Game-changing treatment triples blood cancer patients' chances of surviving
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A 'game-changing' Australian blood cancer treatment triples patients chances of surviving, being cancer free and avoiding serious, life-long complications, new research shows.
The breakthrough is set to change a key part of blood stem cell transplants — which can have life-threatening side effects — and uses an existing, affordable drug.
The research, led by Melbourne's Alfred Hospital and Monash University, has already prompted several Australian health services to switch to the new treatment and several other countries are expected to follow in their foot steps.
The five-year trial involved multiple Australian and New Zealand hospitals and more than 100 leukaemia patients who had received a blood stem cell transplant from a matched donor.
The transplants are a lifesaving blood cancer treatment that allow patients to receive healthy blood-making cells, but they are also high risk.
About one in three patients reject the cells — a serious complication known as 'graft versus host disease', where the donor's immune system attacks their healthy organs.
Alfred haematologist and Monash University Professor David Curtis said doctors gave patients a combination of drugs post-transplant to try and reduce that risk but it did not 'prevent it always'.
He said they wanted to find a better option and their trial found a new, less toxic drug combination halved patients' risk of GVD without increasing the risk of a cancer relapse.
'In people who got the standard treatment, after three years only one in six were alive, free of their disease and without having suffered graft versus host disease,' he said.
'With the new treatment, it's one in two. You're three times more likely to be alive without disease and without having suffered graft versus host disease.'
Professor Curtis said it was important to spare patients from GVD, which was fatal for a small proportion and, for others, a less deadly but chronic, disfiguring disease.
'It lasts basically forever,' he said.
'It can affect any organ, but it often affects people's skin.'
Every year, about 150 of the 600 patients who get a blood stem cell transplants in Australia and New Zealand suffer a serious complication.
Prof Curtis said it caused issues including cataracts, hair-loss and a tightening of the skin that could look like a bad burn, and medications weren't always effective.
The Australian protocol swapped one of the two drugs used in the standard treatment with an affordable chemotherapy drug. The study was sponsored by the Australasian Leukaemia and Lymphoma Group and published in the New England Journal of Medicine.
Leukaemia survivor Stephanie Jouhari, 27, was in the trial and received the new treatment after her cancer relapsed at the age of 22.
Ms Jouhari, now in remission, said research that didn't just improve survival rates — but also what that post-cancer life looked like.
'I want to be where I can be, healed and healthy and at the same level as everyone else who's in my 20s as well and not feel like I've got all these other obstacles now to face for the rest of my life,' she said.
'It's already a difficult time so to make it less likely for there to be ongoing health issues . . . it's just huge . . . If we can continue funding and researching and doing these clinical trials, it'll just mean that the next group of people who unfortunately have to face this disease can walk away with much better prognosis but also a lot less suffering and trauma from the actual treatment itself.' 'Rapid review' of IVF ordered by nation's health ministers
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The Age
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Why my husband's howl over back pain could happen 4 million times around Australia
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Some 38 per cent of back pain patients admitted to hospital via three Sydney EDs for further investigation were found to have a serious underlying cause, such as an infection or fracture, an analysis of medical records showed. They needed to be in hospital. But 57 per cent of admitted patients had no serious underlying causes for their back pain. Associate Professor Gustavo Machado at the Institute for Musculoskeletal Health at the University of Sydney said current approaches to managing back pain in emergency settings often escalate interventions without clinical justification, leading to unnecessary hospital admissions, imaging, and opioid use. Loading Almost one in five patients developed a hospital-acquired complication, most commonly a medication-related adverse effect. 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'If a person is living alone, if they're elderly, they're unable to drive or transport themselves to a medical centre or pharmacy, then calling an ambulance is extremely reasonable.' Clare Beech, NSW Ambulance's executive director of clinical capability, safety, and quality, said a call to triple zero does not necessarily lead to an ambulance transfer to hospital. 'We're increasingly equipped to understand the patient's needs and potentially refer them to someone more appropriate,' Beech said, including via the service's Virtual Clinical Care Centre. 'For people with severe back pain [who] we are unable to manage in their home … there is a likelihood that they would end up being transported to an emergency department,' Beech said. Wilson said GPs were trained to exclude serious causes of back pain and reassure their patients. 'It usually takes about six weeks to resolve, and in that time, we can put a strategy in place,' Wilson said. But long wait times for underfunded GP practices and few after-hours services are major barriers to seeking care. Urgent Care Clinics may divert people from EDs, and Healthdirect's virtualADULTS offers 24/7 urgent telehealth consultations with clinicians. Loading Dylan called Healthdirect. A triage nurse said he would probably need an ambulance. Instead, they put him through to an emergency physician at RPA Hospital, who assessed him, prescribed pain relief and recommended he see a GP and physiotherapist. After about six hours on the bathroom floor, I wedged a towel under his torso and dragged him by his left leg to our bedroom. A singularly bonding experience. He's fine now. Don't ask him about it. He'll tell you I yanked his leg the wrong way on purpose. It was an honest mistake.
