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患者自身の幹細胞を使い，脳腫瘍に対する化学療法の副作用を軽減できるかもしれない。膠芽腫（脳腫瘍の一種）の化学療法では骨髄への副作用が治療の妨げとなる。また，化学療法に耐性の患者が半数以上を占めるが，これらの患者はさらに治療が困難で，生存期間は12～15カ月とされる。そこで，遺伝子を改変した自家幹細胞の移植により，こうした患者の骨髄細胞を，化学療法の効果に影響せずに保護する方法が考案された。今回，進行中の小規模臨床試験の途中経過が発表され，患者3名中2名で生存期間が予想を上回り，1名は治療後ほぼ3年，癌の進行もなく生存している。幹細胞治療の新たな可能性として注目される。（吉田素子）
Transplanted Gene-Modified Blood Stem Cells Protect Brain Cancer Patients from Toxic Side Effects of Chemotherapy
Study is First to Show Feasibility and Efficacy of a New Use for Autologous Stem Cell Transplant
For the first time, scientists at Fred Hutchinson Cancer Research Center have transplanted brain cancer patients’ own gene-modified blood stem cells in order to protect their bone marrow against the toxic side effects of chemotherapy. Initial results of the ongoing, small clinical trial of three patients with glioblastoma showed that two patients survived longer than predicted if they had not been given the transplants, and a third patient remains alive with no disease progression almost three years after treatment.
“We found that patients were able to tolerate the chemotherapy better and without negative side effects after transplantation of the gene-modified stem cells than patients in previous studies who received the same type of chemotherapy without a transplant of gene-modified stem cells,” said Hans-Peter Kiem, M.D., senior and corresponding author of the study published in the May 9 issue of Science Translational Medicine.
Kiem, a member of the Clinical Research Division at the Hutchinson Center, said that a major barrier to effective use of chemotherapy to treat cancers like glioblastoma has been the toxicity of chemotherapy drugs to other organs, primarily bone marrow. This results in decreased blood cell counts, increased susceptibility to infections and other side effects. Discontinuing or delaying treatment or reducing the chemotherapy dose is generally required, but that often results in less effective treatment.
［単語和訳］
Transplanted：移植された Gene-Modified：遺伝子組み換え Blood Stem Cells：血液幹細胞 Brain Cancer：脳腫瘍 Toxic：有害な Side Effects：副作用 Chemotherapy：化学療法
Feasibility：実現可能性 Efficacy：有効性 Autologous Stem Cell Transplant：自家幹細胞移植Cancer：癌 bone marrow：骨髄 ongoing：進行中の clinical trial：治験 glioblastoma：膠芽腫 predicted：予測された progression：進行
tolerate：～に耐える transplantation：移植 M.D.：医師 senior and corresponding author：主席著者・連絡先の著者 Translational：トランスレーショナル（基礎研究を臨床につなげることを目指した）（Science Translational Medicineは雑誌名）
Clinical Research：臨床研究 barrier to：～にとっての障害 toxicity：毒性 organs：器官 primarily：主に blood cell counts：血球数 susceptibility to infections：感染しやすさ Discontinuing：中止すること dose：用量 results in：～につながる
