Eric Tkaczyk, MD, Ph.D., FAAD, Director Vanderbilt Dermatology Translational Research Clinic, Staff Physician Department of Veterans Affairs, Nashville Dermatology and Research Services, Assistant Professor Department of Dermatology, Assistant Professor Biomedical Engineering at Vanderbilt University Medical Center and Inga Saknite, Ph.D., Adjoint Assistant Professor of Dermatology, Department of Dermatology, Vanderbilt University Medical Center Senior Researcher, Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia. In this video, they speak about Noninvasive Videomicroscopy Predicts Blood Cancer Relapse.
A new study from Vanderbilt University Medical Center found that 10-second recordings of white blood cell mobility in the skin 's microvasculature considerably improved the prediction of which stem cell and bone marrow transplant patients would experience a relapse of their blood malignancy.
White blood cells are shown to interact with the inner walls of veins, rolling along them like bowling balls before attaching to them and escaping through them to go to sites of inflammation in the typical immune response.
Transplant patients with higher levels of adhesion and rolling along vessel walls in their white blood cells were more than three times more likely to develop cancer relapse or die than those with normal adherence and rolling levels.
The startling discovery, which is far more predictive than current models of blood cancer relapse and death, was published in JAMA Dermatology on March 26 and presented the same day in Boston at the American Academy of Dermatology 's annual meeting.
In a recent work utilizing noninvasive microscopy and graft-versus-host disease, researchers discovered what appeared to be a link between increased white blood cell activity and cancer relapse.
According to their findings, the clinical utility of employing videomicroscopy to view white blood cell activity in patients ' blood arteries had previously gone undiscovered.
Allogeneic transplant, as opposed to autologous transplant, in which the patient is the donor for himself or herself, uses stem cells or bone marrow from a sibling or other donor who is as closely matched to the patient as feasible. Immunosuppressive medications are frequently used in allogeneic transplantation to prevent graft-versus-host disease.
The team employed confocal videomicroscopy to capture white blood cell activity in the skin 's microvasculature in 56 blood cancer patients who had undergone allogeneic transplants between 34 and 58 days following the transplant. The study group was categorized into 35 participants (62 percent) with low A&R and 21 participants (38 percent) with high A&R based on a clinically significant threshold for high and low rates of adhering or rolling of white blood cells in the microvasculature.
Participants were tracked using electronic health data for a median of 15 months following transplant, during which time 13 relapsed and 14 died. There were nine relapses with high A&R among the 13 relapses, with eight of the nine relapses occurring within four months of imaging.
A&R considerably exceeded the improved Disease Risk Index, a known prediction model of cancer relapse or mortality following bone marrow transplant, such that when the two models were combined, A&R accounted for more than 80% of the prognostic information for relapse and death.
James Patrinely, MD, Zijun Zhao, MD, Heidi Chen, Ph.D., Alicia Beeghly-Fadiel, MPH, Ph.D., Tae Kon Kim, MD, Ph.D., Madan Jagasia, MBBS, and Michael Byrne, DO were also involved in the study from VUMC. The research was funded by the National Institutes of Health (CA090625) and Tkaczyk received a Career Development Award from the Department of Veterans Affairs Clinical Sciences R&D Service (IK2 CX001785).