the leukemia. ... In essence, the team is using gene therapy to accomplish something that researchers have hoped to do for decades: train a person's own immune system to kill cancer cells."
Now this is what I'd call (Score:2)
WICKED COOL!!!
Xkcd on the topic (Score:5, Informative)
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That was actually one of the times where I've grown annoyed with XKCD.
This is the beginning of using a different types of retrovirus to cure deadly diseases.
That is the biggest breakthrough since penicillin.
Which, if you would like to be reminded, is putting mold into your body which is quite deadly and thus killing loads of germs, indiscriminatory.
Which happen to save lives.
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Indeed. Five gods forbid someone actually made a joke about it all.
It a way of coping (Score:5, Informative)
Duplicate? (Score:2)
Didn't we get this a couple weeks back?
Use HIV to reprogram his white blood cells to attack cancer?
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yeah, right here: http://science.slashdot.org/story/11/08/11/1458205/Cancer-Cured-By-HIV [slashdot.org]
but at least this story title is a bit more accurate.
similar tech using proteins instead of genes (Score:2)
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Sort of old news (Score:2, Redundant)
From a few weeks back. XKCD even did a comic on it.
http://www.xkcd.com/938/ [xkcd.com]
woah! so jealous. (Score:2)
Does this mean he's practically immune to cancer now? Like, he could smoke, drink, bqq and huff glue all he wants and not get cancer again... just like, maybe flu symptoms? I'm kinda jealous... I wonder what other super powers this might come with. (Reduced aging anyone?)
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Correction, I think: T cells focus on protein markers. This is why one of the patients died: the protein marker associated with the cancerous cells also turned out to be present on healthy lung tissue.
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If he's lucky, this particular flavor of cancer won't be back to finish him off. Even then, though, there are a zillion others just waiting in the wings...
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He is immune to that particular cancer now. Unfortunately, he remains just as vulnerable as any of us to the others.
Autoimune side effects? (Score:2)
Whenever I see a suggestion about using the immune system in some new and novel way I cannot help but get worried about autoimune side effects.
I guess it is a bit irrational since vaccinations are basically stimulating the immune system to hit specific pathogens, and most of them are very safe as compared to other drugs, but I can't help but feel a bit uneasy about training the body to attack its own cells.
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I think there's much more to worry about here than with a vaccination, seeing as how the cancer is a lot more like us than some random bacteria or virus. However, don't forget "compared to what". People were willing to do some scary shit to avoid Smallpox ("here, I'll infect you from this pus-filled sore on a cow"). Someone who's already got bad cancer is in an even worse place than that.
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Actually, autoimmune reactions are a serious risk with this sort of treatment. One woman died of an autoimmune attack on her lungs when a similar technique was tried to cure her colon cancer. It's particularly tricky since the target is actually cells from the patient's own body that just have damage to a few critical genes.
The patient's recovery is BECAUSE of an autoimmune reaction to his own B cells. ALL of his B cells, cancerous or not. In his case, they weren't working well anyway (the few healthy ones
Where's DrBob? (Score:5, Funny)
I can't gauge the validity of this research without a mention of subluxations as a calibration reference for my stupidity detector.
Repost (Score:2)
http://science.slashdot.org/story/11/08/11/1458205/Cancer-Cured-By-HIV [slashdot.org]
Incredibly interesting nonetheless.
What could possibly go wrong? (Score:3)
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The chance of causing an autoimmune disease with this sort of treatment protocol seems enormous... Do you really think that nothing could possibly go wrong in training the body to kill its own cells of a specific narrow type?
I'd still take that possibility over a terrible death sentence any day. Well, depending on the traffic on the way to the clinic. Then I may just take the death sentence.
"His temperature shot up" (Score:2)
I remember reading about a decades old cancer treatment technique that included fevers with very high temperatures. The physicians of the time claimed it was the body heat that killed the tumors.
Don't know how valid that is, but I know that a doctor told me once when I have fever not to take an aspirin just to lower the body temperature (unless it's dangerously high) because fever creates conditions for the body to fight the germs.
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I remember reading about a decades old cancer treatment technique that included fevers with very high temperatures. The physicians of the time claimed it was the body heat that killed the tumors.
Don't know how valid that is, but I know that a doctor told me once when I have fever not to take an aspirin just to lower the body temperature (unless it's dangerously high) because fever creates conditions for the body to fight the germs.
