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Archive for February, 2014

UNMC HIV research part of New England Journal of Medicine article

by Lisa Spellman, UNMC public relations

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Uriel Sandkovsky, M.D. 

A recent study involving HIV researchers at UNMC revealed that a new, simplified drug may be the most effective treatment for people infected with the disease.

The research was featured in the Nov. 7 issue of the New England Journal of Medicine.

The study compared the traditional drug therapy currently used and thought to be the “gold standard” to a new medication called dolutegravir. When combined with two commonly used HIV medications, dolutegravir is more effective — 88 percent compared to 81 percent — in reducing the viral load of HIV found in a patient’s bloodstream and has fewer side effects.

“The significance of the study was found in the number of people who discontinued taking the traditional drug therapy because of side effects compared to the newer drug,” said Uriel Sandkovsky, M.D., an assistant professor of medicine with the HIV Clinic and transplant infectious disease program at UNMC and the lead UNMC researcher on the study.

As researchers and physicians search for ways to help patients, this study will help in determining which HIV drug therapies are tolerated by the most people, he said.

Dr. Sandkovsky was one of the authors of the study, which included more than 100 investigators from 15 countries. The double blind controlled trial started in 2010 and is still ongoing, he said.

The study is sponsored by GlaxoSmithKline and ViiV Healthcare.

“Fifteen to 20 years ago patients would take 15 pills multiple times a day. Now we are down to a daily combination pill. That’s a great improvement,” Dr. Sandkovsky said.

Currently there are three once-a-day treatments that combine three or more drugs in one pill to offer patients for treatment.

“Now we have one more medication to offer our patients, that we know is actually more effective with the least side effects,” Dr. Sandkovsky said.

“At the HIV Clinic we take research very seriously, carefully evaluating clinical trials in order to offer what we think is the safest and the best option for our patients,” he said. “We have Susan Swindells, M.B.B.S., as a great leader and a fantastic team to support all we do.”

Time out with T.O. – Global memories

by Tom O’Connor, UNMC public relations

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Lance Villeneuve and Elizabeth Blowers 

It’s often said that the college years are the best years of our lives.

Much is learned in the classroom, but it’s what takes place outside the classroom that typically produces the memories that last a lifetime.

For UNMC students, the International Student Research Forum (ISRF) has become one of those memorable experiences outside the classroom.

For the past nine years, the ISRF has given students seeking their Ph.D. an opportunity to see the world and expand their scientific horizons.

“It’s become a world stage for them to present their research and make connections for their future careers,” said Jialin Zheng, M.D., director of the Asia Pacific Rim Development Program for UNMC and one of the organizers of the ISRF, along with Keith Swarts, business services, and Jayme Nekuda, benefits & work life program.

The ISRF brings together top doctorate students from different countries and universities and typically rotates between four countries.

The founding universities include UNMC, Griffith University, Australia, Institute of Medical Sciences at the University of Tokyo, and the Chinese Academy of Sciences.

Other universities may host the forum. In 2014, the ISRF will be hosted for the first time by the University of Southern Denmark on June 1-4.

For Lance Villeneuve, a fifth-year student studying Parkinson’s disease in the laboratory of Howard Fox, M.D., Ph.D., the ISRF has become an annual goal. He’s participated in the past three as a moderator and student leader.

“I formed lifetime friendships with my first trip to Japan,” he said. “I love networking with people internationally and learning about research going on around the world. It’s an eye opener and made me a better researcher.”

Villeneuve grew up in Omaha and went to the University of Notre Dame for his undergraduate degree. He plans to become a M.D./Ph.D. and is in the process of applying for medical school.

For Elizabeth Blowers, a fourth-year student conducting cancer research in the lab of Amarnath Natarajan, Ph.D., Eppley Institute for Cancer Research, the ISRF is “probably one of the best research forums I’ll ever go to.”

“In America, we have our own take on science,” said Blowers, an Indiana native who earned her undergraduate degree from the University of Tennessee and plans to pursue a research career. “With the ISRF, I’ve learned that each country has its own style of science.”

Travel and lodging expenses are covered for ISRF participants — memories are included.

UNMC part of international hepatitis C registry to improve treatment

by Vicky Cerino

The University of Nebraska Medical Center is involved in an international registry that’s evaluating new treatments for hepatitis C, a disease that threatens many baby boomers.

Many of the estimated 3 million people in the U.S. who have the virus – an overwhelming majority are baby boomers – don’t know they are infected. Hepatitis C is responsible for 12,000 deaths annually in the U.S, according to the Centers for Disease Control and Prevention.

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UNMC, a regional referral center for hepatitis C, is part of the Hepatitis C Therapeutic Registry and Research Network, or HCV-TARGET. The network will track thousands of patients over the next five years to monitor the effectiveness and safety of new drugs to determine which ones are most effective and can cure the disease most quickly with the fewest side effects.

The project is important because in the next couple of years, several new, more superior medications will be approved for hepatitis C therapy, said Mark Mailliard, M.D., chief of the UNMC Division of Gastroenterology and Hepatology.

“With the availability of new drugs, we will be able to capture a wealth of information that’s critical to determining which drugs are best and for which patients,” Dr. Mailliard said. “This is a great example of translational research at its best – taking the latest research discoveries to patients.”

The network is made up of university and community physicians at 103 sites in 31 states, Puerto Rico, Canada and Europe, in partnership with the U.S. Food and Drug Administration.