Sydney Morning Herald
5 hours ago
- Sydney Morning Herald
Why my husband's howl over back pain could happen 4 million times around Australia
I am no Carrie. I caught a taxi home. Dylan was, thankfully, wearing pants. An estimated 4 million Australians have back problems, and rising numbers are calling triple zero for ambulances to take them to emergency departments (EDs). Back pain was the fifth-most common presentation to Australian EDs in 2023-24 (almost 155,000). But most people with sudden-onset back pain don't need emergency care, which could lead to unnecessary and potentially harmful complications. 'There's something deeply primal about our response to sudden-onset back pain,' Sydney GP and addiction specialist Dr Hester Wilson said. 'It's very common, but it can be incredibly frightening,' she said. 'All those large muscles protecting the spinal cord suddenly seize up, and the emotional message this sends is 'danger!' 'The problem is, they don't know where to go for help.' 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Dr Simon Vella, a postdoctoral research fellow at the institute, analysed data from one major Sydney ED and found 46 per cent of people with back pain transported by ambulance received opioids, 59 per cent received imaging, and 50 per cent were admitted. 'Emergency staff and paramedics are often pressed for time,' Vella said. 'They need to make fast decisions about people they've just met, which makes it challenging to determine which patients need emergency care and which do not.' An analysis of more than 73,000 NSW Ambulance patients with back pain found 97 per cent of spinal pain was categorised as non-serious, and 81 per cent were transported to EDs. A NSW Health spokesperson said in most cases, back pain can be appropriately assessed and treated by a GP and allied health services, and scans are unnecessary. 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'If a person is living alone, if they're elderly, they're unable to drive or transport themselves to a medical centre or pharmacy, then calling an ambulance is extremely reasonable.' Clare Beech, NSW Ambulance's executive director of clinical capability, safety, and quality, said a call to triple zero does not necessarily lead to an ambulance transfer to hospital. 'We're increasingly equipped to understand the patient's needs and potentially refer them to someone more appropriate,' Beech said, including via the service's Virtual Clinical Care Centre. 'For people with severe back pain [who] we are unable to manage in their home … there is a likelihood that they would end up being transported to an emergency department,' Beech said. Wilson said GPs were trained to exclude serious causes of back pain and reassure their patients. 'It usually takes about six weeks to resolve, and in that time, we can put a strategy in place,' Wilson said. But long wait times for underfunded GP practices and few after-hours services are major barriers to seeking care. Urgent Care Clinics may divert people from EDs, and Healthdirect's virtualADULTS offers 24/7 urgent telehealth consultations with clinicians. Loading Dylan called Healthdirect. A triage nurse said he would probably need an ambulance. Instead, they put him through to an emergency physician at RPA Hospital, who assessed him, prescribed pain relief and recommended he see a GP and physiotherapist. After about six hours on the bathroom floor, I wedged a towel under his torso and dragged him by his left leg to our bedroom. A singularly bonding experience. He's fine now. Don't ask him about it. He'll tell you I yanked his leg the wrong way on purpose. It was an honest mistake.
West Australian
6 hours ago
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Cryonics: Does it really offer the chance for humans to return from the dead?