I dunno about fighting cancer that way (it might work: I just don't know) but the germ thing is valid. Bacteria and viruses are optimized to reproduce as quickly as possible at body temperature. Their proteins are less efficient as temperature varies either way from that optimum. So when you run a temperature, you slow down their reproduction rate, which gives your immune system more time to form a response and go fight them. (Bacteria can reproduce in about half an hour, which means they can increase b
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Smart Blood (tm) (Score:2)
Although it sounds extreme (Score:2)
It sounds like it is right out of a sci-fi movie, where the cure has a kick to it,
looks like you might not make it after taking it, and yet after the storm passes, WOW, the results are amazing.
I hope they get to test this a few more times just to make sure, as well as follow said patient 10 years after,
as it is important to see if the cells will be ok 10 years later and not morph or mutate....I just hope they do not let
him walk away without keeping tabs on him.
Did I miss a memo? (Score:2)
amusing anaecdote. . . (Score:3)
A friend of mine has this condition, and had this treatment.
He has had white hair all his life. After the treatment, he lost his hair, but it grew back black. They do not know if he's "cured", but he's doing better. His condition brought with it, many secondary tumors, and those have stopped.
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It was fiction? And the Hulk then, what about the Hulk?
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Re:Interesting (Score:5, Funny)
The evidence for I am Legend is better than for the American Revolution, after all, they have actual video for I am Legend, but not for the American Revolution. So really, believe what you want, but I prefer things I can see.
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The evidence for I am Legend is better than for the American Revolution, after all, they have actual video for I am Legend, but not for the American Revolution. So really, believe what you want, but I prefer things I can see.
Well there are paintings, drawings, engravings, etc of revolutionary events. You can see those too. :-)
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There are already loads and loads of invisible pink unicorn paintings everywhere, what more proof do you need?
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Yeah, and?
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I can draw and paint unicorns giving it to you. I guess that makes that event real as well.
As real as the unicorns in the movies and as real as the biology in I am Legend. A fun movie by the way.
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*flashes you my double D* doesn't mean they're real ^_^.
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On Slashdot, you don't have to be a girl to have large breasts.
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teehee :D
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Probably...
of course if we don't die from cancer then we still have to deal with aliens coming down to conquer us like independence day.
At least we know we can infect their technology with a wi-fi laptop running mac-os. Thanks will smith!
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When I went to see this movie, there was a standing O in the end. It was a very entertaining experience. For the first 8-10 minutes, the place was silent (save for the movie). Then people started laughing realising it was a comedy intended for laughter. The rest of the movie was hysterical as people laughed harder and harder.
A well deserved standing ovation, in which I participated wholeheartedly.
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Seems more comparable to inoculations (Score:2)
While I think this is awesome, isn't this how I Am Legend happened?
Whatever happened in the movie was fanciful hand waving. This seems more comparable to inoculations. Fluids are introduced to the body, the body learns how to defend itself. Of course this high level perspective is about where the similarity ends.
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I Am Legend is complete fiction.
Slashdotters would never come out into the sunlight, no matter what.
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A subtle distinction between this and the whatever-it-was in the I Am Legend movie is that the drug in the movie was a preventative measure, while this is a curative measure. It's important because preventative measures need to be applied to everyone who might ever get cancer (which would be everyone, unless it's possible to predict cancer, which would be its own major breakthrough), while curative measures are applied to those who already have cancer.
From a societal standpoint, if everyone who has cancer
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From a societal standpoint, if everyone who has cancer suddenly turns into brains-craving zombies, that's a relatively small fraction of the population and it's a threat that can be dealt with.
That is what one would think. However, most zombie infestations only start out from just a handful of zombies, and they still get out of hand very quickly. All it takes is an evil bio-engineering company to try to turn it into a weapon.
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Assuming that the cure/infestation could spread, then sure, it's a serious threat, and I wouldn't want to take it lightly. Even a single zombie should be taken seriously (/wave Clairvius). But if you take the worst case scenario that a few million cancer patients suddenly become infectious zombies, then yes, it's a serious threat, a huge disaster, and the premise for an interesting sci-fi story.
On the other hand, if you take the best case scenario of a non-transferable zombification resulting as a side ef
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You can be that if this treatment worked, there would be heavy work in making it a vaccine. Why get paid for the slow stream of patients when you can just tell parents that they must have the treatment administered to their children before they can be enrolled in Kindergarten?
Of course, if we are worried about destroying the
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Even that wouldn't be too much of a threat. You would get a moderate fever, maybe some chills (a mild version of what happened in the story, except with a lot less foreign cells to kill), then you'd be fine. Might need a few-day hospital stay for monitoring, but likely nothing more.
