OncoLog, Volume 60, Number 2, February 2015 Page: 4
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Natural Killer Cell Therapy
[Continued from page 3]eople have
expanded natural killer cells
from cord blood before, but
not this quickly or reliably."
- Dr. Nina Shahunable to reach them because of the
blood-brain barrier.
Unanswered questions
Allogeneic natural killer cells, even
those expanded using the new artificial
antigen-presenting cells, may have lim-
ited lifespans after infusion. "We don't
know whether natural killer cells prolif-
erate in the body in response to the
tumor the way T cells do," Dr. Lee said.
In leukemia patients who undergo T
cell therapy, under the right circum-
stances the T cells will grow to out-
number the tumor cells, but patients
who undergo natural killer cell therapy
will likely require multiple infusions
or some other means of sustaining the
number of cells.
It also is not known how well natu-
ral killer cell therapy will be tolerated
by recipients, and any patient character-
istics that may be contraindications to
this treatment have yet to be deter-
mined. Although infusions of natural
killer cells are unlikely to cause graft-
versus-host disease, the allogeneic natu-
ral killer cell infusions still could have
adverse effects related to their stimula-
tion of the immune system. Such effects
might include allergic responses, fever,
leaky blood vessels, or low blood pres-
sure; however, these adverse effects have
not been seen in any of the natural kill-
er cell therapy trials ongoing at MD
Anderson. The upcoming phase I trials
at MD Anderson will continue to test
patients' tolerance of this treatment.
Future directions
Although natural killer cells are
associated with fewer adverse effectsthan allogeneic stem cell transplanta-
tion, they also are less specific than
T cells, which target particular tumor
markers. Engineering natural killer
cells to recognize certain tumors may
increase the effectiveness of natural
killer cell therapy. Dr. Shah's group
is currently studying ways to engineer
natural killer cells to target an antigen
on myeloma cells.
Another possibility is banking a
patient's own natural killer cells and
then re-infusing those cells after che-
motherapy. Dr. Lee said, "For a long
time we thought that if a patient de-
velops cancer, then the patient's own
natural killer cells must not be very
effective, suggesting that natural killer
cells from a donor would be better.
But now we have reason to believe
that the patient's cells can still be ben-
eficial if given in high enough num-
bers or delivered to the right loca-
tion."
Yet another possibility for natural
killer cell therapy is the creation of a
product that clinicians can store and
use when needed rather than searching
for a specific donor or generating an
individualized treatment. Because natu-
ral killer cells can be derived from ex-
isting peripheral blood banks and cord
blood banks, expanded to very large
numbers relatively quickly, frozen until
needed, and then used to treat all kinds
of cancer cells, this scenario seems with-
in reach.
FOR MORE INFORMATION
Dr. Dean Lee ........................713-563-5404
Dr. Nina Shah........................713-794-5745Concurrent Tre
Improves Sun
By Bryan Tutt
Concurrent HIV and cancer
in the clinic, regardless of i
first. The simultaneous tre;
complicated by patients' iA
the lack of routine HIV scr(
between drugs. Infectious
University of Texas MD An(
tinely treat HIV in cancer p
ways to overcome these cl
HIV and cancer
The relationship between HIV and
cancer is not fully understood, but the
virus is known to confer a high risk for
various cancers.
"For many years, we had a group of
cancers that were associated with HIV,
the so-called AIDS-defining cancers:
cervical cancer, Kaposi sarcoma, and
non-Hodgkin lymphoma," said Harrys
Torres, M.D., an assistant professor in
the Department of Infectious Diseases.
"Now, with advances in HIV treat-
ment, patients are living longer and
developing non-AIDS-defining can-
cers."
Compared with the general popula-
tion, people with HIV have higher
rates of lung cancer, melanoma, head
and neck cancer, and anal cancer.
"The immunocompromised state pre-
disposes patients to the development
of cancer, similar to what is seen in
solid-organ-transplant patients," said
Bruno Granwehr, M.D., an associate
professor in the Department of Infec-
tious Diseases.
The high rates of cancer among
HIV patients have a devastating con-
sequence. "One-third of deaths among
people with HIV in the United States
are cancer-related," Dr. Torres said.
"That may have to do with the late di-
agnosis of HIV in patients whose can-
cer is diagnosed first and the limited4 OncoLog * February 2015
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University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 60, Number 2, February 2015, periodical, February 2015; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth639459/m1/4/: accessed May 8, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.