It's the stuff of science-fiction movies: you're declared legally dead by a doctor, your body is frozen and stored in liquid nitrogen and 200 years later you're brought back to life. Could this really be possible one day? At the Southern Cryonics storage facility on the outskirts of Holbrook in NSW, Peter Tsolakides believes cryonics could be the future of humanity. Whether people get their second chance at life in 100, 200 or 2000 years is anyone's guess. But he said there have been many encouraging advancements that have made the idea less far-fetched than it once was. The business of storing bodies at low temperatures in the hope they can be thawed and brought back to life has no shortage of sceptics and critics. University of Western Australia associate professor Marcus Dabner, a medical doctor and specialist in pathology, said the science remained unproven and speculative. No one has been brought alive yet anywhere in the world — and there is no evidence it can even be done. Still, the idea has survived for decades. Last month, Australian journalist and filmmaker Clare McCann revealed she was urgently trying to raise $300,000 to cryonically preserve her 13-year-old son Atreyu's body after his tragic death. In a statement posted alongside her recent GoFundMe campaign, McCann explained her 'kind, creative and endlessly loved' son had ended his life in May 'after months of horrific bullying' at his NSW school. She had a seven-day window to carry out the preservation before the chance for a potential future revival — however remote — was lost forever. 'Please help me bring him back so he can get the treatment he needed and we can together have another chance at life,' she wrote in a heartbreaking Instagram post. Her desperate plea reflected how faith in the possibilities of cryonics is alive — and growing. There are now at least two facilities in the US, and one each in Russia, China, Australia and Europe. Last year, Southern Cryonics in Australia cryopreserved its first patient — a man in his 80s who died in a Sydney hospital. Mr Tsolakides said the not-for-profit facility started with 35 founding members when it opened its doors last year and within 18 months it had 70 people on its books, ranging from doctors to bus drivers. Roughly 80 per cent are men and 20 per cent are women, and the youngest person, who hopes to one day be cryopreserved like their parents, is aged about 14. 'They are all very optimistic about the future and want to live extremely long lives,' Mr Tsolakides explained. 'They go back, say, 100 years and compare that to what it is like now and see it has improved significantly. 'They believe that in the next 100 or 200 years when they are possibly revived it will be very exciting to be in a new world. 'The thinking is in about 200 years science will have progressed to the stage where a person can be revived and be in a youthful body, all diseases cured, and be that same person in that youthful body.' The most widely-held view of cryonics is that it is pseudo-science. The majority of scientists and medicos take a dim view of the controversial industry, and there's been much debate about its ethical implications. With a hefty price tag of between $150,000 and $200,000 to undergo cryonic suspension in Australia, not including what it may cost for revival in the future, many critics point out that cryonics sells nothing more than false hope. That vulnerable people, consumed by grief, will be taken advantage of as they consider going to go any length for a chance to be reunited with the person they love. Clive Coen, a professor of neuroscience at King's College London, told The Guardian in 2016 that a high court decision which allowed a dying 14-year-old girl to have her body frozen could have the 'unintended consequence … that a lot of people are going to think this is worth a punt'. 'Ethically it's very complicated,' he said. Mr Tsolakides said while the industry is unregulated in Australia and not subject to any special laws, Southern Cryonics would never promise potential clients they would be restored in full health, or at all, in the future. And, it says it only caters to clients who've had a long-term interest in cryonics. 'We have fairly strict conditions around who we tend to take,' said Mr Tsolakides, who has degrees in science and business administration. 'All of our members have some interest in science technology and we tend to take people who have shown interest in cryonics in the past. 'We tend not to take somebody whose child, mother, father died and they tell us they have just read about cryonics now and in a distressed state want to have them 'frozen'. 'We want people interested in cryonics and we want people to join us before they pass away.' Dr Kate Falconer, a law lecturer at the University of Queensland, recently wrote in The Conversation that the successful revival of a patient could pose a legal minefield. For starters, a dead person cannot own property, so when they die, their estate — money and material possessions — is distributed to others according to their will. Dr Falconer said that means none of the wealth or belongings they previously enjoyed will be available to them, which could lead to a world with 'cryonics refugees' — people who wake from cryopreservation in the future with no social or community ties to rely on and no funds to live off. She noted that in the US, one cryonics facility has attempted to get around this issue by encouraging patients to place their assets in a long-term trust. But Mr Tsolakides said most interested Australians plan to use their life insurance policies to pay for their preservation, and put any leftover funds into an interest-accruing account for the future, especially given the cost of revival cannot yet be known. Some plan to, and some already have, put their money into 'revival trusts', he added, so instead of passing wealth down to family members they will pass it down to their future selves. Cryonics enthusiasts, it seems, are largely driven by curiosity and optimism. They are encouraged by research that appears to show an entire organism can transcend death, pointing to cases such as when scientists cryopreserved a roundworm and returned it to full function. They cite examples including livers that were retrieved from rodents in the US and cryogenically stored for 100 days before being successfully transplanted into five rats. 