It’s estimated about 2 percent of the world’s population is infected with hepatitis C. If left untreated, the virus causes liver damage, cancer or cirrhosis. Fatigue may be the only symptom of the disease.

Anyone being treated for the virus using newer medications is eligible to participate in the registry.

Dr. Mailliard said most of the current drugs used to treat hepatitis C – typically interferon and ribavirin – have many side effects and require self-administered injections. But he said, over the next three years, the use of interferon will slowly go away because of new drugs that will be more effective with much less side effects.

“We’re really very excited about the registry. So far we’ve provided outcome data on more than  120 patients of the 2,000 studied so far,” Dr. Mailliard said. “Our treatment success rate was significantly better than the average rate.”

People born between 1945 and 1965 are encouraged to get tested since many don’t recognize they are at risk for the disease. A simple blood test can diagnose the disease.

“Not only will treatment reduce the chance for liver failure and liver cancer, the diagnosis reminds patients of the danger of alcohol use and obesity, which increase the risk of getting cirrhosis and cancer,” Dr. Mailliard said.

Hepatitis C virus is usually is spread through contact with an infected person’s blood — mostly by sharing needles, syringes, or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the U.S., hepatitis C also was commonly spread through blood transfusions.

The network receives support from pharmaceutical companies.

Those currently being treated for hepatitis C can learn more about participating in the registry by contacting Mary Capadano at (402) 559-3652 or mcapadano@unmc.edu. For more information about hepatitis C, go to www.cdc.gov.

Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu.

 

Bone Marrow Brothers

They were brothers. Best friends. Bonded for life. They enjoyed skiing, hunting and riding motorcycles – things teenage boys do. But, in October 2012, life took a very dramatic turn for Tyler and Tanner Snow, when Tyler came home from college with a bad stomachache.

“It was hard because nobody knew what was wrong with him,” remembers 18-year-old Tanner. “It was a difficult and scary time.”

Tyler’s stomachache lingered for a week. When he started vomiting blood, his parents rushed him to the emergency room in Kearney, Neb. Doctors ran a number of tests and referred Tyler to Mojtaba Akhtari, MD, an oncologist/hematologist at The Nebraska Medical Center.

“When I first met Tyler, I thought his illness could be a diagnostic challenge,” says Dr. Akhtari. “He was very young, pale and chronically ill. I was worried about him.”

After running more tests, Dr. Akhtari was able to diagnose Tyler with paroxysmal nocturnal hemoglobinuria (PNH) and aplastic anemia.

“PNH is a very rare blood disorder in which red blood cells are destroyed by the immune system and it could be associated with an empty-looking bone marrow,” explains Dr. Akhtari. “Aplastic anemia is when the bone marrow gets wiped out by the immune system and blood numbers drop. Patients need frequent transfusions and could die due to infection or bleeding.”

Given the seriousness of the situation, Dr. Akhtari began consulting with other doctors around the country. They came to the conclusion that Tyler would need a bone marrow transplant, or he may not live to see his 30th birthday.

“It didn’t matter what it took to get well,” says 20-year-old Tyler. “I didn’t have very long. Everything kept going downhill and I needed a life saver.”

bm_brothers_1Tyler’s brother, Tanner, was one of several family members tested to see if they would be a match.

Doctors began looking for a bone marrow donor. Immediate family members were tested first, but none proved to be a match.

“Our family is very close, so I was bummed when I found out I couldn’t help my brother,” admits Tanner. “I wanted to make things better.”

Determined to make a difference, Tanner looked to his fellow high school students for help. “Each year, the senior class does a blood drive. So, we decided to host a bone marrow drive too,” smiles Tanner. “It was great. We live in a small town, so people made meals and volunteered. Word got around. More than 100 people signed up on the bone marrow donor registry.”

Unfortunately, none of the donors in the brothers’ hometown of Litchfield, Neb., were a match. But, in May 2013, doctors found an anonymous donor.

“All I know is it’s a young male who lives outside the United States,” says Tyler. “I wrote my donor a letter and hope to be able to meet him one day.”

bm_brothers_2Tyler, the day after his transplant, flanked by brother Tanner (left) and a cousin.

Once the donor was located, things started moving quickly for Tyler. He had chemotherapy for six days prior to the transplant, in order to kill off the bone marrow that was already in his body. Finally, on June 12, the bone marrow transplant took place.

“The cool part was that I could see the clumps of cells going into my body,” remembers Tyler. “I immediately felt better. No more fatigue, no more headaches.”

Four months after the transplant, the Snow brothers were met with another surprise – this time on Tanner’s end.

“I got a phone call saying I was a bone marrow match for someone!” recalls Tanner. “All I know is that it’s a woman in her 40’s who has leukemia. It’s really exciting knowing I can help someone.”

While the transplant has yet to be scheduled, Tanner and Tyler are seizing the moment and encouraging everyone to sign up on the bone marrow registry.

“It’s so easy. Just go to bethematch.org and they’ll send you a free kit,” explained Tyler. “You could save a life.”

For now, the Snow brothers plan to live life to the fullest – knowing exactly what they’re grateful for this Christmas.

“We are so thankful for Tyler’s donor; but especially the doctors and nurses at The Nebraska Medical Center. They saved my brother’s life,” says Tanner. “This entire experience has brought our family closer together. You never know what will happen the next day.”

bm_brothers_3The Snow family (from left to right: Rod, Jenelle, Tanner and Tyler) have much to be grateful for this holiday after Tyler received a successful bone marrow transplant and Tanner is a match for someone he doesn’t know.

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