KIR Donor Profiling: The Next Step in Finding the Best Hematopoietic Stem Cell Transplantation Donor
For many leukemia patients after chemotherapy, an allogeneic hematopoietic stem cell transplantation (HSCT) is a key therapeutic element. These transplants effectively replace the damaged immune and hematologic systems that are eradicated by the chemotherapy regimen with hematopoietic stem cells from a HLA-matched donor. Unfortunately, even after such an extensive transplant process, the leukemia often returns. This occurs because of residual leukemia cells that were not fully eliminated by the chemotherapy.
Hematopoietic stem cell transplantation (HSCT) is considered a curative therapy for a number of patients suffering from certain hematological malignancies and other hematologic or immune disorders. The most favorable patient outcome occurs when the best HSCT donor is found. However, determining which donor will provide the best patient outcome is a complex decision.
T.N.B.C… Awful letters for an oncologist to have to say and so much worse to have to hear. But what does it mean? These initials stand for Triple Negative Breast Cancer. TNBC diagnosis occurs in 15-20% of breast cancer patients. Unlike other diagnoses, TNBC is a descriptive term that means the breast cancer tested negative for three common hormonal cancer drivers. The negative results indicate that the growth of the cancer is not supported by the hormones estrogen or progesterone nor by HER2 amplification, all three of which have predefined treatment options.
Next Generation Sequencing (NGS) platforms are quickly becoming key technologies to characterize the resistant tumor profile because of their ability to test for multiple mutations simultaneously, as well as their potential to discover novel uncharacterized mutations, and the requirement for only a small amount of specimen needed to run the assay.
For a subset of patients with non-small cell lung cancer (NSCLC), treatment has been evolving. Patients whose tumor has a genetic rearrangement in the anaplastic lymphoma kinase (ALK) gene can be treated with the drug Xalkori® (Pfizer, crizotinib), which inhibits the effects of the mutation and in the majority of cases (about 2/3rds of patients) shrinks the tumor, indicating that the patient is responding to the drug. The happy outcome of this story is short-lived, however...