'A rabbit kidney was also brought back,' Mr Tsolakides said. 'Very simple cells like sperm, embryos and a whole lot of things like that have been suspended. 'When they do reproductive technologies like IVF they suspend them in exactly the same conditions — vitrified like we do. 'We are talking very simple organisms and very small organs at this stage which are easier to suspend than bigger ones but what we are doing is projecting what the capabilities will be 200 years into the future.' Dr Dabner, who specialises in the various things that go wrong in the body to cause disease, including what happens when we die, said no proof exists that organisms with brain structures as complex as humans can successfully be restored. 'Based on our understanding of the biology around life and death, there is currently no plausible way to bring someone back to life,' he said. 'Nothing more complex than a microorganism — tardigrades and nematode worms that were accidentally frozen in ice or permafrost — have been restored. 'Mammals are hundreds of times more complicated, and our cells don't survive freezing as well as these more simple organisms, so even the basic process of storing the cells is very different to the experience with these micro-organisms. 'There is no evidence that any mammal has ever been preserved and restored, whether it was alive or dead at the time of being preserved. 'The fundamental issue in whole body cryopreservation is whether the brain and other complex organs — which have already undergone damage as part of the dying process — can be first preserved, then stored indefinitely, and then at some point in the future restored, kept alive after restoration and have the damage reversed. 'That's a lot of steps to have to try and solve in order for it to be possible. 'Even then, how much of our 'selves' — our personality, memories and emotions — is likely to be restored? 'This is something that's impossible to answer, but complex tissues like the nervous system are extremely hard to preserve, and despite huge advances in many areas of technology and our understanding of biology, the progress we've made in trying to repair critical tissues like the brain and spinal cord is still very limited. 'That's why we still don't have cures or even effective treatments for most degenerative conditions. At that rate of progress, realistically we're still most likely decades away from repairing even minor damage, and probably centuries away from being able to heal the kind of changes that happen as part of the dying process, if it is in fact possible at all.' Mr Tsolakides agreed the brain is a major stumbling block and hopes advancements in fields such as nanotechnology will help solve this. 'So many advances are going on at the moment,' he said. 'So much research is being done in ageing, brain preservation, hypothermic medicine techniques, in cloning, synthetic limbs, regenerative medicine, nanotechnology to repair cell damage and all these things are in early stages, but project them out and you are getting to a reasonable chance people can one day be revived. 'Everything we focus on (at the facility) is trying to keep that brain preserved.' To cryopreserve a person, the most important step is a process called 'vitrification', he said. This where the blood is pumped out of the body and replaced with a cryoprotectant agent to partially replace the water in the body's cells and prevent the formation of ice. He said the body of the 'patient' is then stored head-first in a dewar — a tall steel flask filled with liquid nitrogen — and maintained at a temperature of around -190C until medical science has advanced sufficiently enough to rejuvenate them and cure whatever diseases led to their death. 'Let's say you were a member, our optimum case is you contact us so that we would have somebody at your hospital bed at the time you are going to pass away,' Mr Tsolakides said. 'As soon as you pass away, we start putting ice packs around you and cooling you, and this gives us about two or three hours … to take you to a funeral home where we have our team that we have outsourced of doctors and clinical perfusionists, etc, and they work on you and perfuse you with special chemicals. 'Then we cool you down in dry ice and once you are at -78C we have about two or three weeks to take you to a facility and do another process where we slowly bring you down into liquid nitrogen and we put you in in a vacuum flask full of it. 'In those conditions you can stay for hundreds of years without deterioration.' Dr Dabner said there were simply too many scientific and technical hurdles to overcome. 'It's still largely the realm of science fiction,' he said. 'Life is an extraordinarily complex process, and suspending it for any prolonged period of time requires overcoming a huge number of technical challenges. 'Reversing death is even more complex, and I suspect that will remain a limitation forever. 'There are also existing ways that people, both living and deceased, can contribute to scientific advancement or continue to do social good after someone dies, for example body bequest programs, the organ donor registry and charities — these are all ways of having some kind of legacy after death, and finding meaning for the family members and friends left behind.' Mr Tsolakides said many areas of science were sceptically viewed until they became mainstream, adding he was forking out the money to cryopreserve himself. 'One possibility is you are put in the ground and the other is you are burned, but there is now another possibility — the chance of coming back,' he said. 'I know which one I would choose.' Lifeline on 13 11 14 headspace on 1800 650 890 Beyond Blue on 1300 22 4636
