South Florida Adult Stem Cell Health Bank - Dr. Dipnarine Maharaj MD Medical Director

Thursday, September 5, 2013

Qualified Blood Donors 18-35 years old Needed in South Florida

WE NEED YOUR HELP!

Qualified Donors 18-35 years old Needed

We are currently recruiting participants for a

Research study that will test the ability of donated white blood cells to fight cancer

If you would like to donate white blood cells, or for additional information regarding this trial, please call the South Florida Bone Marrow/Stem Cell Transplant Institute research team at (561) 752-5522 or visit www.bmscti.org/clinicaltrials.htm

and fill out a “Donor Reply Form”

Note: compensation for time and travel will be given to Qualified Donors

Monday, August 5, 2013

The South Florida Bone Marrow Stem Cell Transplant Institute

The South Florida Bone Marrow Stem Cell Transplant Institute

Dr. Dipnarine Maharaj MD - Medical Director - South Florida Bone Marrow Stem Cell Transplant Institute

The South Florida Bone Marrow Stem Cell Transplant Institute (The Institute) is a Joint Commission Accredited Ambulatory Health Care Facility located at Bethesda Health City, Boynton Beach, Florida.

The program, which provides totally outpatient bone marrow stem cell transplant services, treated the first patient in 1998. At that time, it was under the management of Bethesda Memorial Hospital and functioned as a unit of the hospital. In 2001 it became independent of the hospital and is now freestanding and not associated with the hospital, except that the physicians are on staff at the hospital and may admit to the inpatient oncology unit at Bethesda Memorial Hospital, or the medical intensive care unit, if needed by the patient. The Institute received Joint Commission Accreditation in 2003 and was re-accredited in 2006 and 2009.

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Tuesday, July 30, 2013

Dipnarine Maharaj - Cancer Clinical Trial Information

Dr. Dipnarine Maharaj M.D., FACP - Medical Director - South Florida Bone Marrow Stem Cell Transplant Institute

South Florida Bone Marrow Stem Cell Transplant Institute (SFBMSCTI), based on a scientific collaboration with Dr Zheng Cui at Wake Forest University (WFU), has received IND (Investigational New Drug) approval from the FDA and WIRB (Western Institutional Review Board) approval to conduct a Phase I/II clinical trial using granulocytes for treatment of solid tumors in cancer patients. The clinical trial designation is 08001-BMSCTI.

In its simplest terms the protocol involves recruiting donors with a matching ABO/Rh (blood type) to the cancer patient and a significant HLA (tissue typing) mismatch, screening them on the basis of a predetermined set of study criteria, collecting their granulocytes from their peripheral blood, and transfusion of the fresh product to the matching cancer patient. On average, it requires 5 qualified donors to yield sufficient numbers of granulocytes to treat one cancer patient. Again on average, it takes 25 willing donors to yield those 5 qualified donors. (Based on potential Patient C-H, 10 qualified donors were obtained from a pool of 47 willing donors that met the study criteria).

Wednesday, July 24, 2013

Adult Stem Cell Current Clinical Applications – Hematological Disorders and Malignancies - Dipnarine Maharaj M.D. FACP

Current Clinical Applications – Hematological Disorders and Malignancies - Dipnarine Maharaj M.D. FACP

Dr. Dipnarine Maharaj M.D. - Medical Director - South Florida Bone Marrow Stem Cell Transplant Institute

Adult stem cells have been successfully used to treat blood disorders, blood cancers, and immune system disorders, for the last 50 years or so. Such treatments are routine medical procedures that provide curative protocols.

An adult stem cell transplant, or hematopoietic stem cell transplant (HSCT), is a procedure in which progenitor cells that are capable of reconstituting normal bone marrow function are administered to a patient. HSCT is usually carried out to eliminate a bone marrow infiltrative process, such as leukemia, or to correct nonmalignant disorders. In order to carry out a HSCT the patient’s bone marrow is destroyed with high-dose chemotherapy and radiotherapy and the new stem cells are then transplanted into the patient.

