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Discovery Could Prevent Pneumonia in Leukemia Patients

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Scott Evans, M.D., turned his frustration into a finding.

All too often, Evans, an assistant professor in the Department of Pulmonary Medicine at MD Anderson, has seen leukemia patients experience pneumonia in their initial treatments. This is the case in at least 40% of leukemia patients he sees, and a large number of them don't survive it.

One patient, in particular, comes to mind.

A young East Texas man in his early 30s was responding well to his treatments, until he contracted pneumonia. Before long, he was in intensive care, where he died.

Infection control for acute leukemia patients
Evans and his colleagues have identified a combination of two small molecules that stimulate the lungs to become resistant to infection. Their goal is to use this combination to prevent pneumonia in leukemia patients whose white blood cells are either suppressed by chemotherapy or are nonfunctional because of the disease.

Evans says the work began several years ago when the team simulated responses to infection by giving mice a bacteria-based aerosol treatment.

"The idea was to stimulate the epithelial cells that line the lungs' air passages with a mixture of molecules that are recognized by the innate immune system in proportions they occur in nature," Evans says.

Evans says the innate immune system is more primitive than the adaptive immune system, which is responsible for the effectiveness of vaccines. "But to its advantage, the innate immune system responds within minutes and defends against a variety of infectious agents at once," he explains.

Results provide hope
The aerosol treatment made mice highly resistant to infection with live bacteria, fungi and viruses, and was effective even in mice whose white blood cells were suppressed by chemotherapy.

Now that preliminary studies show these molecules can be delivered safely to the lungs of animals, plans are under way, in collaboration with William Wierda, M.D., Ph.D., associate professor in the Department of Leukemia, to launch clinical trials to protect patients who are undergoing chemotherapy for the treatment of acute leukemia.

Read the study in the Journal of Immunology

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