FY 1994 Annual Report to the Regents

Highlights from Medical Research, 1994

Mark Kaminski with patient

Patients with advanced stages of non-Hodgkin's lymphoma are now free of disease thanks to a revolutionary new cancer treatment developed by Mark Kaminski, associate professor of internal medicine and Richard Wahl, professor of internal medicine and radiology, of the UM Comprehensive Cancer Center. The new treatment, called radioimmunotherapy, involves the injection of cancer-seeking and cancer-destroying radioactive monoclonal antibodies into patients with B-cell lymphoma. In a clinical trial, the treatment caused the tumors to shrink in size in 70 percent of patients and to completely disappear in 50 percent. The patients experience few side effects.

Richard Wahl and researchers at the UM Medical Center reported success in using non-invasive means to determine whether melanoma, a skin cancer, has spread beyond the skin to lymph nodes or elsewhere in the body. The research team used Positron Emission Tomography (PET) to detect melanoma that was not found during a physical exam or with a computer tomography (CT) scan.

Gary Nabel, professor of internal medicine and professor of biological chemistry, is taking an innovative approach to HIV infection-using gene therapy. Because the virus enters immune cells and behaves much like a mutant human gene, Nabel's research team has introduced new genetic material into a patient's immune cells, altering a protein in them. A research trial with twelve patients is testing the safety of the procedure and potential for improving survival of T-cells, a type of immune cell. The eventual goal of such therapy is to delay symptoms of AIDS, since laboratory studies found that gene manipulations can impede the growth of HIV.

An advance that will reduce the costs and problems of bone marrow transplantation was reported by Bernhard Palsson, UM associate professor chemical engineering, Stephen Emerson, associate professor of internal medicine and chief of hematology, and Manfred Koller, a researcher at Aastrom Biosciences. They have succeeded in growing large numbers of stem and progenitor cells from small samples of human bone marrow. The automated culture process produced cells in sufficient volume and with the proper characteristics to complete a full bone marrow transplant.

The UM was recently awarded a $10.5 million grant from the National Institute on Aging to continue work at the Michigan Alzheimer's Disease Research Center. According to Sid Gilman, professor of neurology, the center's emphasis is on basic research that will lead to a better understanding of Alzheimer's disease and related disorders. The grant covers six research projects, including a study of public knowledge of and attitudes toward dementia. It will also expand dementia-related services in the state, especially in northern Michigan and Detroit.

Steven Donn with infant in incubator

A new device for mechanical ventilators is proving to be useful for treating pre-term infants. Older children and adults have long had the benefit of ventilators that breathe in a natural rhythm controlled by the patient, but the technology was not sensitive enough to respond to the breathing needs of small infants. Now a new transducer can detect the slightest wisp of change in the airway flow, making it possible to return ventilator control to babies, according to Steven Donn, professor of pediatrics and communicable disease. In a randomized study, infants with respiratory distress syndrome assigned to the new device came off the ventilator twice as fast. The decreased ventilation time resulted in a less chronic lung disease as well as savings of more than $4,400 per patient. Also, the infants required less sedation, gained weight faster, and experienced better oxygenation and more efficient gas exchange. Bird Products Corporation of Palm Springs, California worked closely with UM neonatologists and respiratory therapists to design the sensor.

The cost of treatment of infants in intensive care units is approaching $3 billion a year. The sickest babies generate much disagreement over treatment and prognosis among doctors, nurses, and parents. UM sociologist Renee Ansbach documents these problems in Deciding Who Lives: Fateful Choices in the Intensive Care Nursery (University of California Press). For the book, she observed intensive care nurseries and interviewed nurses, doctors, and parents.