In new research, 10-second videos showing white blood cell motion in the microvasculature of the skin greatly enhanced the prediction of which stem cell and bone marrow transplant patients would suffer a relapse of their blood cancer.

According to a EurekAlert! report, researchers from Vanderbilt University Medical Center stated in their research that in the typical immune response, white blood cells are seen interacting with the inner walls of veins, rolling along with them like bowling balls before they adhere to them, then, exiting through them to go to areas of inflammation.

Essentially, transplant patients whose white blood cells were caught on video, which have greater levels of adherence and greater rolling along vessel walls, were more than thrice as possible to have cancer relapse or die, than those who have normal adherence and rolling levels.

The stark finding, much more predictive compared to established models of blood cancer relapse and death, was reported recently and presented in Boston at the annual meeting of the American Academy of Dermatology.

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Cancer research
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New research showing white blood cell motion in the microvasculature of the skin greatly enhanced the prediction of which stem cell and bone marrow transplant patients would suffer a relapse of their blood cancer.


Link Between Blood Cell Activity and Cancer Relapse

In a previously conducted study involving non-invasive microscopy and graft-versus-host disease, the authors stumbled on what seemed to be a link between higher white blood cell activity and cancer relapse.

According to adjoint assistant professor Inga Saknite, Ph.D., who provided the presentation in Boston, when they could turn their focus to the activity and gauge it carefully in the new study, they found the link to be "striking."

Saknite led the research published in JAMA Dermatology with Eric Tkaczyk, MD, Ph.D., assistant professor of Dermatology and Biomedical Engineering, director of Vanderbilt Dermatology Translational Research Clinic, and staff dermatologist at Nashville VA Medical Center.

Based on their report, the clinical value of utilizing videomicroscopy to noninvasively view white blood cell activity in patients' blood vessels has been unexplored to date.

'Diagnostic Optical Biopsy'

Tkaczyk explained that their study is raising the prospect of a new application of so-called "diagnostic optical biopsy," along with a special confocal microscope delivered to stem cell and bone marrow transplant for their skin's non-invasive right at the bedside.

Whereas this is a pilot study of only more than 50 patients, it points strongly to potential clinical applications for improved evaluation and management of patients. Patients at high risk for relapse could, for instance, be more readily referred to clinical tests.

Unique from autologous transplant, where the patient becomes the donor for him or herself, allogeneic transplant utilizes stem cells or bone marrow from a sibling or other donor matched as closely as possible to the patient.

Use of Allogeneic Transplant

Utilizing allogeneic transplant, immunosuppressant drugs are frequently used to avoid graft-versus-host disease. In 56 patients with blood cancer who had experienced allogeneic transplants, the team used confocal video microscopy to document blood cell activity in the microvasculature from 34 to 58 days following the transplant.

With a clinically meaningful threshold having been chosen for both high and low rates of adhering or rolling, also known as A&R of white blood cells in the microvasculature, the study group was divided into 35 participants with low A&R and 21 with high A&R.

As specified in the VUMC report, participants were followed through a review of electronic health records for 15 months from the transplant, during which 13 relapsed and 14 died. Out of 13 relapses, nine were found to have high A&R, with eight of the nine relapses taking place within four months of imaging.

 

A&R greatly outperformed an established predictive prototype of cancer relapse or death after bone marrow transplant known as the refined Disease Risk Index, such that when the two models were integrated, A&R accounted for more than 80 percent of the prognostic information for relapse and death.

Related information about blood cancer relapse is shown on Boston Children's Hospital's YouTube video below:

 

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