UW-Madison researcher saved by stem cells

In ALL ARTICLES on September 7, 2009 at 7:44 pm

UW-Madison researcher saved by stem cells

Todd Finkelmeyer | Posted: Monday, September 7, 2009 9:15 am |

UW-Madison researcher Kurt Saupe, who studies the effects of age and diet on stem cells, found himself in need of a stem cell transplant.

It was the day after Christmas in 2007 when Kurt Saupe finally agreed to head into urgent care.

His wife had noticed that the seemingly fit and healthy researcher with UW-Madison’s department of medicine was getting out of breath simply walking up stairs at home, and prodded him to get checked out.

An X-ray showed that much of Saupe’s left lung was filled with liquid. Two days later, a needle was inserted between his ribs, and three liters of fluid were drained off.

“And I was feeling much better,” says Saupe, whose name rhymes with “copy.”

But Saupe’s wife, a heart failure and transplant specialist with UW Hospital and Clinics, sensed something was very wrong.

“He was confident he just had a little pneumonia and would get better,” says Dr. Nancy Sweitzer. “But as soon as I looked at (the X-ray), I knew that for this to happen to a 45-year-old, something really bad was going on.”

So Sweitzer kept logging onto the UW Hospital and Clinics’ database in an attempt to find information on the lab work performed on her husband. At about 6 p.m. on Friday, Dec. 28, the results were finally in – it appeared Saupe had leukemia.

It would be five long days – due to the weekend and New Year’s holiday – before the family could track down the necessary experts to give them more information on what, exactly, the lab results meant.

“That was probably the worst five days of my life,” says Saupe. “There were a lot of tears shed those days. But that was also the time I sort of came to terms with how bad it was.”

The official diagnosis: acute lymphoblastic leukemia (ALL), a relatively curable form of cancer among children. But among middle-age adults, ALL is extremely rare and very lethal.

In this cancer of the white blood cells, malignant, immature cells continuously multiply and are overproduced in the bone marrow. It ultimately kills by crowding out normal cells in the bone marrow and by spreading to other organs.

Saupe was told the one-year survival rate for his condition was about 50 percent – with the five-year rate about 25 percent.

It quickly became apparent that if Saupe – who currently devotes about half of his energy to researching the effects of age and diet on stem cells – was going to be around to watch his two young children grow up, he would need a new immune system via a successful stem cell transplant from a donor.

“When some people hear about stem cells, they think of science fiction and promises of cures years from now,” says Saupe. “But it’s important to show people that stem cell therapy isn’t a Frankenstein thing or 10 years away – it’s something that’s the standard of care for people like me.”

Adult stem cells appear in different parts of the body and have specialized roles. Found in places such as the liver, heart, fats and blood, they help repair and rejuvenate specific tissues.

In Saupe’s case, the adult stem cells found in bone marrow were the key to beating leukemia.

Adult stem cells don’t carry the ethical implications attached to embryonic stem cells that have ignited a firestorm of controversy over the last decade and engulfed Saupe’s research colleague, Jamie Thomson. In a critical development more than 10 years ago, Thomson was the first scientist to coax stem cells from human embryos. These stem cells are capable of transforming into cells from any tissue in the body, and scientists believe these so-called pluripotent cells hold the key to discovering the causes and cures for many human ailments, including Parkinson’s disease, juvenile diabetes and spinal cord injuries. But because embryos are destroyed in the process, embryonic stem cell research is a target of anti-abortion groups and socially conservative politicians.

More recently, in November of 2007, Thomson and others recorded another ground-breaking discovery – this time announcing that ordinary adult skin cells had been reprogrammed to resemble embryonic stem cells. These so-called induced pluripotent stem cells appear to have the ability to change into any type of cell in the body. And while some believe this discovery could finally end the ethical debate surrounding stem cell science, others contend more studies must be done to show these iPS cells don’t differ from the embryonic stem cells in unexpected ways.

As a stem cell researcher married to a transplant specialist, Saupe saw the irony of his situation.

“We’ve been talking for years about organ transplantation and heart transplants and what it’s like for a donor family and a recipient to go through all this,” says Saupe, a 47-year-old Madison native who graduated from Memorial High School in 1980. “So the idea that I was going to be the recipient of an organ (stem cell) transplant was sort of ironic in the context that Nancy has been working in this field for years.”

As for Saupe’s area of expertise, although he works with stem cells, it’s not like he was in a position to make a breakthrough that would directly impact his life.