The stem cells which are used to replace the bone marrow and restore immune function are obtained from the patient (an autologous transplant), a donor (an allogeneic transplant), or from a genetically identical individual e.g. monozygotic twins (a syngeneic transplant). In order to conduct an autologous transplant the patient has to be in complete remission and the bone marrow has to be clean of tumor cells. In the case of allogeneic transplants, the donor and the recipient are not genetically identical, but they are histocompatible. There are several different types of allogeneic transplants: HLA (human leukocyte antigen)-matched sibling, HLA-matched unrelated donor, unmatched donor, and cord blood transplant. A relatively new technique is a nonmyeloablative or “mini” allogeneic transplant. In this procedure the bone marrow is not ablated. Instead, lower doses of chemotherapy are used to create a space within the bone marrow. The donor stem cells from the normal donor are then infused into the space, thus creating a chimera – where both recipient and donor cells coexist within the bone marrow space. Ultimately, the normal cells will destroy the abnormal stem cells. Nonmyeloablative transplants are still somewhat experimental; however they are associated with a lower risk of transplant-related mortality and thus offer a potential cure to patients who are considered too high-risk for conventional allogeneic HSCT. Common indications for allogeneic HSCT include:

· Malignant disorders:

Acute myelogenous leukemia (AML)
Non-Hodgkin’s lymphoma (NHL)
Hodgkin’s disease
Acute lymphoblastic leukemia (ALL)
Chronic myeloid leukemia (CML)
Multiple myeloma (MM)
Chronic lympocytic leukemia (CLL)

· Nonmalignant disorders:

Aplastic anemia
Thalassemia major
Severe combined immunodeficiency
Myelodysplastic syndromes
Sickle cell anemia

What about autologous transplants? Multiple myeloma remains the most common indication, followed by lymphoma, and then leukemia. Autoimmune diseases are also considered for autologous transplant.

Figure 1. Indications for Hematopoietic Stem Cell Transplantation in North America (2005)

Figure 1 illustrates data taken from the Center for the International Bone Marrow Transplant Registry. The green shows the number of allogeneic transplants that were carried out for different disease types and the yellow shows the autologous transplants. From this illustration it can be seen that the most common type of HTSC for multiple myeloma is an autologous transplant, whereas for acute lymphoblastic leukemia, the most common indication is for an allogeneic transplant.

Table 1. 5-Year Disease Free Survival Rate is Dependent Upon Transplant Type

5-Year Disease Free Survival
Disease		Autologous Transplantation	Allogeneic Transplantation
AML	1^st Complete Remission	40%	55%
AML	2^nd Complete Remission	30%	45%
Advanced AML		10%	20%
Multiple Myeloma		40%	35%
ALL	1^st Complete Remission		40%
ALL	2^nd Complete Remission		25%
HG Non-Hodgkin’s Lymphoma		50%	25%
Hodgkin’s Lymphoma		60%
CML	Chronic Phase 1^st Year		68%
CML	Chronic Phase >1^st Year		53%

As can be seen in Table 1, different types of HTSC are better than others for specific diseases. For example, the 5-year survival rate of a patient with multiple myeloma is approximately 40% with autologous transplant. However, with allogeneic transplants it is approximately 35. So, for multiple myeloma, an autologous transplant is the treatment of choice.

Research has shown that adult stem cells decline in function as we get older, but not in number. DNA damage and epigenetic modifications present in the older individual are known to limit the regenerative potential of adult stem cells. Thus, it is important to consider the age of a patient or stem cell donor, because even though we may be collecting large number of the cells many of them may be nonfunctional, and that will obviously have an impact upon the outcome of the transplant procedure. There is an obvious way around these problems, and that is to collect and store stem cells when we are young and healthy. The storage of healthy and functional adult stem cells provides biological insurance for the treatment of blood malignancies and for future regenerative therapies.

Tuesday, July 23, 2013

Storing Your Healthy Adult Stem Cells - Adult Stem Cell Banking - Commentary from Dr. Dipnarine Maharaj MD FACP

The best time to collect and store your healthy adult stem cells is before you develop a major cancer such as leukemia, lymphoma, multiple myeloma, breast cancer, etc. or a major chronic illness such as Parkinson's disease, diabetes, Alzheimer's disease, or stroke.

By Collecting and storing your healthy adult stem cells you are able to create a reset point for your immune system. So if and when you do get a type of illness you can have your immune system from when you are healthy to help you fight the disease that you develop when your immune system is weak.

In addition to banking your adult stem cells for the future it is critical to test your own immune system to see how your immune system is doing. You need to know your inflammatory and anti-inflammatory markers as well as your Cancer Killing Activity (CKA).

Dr. Dipnarine Maharaj M.D. is the Medical Director of the South Florida Bone Marrow Stem Cell Transplant Institute located in Boynton Beach, FL in Palm Beach County. He has over 30 years of bone marrow and stem cell transplant experience.