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investigator-initiated studies, but also in many large national cooperative group studies and clinical trials, including the elite Bone Marrow Transplant Clinical Trials Network, the Eastern Cooperative Oncology Group, the Bone Marrow Transplant Information Network and the Pediatric Blood and Marrow Transplant Information Network." A recent study involves the use of mesenchymal stem cells and multi-potent adult progenitor cells, which are similar to mesenchymal stem cells but possess greater proliferative and regenerative properties. In collaboration with a local biotechnology cell therapy company called Athersys, UH Seidman Cancer Center researchers are currently investi- gating the role of these cells in GVHD and their use in allogeneic transplantation. UH Seidman Cancer Center also has an active umbilical cord blood transplant program as an alternative stem cell source for patients — adult as well as pediatric — who do not have a related matched donor. Umbilical cord blood transplant is limited by the relatively small stem cell content, according to Dr. de Lima who plans to investigate ex vivo expansion of cord blood cells in the lab prior to transplanting them into the patient, in order to induce faster engraftment. "It's an issue of improving access to treatment," says Dr. de Lima. "Cord or placenta blood increases the possibility of offering transplants to more people, because these cells are immunologically naïve — leading to less stringent match- ing criteria and an increased donor pool for minorities (which are under- represented in the national registry)." One of the biggest issues in leukemia management is which patients actually need to have transplantation and, of those, how to make it safer because of GVHD. So researchers at UH Seidman Cancer Center are looking at a certain type of lymphocytes called KIR (killer immuno- globulin receptor) cells and categorizing the KIR status of the donor visa vi the recipient to identify the safer transplant donor for the patient. The expectation is that GVHD will be significantly Marcos JG de Lima, MD, director, UH Seidman Cancer Center's Hematologic Malignancies and Stem Cell Transplant Program reduced. Dr. de Lima is also interested in epigenetic manipulation of the immune- mediated graft-versus-leukemia and graft-versus-host disease phenomena. Patients with myelodysplastic syn- drome and with chronic lymphocytic leukemia are two populations with very difficult to treat disorders for which transplantation has not historically been used very frequently. At UH Seidman Cancer Center these patients, especially those who are characterized as being at high risk because of chromosomal mutations in their bone marrow sta- tus, are being actively evaluated for allogeneic transplantation. "The results are so good," Dr. Gerson reports. "We're finding that a significant number of these patients can have the disease either cured or corrected by transplantation." Clinical trials investigating preparative regimens and post-transplant supportive therapies have also resulted in new protocols for acute lymphocytic leukemia patients to improve safety and outcomes. Along those same lines, UH Seidman Cancer Center is studying vaccines, antibodies and an immunogen named B212 and their ability to reduce toxicity and improve outcomes in patients with advanced lymphomas. "We have and are developing clinical trials that are actually redefining, and sometimes defining, standards of care," says Dr. de Lima, who plans to work with his UH Seidman Cancer Center colleagues to develop and offer patients access to clinical studies covering most hematologic malignancies. "We are working very hard to find new treatments that could, hopefully with time, lead us to an increased cure rate." For more information about UH Seidman Cancer Center's Hematologic Malignancies and Stem Cell Transplant Program, visit wwwUHSeidman.org. To refer a patient, call 216-844-3951. s NOVEMBER-DECEMBER 2012 s MDNEWS.COM s MD NEWS Cleveland/Akron/Canton | 17