As long as they aren't Reginald Barclay's T cells. http://en.memory-alpha.org/wiki/Barclay's_Protomorphosis_Syndrome [memory-alpha.org]
Re:Is there a drug? (Score:4, Interesting)
Re:Is there a drug? (Score:4, Interesting)
I am currently a candidate for an experimental treatment that does just that - plasma collection at start, then they convince the white blood cells to reproduce like mad, then put them back into me at weekly intervals.
Hopefully, my turn to play guinea pig for this one will come up this next month.
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I wish you luck. There are so many possibilities for this, but also risks.
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I am currently a candidate for an experimental treatment that does just that - plasma collection at start, then they convince the white blood cells to reproduce like mad, then put them back into me at weekly intervals.
I've heard of some trials of autologous immune therapies that were going on -- Dendreon (Prostate), Genesis/Lonza (Melanoma), and Sloan-Kettering Memorial (Ovarian & Leukemia) were supposedly doing some. Any chance you're in one of these?
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Selfish as I may sound, it would be great to hear your tale once the experiment is over - say, as a Slashdot story *wink wink*.
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Is there a drug that requires a prescription or some sort of long term "treatment" that goes along with this procedure? If not, then it probably won't catch on in our wonderful privatized health care system, sadly.
Really? Why? If you had a single dose, effective treatment for a fatal cancer, just how high do you think you could jack up the cost? People are already paying 100,000 a year for drugs that only prolong life by months. A 'cure' could be worth a million, easy. In the cold hearted world of the Medical Industrial Complex, you can bet your spreadsheet that they've already figured out exactly how much they would charge and how much they could make.
No, it's not going to be cheap - these sorts of treatments a
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Actually insurance companies (and you know how they love money....) will decide its merits as an intervention. What is more expensive, spending months or years in and out of the hospital with expensive chemo (which is going through shortages at the moment), or doing this one procedure and a couple weeks in the hospital? If this works, insurance companies may cover it and refuse to pay for chemo if the patient is a candidate for this treatment.
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Re:Is there a drug? (Score:4, Interesting)
A killer T cell is an end product cell type. It does not divide. As such introduction of the cells shouldn't cause lasting immunological issues, unless the synthetically activated cells initiate a cascade autoimmune reaction.
(T cells destroy pathogens, but they also pass antigen information on to B cells, which "remember" previous infectious agents, and mass replicate antibodies in the hystamine cycle. This mechanism is how vaccination works. Deactivated virus is introduced, white cells engage, destroy, and then present the debris to B cells, which produce antibodies. When the real virus comes along, the immine system reacts with a flood of antibody production, which greatly inhibits proliferation of the pathogen. In this case, researchers would have to be VERY careful what cellular membrane cues they program their new mutant superhero T cells to go after, or else the body may become sensitized against its own cellular membranes, resulting in runaway autoimmune reactions.)
Assuming that everything goes well, then the modified T cell culture will natually self-terminate like normal T cells do, and then all traces of the manipulation would be gone from the host.
This means that there shouldn't be a need for long term antirejection meds, like with a bone marrow transplant.
Re:Is there a drug? (Score:5, Interesting)
A killer T cell is an end product cell type. It does not divide.
T-cells are differentiated cells, but they most certainly do undergo clonal expansion.
(T cells destroy pathogens, but they also pass antigen information on to B cells, which "remember" previous infectious agents, and mass replicate antibodies in the hystamine cycle. This mechanism is how vaccination works.
Huh? "Histamine Cycle"?
Deactivated virus is introduced, white cells engage, destroy, and then present the debris to B cells, which produce antibodies. When the real virus comes along, the immine system reacts with a flood of antibody production, which greatly inhibits proliferation of the pathogen
This description relates to the humoral branch of the adaptive immune system, but is irrelevant here. The treatment in question primarily operates via a cell-mediated mechanism.
In this case, researchers would have to be VERY careful what cellular membrane cues they program their new mutant superhero T cells to go after, or else the body may become sensitized against its own cellular membranes, resulting in runaway autoimmune reactions.)
Target cue was CD19, a B-cell specific receptor (but not cancer-specific receptor). Hence the patient's ensuing state of hypo-gammaglobulinemia, due to indiscriminant destruction of antibody-producing cells.
Moderators, please refrain from moderation when not sufficiently versed in a field to accurately gauge the value of a post.
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Hey, I thought I was doing good dredging up information I was exposed to more than 20 years ago. (And at midnight, no less.) :)
I did not know T cells underwent mitosis. I thought they were produced as needed by their progenitor cells in the bone marrow, similarly to red cells.
