What?
A woman with HIV has become the third person ever to be cured of the disease using a novel umbilical cord blood treatment.
The patient in question was diagnosed with HIV in June 2013, and was being treated with antiretroviral therapy. Later, in March 2017, she was diagnosed with acute myeloid leukaemia (AML), a type of white blood cell cancer.
AML is an often aggressive type of cancer which can only be cured by completely removing a recipient patient’s immune system (and all of the cancerous white blood cells), and replacing it with a donor immune system grown from donor stem cells. This is commonly known as a bone marrow transplant, but it may involve the use of stem cells from sources other than bone marrow.
In August of that year, she received umbilical cord blood from a donor with a mutation that blocks HIV’s entry into cells. But as it can take about six weeks for cord blood cells to engraft (become part of the patient’s immune system), she was also given a ‘bridging’ blood stem cell transplant from a first-degree relative.
The researchers who treated her stated:
“The half-matched ‘haplo’ cells from her relative propped up her immune system until the cord blood cells became dominant, making the transplant much less dangerous. The transplant from the relative is like a bridge that got her through to the point of the cord blood being able to take over.
The patient opted to discontinue antiretroviral therapy 37 months after the transplant. More than 14 months later, she now shows no signs of HIV in blood tests, and does not seem to have detectable antibodies to the virus.”
Why?
HIV (human immunodeficiency virus) attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).
Despite effective anti-retroviral drugs, according to the World Health Organization (WHO), more than 36 million people have died of HIV since the start of the HIV/AIDS pandemic. This compares to under six million so far in the first two years of the COVID-19 pandemic. In 2020, 37.7 million people were living with HIV, and around 680,000 died.
Dr Jingmei Hsu and colleagues (from Weill Cornell Medicine, Staten Island, NY), published the case report, which can be accessed here.
How (does this affect you)?
Unless you have HIV/AIDS, this treatment is interesting but does not affect you.
Normally a bone marrow transplant is the best treatment for AML that does not respond to chemotherapy. However, such transplants are highly risky, so they are generally offered only to people with cancer who have exhausted all other options. Because of this, it is not a realistic option for most HIV patients.
But as Dr Steven Deeks (an AIDS expert at the University of California, San Francisco) said:
“Umbilical stem cells are attractive. There’s something magical about these cells and something magical perhaps about the cord blood in general that provides an extra benefit.”
Hence there may be other long-term viral conditions that, when combined with cancer, could affect you and may one day be amenable to such novel treatments.
Read more about the treatment in a New York Times article here.
Best wishes, as ever, from myHSN!
