New stem cell transplant is gentler

Ryan Patrick, 8, knows a lot about trains. But he doesn’t talk much about his health. He has a rare immune disease that has left him with diabetes and life-threatening allergies.

Patrick's allergies include wheat, rye, barley, soy, eggs, legumes, apples and fish. Kids in his condition are lucky to live past 5, so his parents took a gamble on a treatment that could save his life.

Pediatric oncologist Shalini Shenoy and her colleagues at Washington University School of Medicine in St. Louis are studying a new kind of stem cell transplant.

Patients typically get radiation and chemo so they won’t reject the transplant. But toxic doses can cause brain damage and infertility.

"There are numerous organs that can be affected," Shenoy said.

The drug Campath (alemtuzumab) helps prevent rejection and is usually given at the time of stem cell transplant. Now, Shenoy gives it three weeks before. That eliminates the need for radiation and lowers the dose of required chemo.

"If you told me 10 years or 15 years ago that a transplant could be done without a lot of chemotherapy or radiation, I would have said, 'Oh, you’ve got be kidding me,'" Shenoy said.

Most patients who undergo stem cell transplant coupled with the early Campath treatment recover immune function about one year later with no major infections.

Patrick had the transplant and now eats food that could have killed him before.

"It’s like we woke up and we found out the last eight-and-a-half years were a horrible, horrible nightmare," said his mother, Amy. "Now, it’s morning."

This type of stem cell transplant shows promise for metabolic disorders, some genetic disorders, and even sickle cell disease. Shenoy says its use for fighting cancer that requires a transplant is possible too but has not been tried yet.

There are risks for infection with this procedure, and patients need to be closely monitored. Six centers are involved in the research.