TUCSON, AR – Leukemia, a type of blood cancer, is often treated with a bone-marrow transplant. For people of color diagnosed with the illness, however, there is less of a chance of finding a perfect match.
Dr. Emmanuel Katsanis has, for the past two years, developed a method for treating patients of color to improve their likelihood of beating the illness.
The haploidentical transplant, or haplo for short, allows for a transplant from a stem-cell donor with only half the matching proteins, using a method of human leukocyte antigen typing, rather than full or near-perfect matches, which are usually preferred.
As reported in the Arizona Daily Star, “No matter what transplant method is used, it’s important to search for a stem-cell donor with similar human leukocyte antigens. Matching antigens trick the body into welcoming the helpful, foreign cells without trying to destroy them.”
Dr. Katsanis told the Daily Star, “Haplo is relatively new. It’s exciting, but for us… we have evidence that it has impacted our (diverse) community. Haplo has really increased the survival of minorities.”
Also a Professor of Pediatrics, Medicine, Immunobiology, Pathology and a member of the University of Arizona Cancer Center, Steele Children’s Research Center, and the Bio5 Institute, Dr. Katsanis told The National Herald of his Greek roots. “My parents were born in the town of Filoti in Naxos,” he said.
Dr. Katsanis is also the Louise Thomas Chair in Pediatric Cancer Research; chief of the Division of Pediatric Hematology/Oncology, and is director of the University Medical Center (UMC) Blood and Marrow Transplant Program since 2012.
As noted in his biography, Dr. Katsanis received his MD in 1980 from the National University of Athens Medical School in Greece. He did postdoctoral work in medicine (1981-1982) and a rotating internship (1982-1983) at McGill University, Montreal, Canada, followed by a pediatric residency (1983-1987) at the University of Ottawa in Canada. He then completed his fellowship in pediatric hematology, oncology and bone marrow transplantation (1987-1990) and postdoctoral work in tumor and transplant immunology (1990-1991) leading to an Assistant Professor position in the Department of Pediatrics at the University of Minnesota (1991-1997).
In 1997, he joined the faculty at the University of Arizona and was promoted to Associate Professor in 1998 and Professor in 2004. In 2005, he was named Head of the division of Pediatric Hematology/Oncology and in 2012 appointed Director of the Blood and Marrow Transplantation Program. As a physician-scientist, Dr. Katsanis provides clinical care for children with cancer and blood disorders and conducts research at the UA Steele Children’s Research Center. He currently serves on NIH grant study sections, numerous international granting organizations and on journal editorial boards. Dr. Katsanis has published extensively in the areas of cancer immunology and hematopoietic stem cell transplantation. He has received grants from the Medical Research Council of Canada, the National Institutes of Health, the Department of Defense, the Canadian and American Cancer Societies and the Leukemia and Lymphoma Society.
As a pediatric oncologist, Dr. Katsanis provides care for children with cancer and other blood diseases at Diamond Children’s at UMC and the Hematology/Oncology/BMT Clinic, an outpatient clinic housed within Banner University Medical Center.
When he took over as director of the UMC Blood and Marrow Transplant Program in 2012, he noted, “I looked at our outcomes and I felt that they needed to be improved,” as reported in the Daily Star.
In the last two years, Dr. Katsanis has performed haploidentical transplants on 10 pediatric patients, all of whom are alive and leukemia-free, as the Daily Star reported. For adults, Dr. Katsanis noted that “the results also appear better than near-perfect donor matches.”
Dr. Katsanis is also working on improving chemotherapy through the clinical study of the drug Bendamustine to help suppress donor stem cells from attacking the recipient’s body but still allow the donor stem cells to attack the leukemia. The current drug, cyclophosphamide, does so well it even suppresses the donor stem cells from attacking the leukemia, the Daily Star reported.
Finding an ideal bone marrow donor usually begins with the siblings of the patient, if none is perfectly matched, non-related donors are sought, usually from volunteers registered in the National Marrow Donor Program (NMDP). Minorities are underrepresented on the list, however, so haplo offers more options since parents are already a half match for their children.
“There’s also a 50 percent chance that someone’s sibling will be a half match, a 25 percent chance they will be a perfect match and a 25 percent chance they inherited the opposite antigens. But there are many minor human leukocite antigens that are not tested for, and people are more likely to share those with family members than unrelated donors, Katsanis said, another advantage of haplo,” as reported in the Daily Star.
Finding a perfectly matched donor is about 80 percent for white patients, and for a one-antigen mismatch, 97 percent. For Hispanics, Native Americans, and Asians, it’s about 40 percent for perfect matches or about 80 percent or less for a one-antigen mismatch. Black patients have about a 20 percent chance for a perfect match and a 76 percent chance for an unrelated mismatch, according to a 2014 paper in the New England Journal of Medicine cited by the NMDP, as reported in the Daly Star.
Since it is new and still being studied, the haplo method is less likely to be used by more conservative doctors, though Dr. Katsanis “believes that in 10 years, haplo will be used more often than finding an unrelated donor,” the Daily Star reported.
“Pretty much each of these are a miracle in terms of what we’ve managed to do over 10 years ago,” Dr. Katsanis said, as reported in the Daily Star. “And I have patients that I remember — if this was now … they would have been alive because haplo was not even an option back then.”