Part of his research focuses on the effects an anti-aging, low-calorie diet has on the adult stem cells in the hearts of mice. In a nutshell, low-calorie diets have proven to increase the health and life expectancy of lab animals, and the staff in Saupe’s lab are interested in why and how this is so, especially as it relates to the heart.

The other half of Saupe’s research focuses on the role of an enzyme and its connection to brown adipose tissue, which helps control body weight and how many calories a body burns.

“We’re kind of looking for a fountain of youth, trying to find the molecular mechanism that triggers youthfulness,” says Saupe, whose research is currently connected with the UW Stem Cell and Regenerative Medicine Center, UW Institute on Aging, UW Cardiovascular Research Center and UW Physiology Department. “After all, none of us want to live longer if it means we’re going to be hungry and crabby.”

Despite his background as a scientist, Saupe said he decided shortly after being diagnosed with leukemia that he wasn’t going to spend too much energy delving into scientific literature to learn every detail about his disease.

“Sometimes it became very draining when I’d try to process too much information,” he says. “There were times when I just wanted to be the patient, I didn’t want to be the co-doctor or too involved with my treatment. I decided to let my oncologist be the expert.”

Conversely, his experiences as a researcher and the knowledge Sweitzer brought to the table about transplants and UW Hospital and Clinics was invaluable.

“One of the major things I’ve learned as a patient is the more you know about your treatment options, the more background you have, the better off you’re going to be,” says Saupe. “In the hospital, lots of things can fall through the cracks – switches in nursing shifts and doctors handing you off to different doctors. And if you don’t understand what pills you’re taking, what your treatment options are, you need to press them on it. Being a well-informed patient in general is incredibly important for your successful treatment.”

After the initial diagnosis early in 2008, Saupe started chemotherapy almost immediately. He handled the treatment well, and his disease went into remission.

But after a second round of chemo, blood work revealed mutations in his cells and it was determined a stem cell transplant would likely be necessary to save his life.

“You have to weigh the costs versus the potential benefits,” says Saupe.

The risks, as Saupe recalls, included a 2 percent to 10 percent chance that the transplant wouldn’t take, and he would die in the hospital. Additionally, the transplant process generally includes a gruelling, four- to six-week hospital stay.

The benefit was a potential large increase in lifespan.

“For us, it was a 30-second decision,” says Saupe, whose children now are 8 and 10.

But seven “perfect matches” were found in the National Marrow Donor Program Registry, which is linked to many transplant centers outside the United States.

“I don’t want to downplay the significance of the donor or what they go through, but it’s really a lot like giving blood,” says Saupe.

In the weeks leading up to the stem cell transplant, Saupe spent time regaining his strength. At the beginning of May in 2008, he weighed about 185 pounds as he entered the hospital to prepare for the transplant.

Over the next week, he received six rounds of high-dose chemotherapy and two high-dose radiation treatments.

With his immune system killed off, he was given one day of rest before it was time for the transplant on May 9.   “It’s anticlimactic, really,” says Saupe. “You get half a liter of yellowish fluid.”

Over a two-hour period, Saupe received roughly 5 million stem cells through a simple IV drip.

“And somehow, these cells home to the bone marrow and do what they do,” he says. “When they give you the high-dose radiation and chemo, your white blood cell count goes to zero. So they start checking that count every day, looking for your immune system to start back up again. They say that around day 14 it should start up, and if they don’t see anything by day 18, you’re in deep trouble.”

Adds Saupe: “Mine started on day 12. It was a really encouraging sign and things sort of improved from there.”

After his month-long stay in the hospital, Saupe had dropped about 45 pounds. But the transplant appeared to be a success.   “I’m incredibly grateful,” says Saupe.

Now, more than one year after the transplant, Saupe’s outlook is good.   He is cancer-free and his immune system is entirely female – composed solely of the XX chromosome instead of the XY chromosome – showing that the stem cell transplant provided by the woman from Germany took completely.

“That’s lead to some jokes among friends,” Saupe said of having the immune system of a woman. “But that’s OK.”  With the damaged cells out of his body, Saupe says he is convinced that if something bad is going to happen to him now, “it’s not going to be the cancer, but some sort of bacterial or fungal infection. But they have such good drugs to threat those things these days, I’m feeling pretty confident.”

“It has in some ways changed my outlook,” he says. “But the healthier I get, the more I recover and the stronger I get, those lessons sort of get pushed to the background. When I’m having bad days and not doing well, then I start remembering all these great lessons about appreciating every day. But it’s strange, I tend to have a very short memory in that regard.”

via UW-Madison researcher saved by stem cells.

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