Stem Cell Transplants From Umbilical Cord Blood

"This is now the third report of a cure in this setting, and the first in a woman living with HIV."

"[The report] confirms that a cure for HIV (Human Immunodeficiency Virus) is possible and further strengthens using gene therapy as a viable strategy for an HIV cure."

"It was previously thought that graft versus host disease might be an important reason for an H.I.V. cure in the prior cases."

"Taken together, these three cases of a cure post stem cell transplant all help in teasing out the various components of the transplant that were absolutely key to a cure."

Dr.Sharon Lewin, president-elect, International AIDS Society

"The fact that she’s mixed race, and that she’s a woman, that is really important scientifically and really important in terms of the community impact."

"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."

Steven Deeks, HIV researcher, University of California, San Francisco

A colored scanning electron micrograph of H.I.V. particles, in yellow, infecting a host cell. The patient received cord blood from a donor with the mutation that blocks H.I.V.’s entry into cells.   Credit...Thomas Deerinck, NCMIR/Science Source

Worldwide, approximately 38 million people are infected with and live with H.I.V. Some 73 percent of these H.I.V.-infected individuals receive treatment through antiretroviral therapy. Of that staggering number of people afflicted with the virus that causes AIDS, three people having undergone novel new surgeries have now been declared cured of the virus. The latest is an American woman with leukemia, the first woman and only the third person to the present cured after receiving a stem cell transplant, the donor of which was naturally resistant to the virus.

This breakthrough case of a middle-aged woman of mixed race was announced at the Conference on Retroviruses and Opportunistic Infections taking place in Denver, Colorado. The case study also represents the first involving umbilical cord blood, an emerging approach with the promise of expanding such treatment to greater numbers of H.I.V.-infected people.

The woman has been in remission, free of the virus, for 14 months, no longer requiring potent H.I.V. treatments known as antiretroviral therapy, since she received the cord blood treating her acute myeloid leukemia. This is a type of cancer that begins in blood-forming cells located in bone marrow. Before this case, there were two previous ones that occurred in H.I.V.-infected males. They too had received adult stem cells, more frequently used in bone marrow transplants.

The newly reported case outcome is part of a large U.S.-supported study with the intention of following 25 patients with H.I.V. who undergo transplants with stem cells taken from umbilical cord blood for cancer treatment and other serious conditions. At this point, doctors transplant stem cells from individuals having a specific genetic mutation where they lack receptors utilized by the virus to infect cells.

These individuals, scientists believe, then go on to develop an immune system that has become resistant to H.I.V. infection. While a considerable number of H.I.V. patients will go on to take advantage of this therapy, bone marrow transplants do not represent a viable strategy as a curative for most people living with H.I.V. But it is a building block that may lead to additional therapies whose treatment may have similar results.

 

This scanning electron microscopic image shows the presence of numerous HIV virions. Since receiving umbilical cord blood to treat her acute myeloid leukemia a 64-year-old woman from the U.S. has been in remission and free of the virus for 14 months, researchers said. (C. Goldsmith, P. Feorino, E. L. Palmer, W. R. McManus/CDC/Reuters)