Admittedly, I did not read tfa, (paywall, LONG out of university.) so I did knot read that it directly targets B cells. The issue of runaway autoimmune reactions is still relavent. Indescriminate destruction of B cells is a very bad th
Re:Is there a drug? (Score:4, Insightful)
I did not know T cells underwent mitosis. I thought they were produced as needed by their progenitor cells in the bone marrow, similarly to red cells.
Yes, that's correct, there are T-cell progenitors in the bone marrow that generate new T-cells. However, experienced T-cells are maintained in a population of circulating "memory" cells that persist long-term, and undergo rapid expansion upon encountering their triggering antigen.
Indescriminate destruction of B cells is a very bad thing and would make the patient extremely immune suppressed following the initial "thermonuclear" immune response, as the patient's immune system would effectively be given a lobotomy and would forget every pathogen it had encountered, and would remain that way until new B cells are produced.
Yes, these patients are currently on IVIG (Intravenous Immunoglobulin - antibodies collected and pooled from donors), and will be for a long time, possibly for the rest of their lives. Very expensive.
This treatment could be adapted for other types of cancer besides this flavor of leukemia, just as long as there is a reasonably reliable target for the t cells to go after.
Yes, I believe one of the next targets they are going after with this technique will be mesothelin-expressing tumors (found in certain ovarian/mesothelioma/pancreatic tumors). Will probably be messy, as it is expressed in certain populations of normal mesothelial cells.
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You learn something new everyday. :)
However, if the artificially sensitized T cells programmed to eliminate B cells stick around, the patient would not be able to properly recover. Any freshly produced B cells would be marked for elimination immediately after production.
Perhaps the population could be coaxed into premature senesence (sp? I am tired...) by carefully regulated injections of refined trigger protein? The idea is to get the memory population to spike and exhaust the longevity of the population.
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Perhaps the population could be coaxed into premature senesence (sp? I am tired...) by carefully regulated injections of refined trigger protein? The idea is to get the memory population to spike and exhaust the longevity of the population.
Well, nobody knows yet if the leukemia has been permanently eliminated, or is instead being continually suppressed by the constant T-cell response.
However, I believe the researchers involved have stated they would like to include a kill-switch (as a long-term goal), both to be able to turn off the attack when therapy is concluded (assuming it can ever be concluded). and as a safeguard against T-cell leukemia that might possibly be induced by the therapy.
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It's not the privatized health care that would be the problem (in this case) but rather the privatized medical research companies. Health care companies would prefer a cure, that way they get to keep the money that you keep paying them rather than give it to someone else. Plus they could probably find a reason to treat you as having a higher risk for other kinds of cancer or other conditions afterwards.
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If I don't make chemo drugs, say, I get 0% of Mr. Cancer Patient's medical spending. If I can develop a cure for his particular flavor of cancer, suddenly I capture a substantially greater than zero slice of the pie. Even if the absolute size of the pie shrinks(because my hypothetical single treatment is cheaper than his previous slow demise), my slice is larger. Assuming I c
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True, but they are still in competition. If you come up with a cure for a disease that you also treat and don't market it, then you risk your competitors coming up with a cure and then destroying your market for the treatment or the cure. Given the FDA approval lead time, if you can get your cure to market as soon as you develop it, then you probably have a good three years when you're selling the cure and your competitor isn't selling the treatment (because it's obsolete) or their cure (because it isn't
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It's not the privatized health care that would be the problem (in this case) but rather the privatized medical research companies.
No, it's the regulations that massively increase the cost of drugs.
Health care companies would prefer a cure, that way they get to keep the money that you keep paying them rather than give it to someone else.
As I understand it, the health insurance companies like big payouts, because it increases their income and hence their profits. For example, if they were collecting $100 and spending $50 then they'd face a backlash from the government, but by collecting $1000 and spending $950 they get the same amount of profit but can claim their margins are very tight. Or, when the stock market is actually going up, they can invest that $1000 until they ha
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Now that he has 1 billions modified T-cells, possibly double that now, how do they plan on getting them out, or make the body accept them?
They gradually diminished on their own as the targets disappeared.
This is a great article in explaining what happened. Something on this was posted a couple of weeks ago and most responses were jokes about getting AIDS to kill cancer. In any event I never did see what the explanation was until now.
