Current Research

UPMC Cancer Centers works in tandem with the University of Pittsburgh Cancer Institute (UPCI), which comprises the academic and research activities for cancer at the University of Pittsburgh and UPMC, to offer patients the latest advances in cancer prevention, detection, diagnosis and treatment. A variety of clinical and laboratory investigations are underway under the direction of stem cell transplantation researchers at UPCI’s Hematologic Malignancies Program. A number of ongoing clinical trials in stem cell transplantation are underway to test promising new therapies.

Clinical research

The Stem Cell Transplantation Program is actively involved in clinical research to improve stem cell transplantation. These include:

• Exploring alternative allogeneic stem cell transplants. Lack of HLA-matched donors is a major problem that limits the use of allogeneic stem cell transplantation. UPCI scientists and clinicians are looking at transplantation of purified stem cells from partially matched relatives or from unrelated placental/umbilical cord blood cells for treatment of high-risk leukemia, lymphoma or other cancers of the blood-forming system. In addition, they are studying how specific HLA markers on the surfaces of donor and recipient cells influence graft-versus-host disease, graft rejection and other post-transplant complications. In a new trial use of haploidentical donors (mismatched family members) is studied for patients who not have a matched related or unrelated donor.
• Reducing transplant-related problems. A potentially serious and life-threatening complication of allogeneic stem cells transplantation, graft-versus-host disease, or GVHD, occurs when immune cells derived from the donor stem cells injure the recipient’s organs and tissues. UPCI investigators are evaluating new immunosuppressive agents to prevent and treat GVHD. In addition, UPCI scientists are studying how to decrease the toxicity of allogeneic stem cell transplants by giving patients lower-than-usual doses of chemotherapy in the pre-transplant period. These “mini-transplants” extend allogeneic stem cell therapy to patients who are otherwise at an unacceptably high risk of severe complications after conventional intensive pre-transplant therapies.
• Improving supportive care. After stem cell transplantation, a patient’s immune system is profoundly weakened and must gradually restore itself. During this time, a patient is susceptible to different kinds of infections. Clinical studies are underway at UPCI to boost the recovery of a patient’s immune system and decrease the risk of these severe infections.
• Performing research studies on outcomes and cost-effectiveness. Key to advancing transplantation is knowing whether new therapies actually improve patient outcome and reduce costs and suffering compared with existing therapies. UPCI’s Stem Cell Transplantation Program is investigating these issues as part of several large-scale clinical trials.

Laboratory research

Through the Stem Cell Transplantation Program, Program scientists are conducting studies on the basic biology of stem cells and the immune system to enhance transplant success and to expand the application of transplants to different diseases. Current projects in the area of immunobiology, immunotherapy and hematopoietic stem cell transplant include: a) delineation of the inflammatory signaling pathways during the early phase of Graft-versus-Host disease (GVHD) with the aim of developing targeted approaches that can reduce the transplantation-induced inflammatory reaction and thereby prevent the development of graft vs host disease (GVHD) b) mechanism(s) by which donor lymphocyte infusions induce Graft-versus-Leukemia (GVL), and development of strategies to enhance GVL effect; c) identification of minor histocompatibility antigens in order to achieve a more selective targeting of host hematopoietic cells by GVL effect.

For more detailed information on the Program’s research activities, including current research, accomplishments and future directions, visit the Hematologic Malignancies Program at the University of Pittsburgh Cancer Institute.