On a further note, so I don't have to start a new post and get a rejection
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The sensation of "feeling sick" is (in layman's terms) your body shunting all resources to the immune system. You get sick to get better. This is partly why people who claim to never get sick have a tendency to suddenly drop dead. Their body is still full of garbage, they just never noticed because the fight was subtle. The more responsive your immune system, the more it beats the crap out of you. I'm dumbing it down to extremes here, so don't go and write this in your Med school entry exam :P
It can, a
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They're still his T-cells, they just got some direct reprogramming. Other than cells bearing the target protean (his cancerous B cells), nothing in his body will have any problem with them. The actual T-cells will die off now that the cancer is gone, but memory cells will now be primed to mount a new response if it's ever needed.
The fact that his new immune response is permanent is a good thing. If the cancer tries to come back, it'll get nipped in the bud before he even knows it happened.
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Yeah, but that one had a very poor title, implying that the HIV did the curing, whereas it was really only used to do the reprogramming.
House (Score:2)
He'd nearly kill the patient 3 times while making remarks about Cuddy's ass. And after the successful cure, he'd admit that the procedure had not yet been approved for use on rats, let alone people.
If it was Fringe, they'd be using alien DNA.
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And the doctor would have dropped acid first.
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Okay, what about prevention? (Score:4, Interesting)
Any chance of using this technique in a preventative way? I mean, could you give an inoculation to train your body to fight off the cancer when it first starts? Not an MD by any stretch.
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That probably wouldn't be a good idea.
The way the treatment works is by killing off most of your healthy T-cells. Then replacing them with the altered ones.
This leaves you open to infection pretty much forevermore.
Right now the treatment is kind of a russian roulette game. Things like kidney failure (due to being clogged with the byproducts of killed cancer) is no joke.
What they've got to do after they verify the results with further trials is find a way to control the reaction a bit more. Maybe lower d
Re:Okay, what about prevention? (Score:4, Insightful)
Maybe I am oversimplifying as I am not trained in this area... but I got that most of the side effects were due to how much cancer had taken over the body... two pounds of waste in one article I read. If you used a variant of this technique earlier, I was thinking that it might not be such a traumatic experience.
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Yes. But if you look at the article again. Part of the treatment is an intensive round of chemo to kill off most of the existing T-cells in the body. This way they don't attack the modified ones.
The problem is, after that, your immune system is more or less permanently compromised. You have enough to basically continue to try and fight off the cancer. But you're more susceptible to infections and the like. This is why the patients require regular infusions of immune globulin. To help bolster their im
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I have no expert knowledge in the field, but what would prevent the body from regenerating its own natural T-cells after the treatment? If the new, modified T-cells are the issue, can't you do the same thing as the first time around, having stored a batch of his old T-cells and kill off all the modified ones before pumping them back in again?
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It's the bone marrow who creates T-cells and I do believe they kill of that bone marrow in the proces. I assume it's not possible to store bone marrow outside of the body. Or I could be completely wrong.
You are. But hopefully Sam Wright will show up and save us with a car analogy to clear it all up. :)
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Multicellular organisms generally, humans not excepted, have a whole bunch of mechanisms to terminate abberant cells. Some are internal to the cell, conditions that trigger cellular suicide, and some involve the immune system coming in for the kill.
What we call "cancer" are the abberant cells that manage to overcome the internal defenses and multiply their way to clinical significance.
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Your body will often do this on it's own if you are healthy. When it doesn't, that's when you get cancer. I'd think, since it's actually a cure, it would be better to use it only on people that have cancer (especially since it could have a lot of nasty side effects). Perhaps using it preventatively might cause resistant forms of cancer to become more prevalent as well (I know that sounds crazy).
Want another test subject? (Score:2)
I have a relative in Ontario dying of cancer right now who might be willing to give it a shot.
Anyone in the field know if these guys can test on willing terminal patients? She's been given a year to live max.
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Do organizations often have a structural problem with dependence on what they are supposed to fight? That they do, and a fair few succumb. However, there is a nontrivial additional burden of proof when you go from saying that an organization is merely bloated, feckless, and profiteering, to saying that the organization is willing and capable of halting progress in order to preserve its reason for existence.
It can, and does,
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There are animals that are completely immune to the effects of cancer and "live forever" (try and age most lobster-species - you can't because they literally "regrow" their cells all the time). There are human groups that are vastly more immune to certain types of cancer (and some vastly more susceptible) - and yet they would probably die if you gave them the flu.
Cancer is merely the result of a cell going haywire and instead of dying it reproduces like mad and keeps going. It's a DNA mutation caused by t
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I know this is off-topic, but is that why lobster tastes so good? It's like the veal of the sea?
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Yes, that's mostly true. I wouldn't quite call it analog, since there's a checksum algorithm and all that (which still fails). But we have quite a number of redundancy in our non-cancerous cells to "restore from backup," so to speak.