15 February 2021

MSc Bioethics and Society student, King's College London

The '14-day rule', initially proposed in 1979 in the USA, was first recommended in the UK by the Warnock Committee in 1984. It limits research on intact human embryos to 'prior to 14 days' gestation or the beginning of primitive streak formation' and is part of the Human Fertilisation and Embryology Act 2008.

This legislation has been successfully implemented in the UK, but also in several other countries (eg, Australia's Research Involving Human Embryos Act 2002). It is followed in jurisdictions without relevant laws or even guidelines. While researchers accepted the rule, and have been content to keep to it, many contend that it was simply an arbitrary time limit that was chosen as a compromise to authorise any research at a time when prolife views were strong. While originally it was a barrier that could not be breached for practical reasons, recent research on human and non-human primate embryos suggest that we now have methods to culture intact human embryos beyond 14 days.

I recently argued, in the Journal of Medical Ethics, that the current limit for embryo research should be extended to 28 days to permit research that will further explore our origins as well as potentially provide new therapeutic possibilities to reduce developmental abnormalities and miscarriage.

This conversation is something the Progress Educational Trust (PET), the charity which publishes BioNews, has been advocating for many years. Recent work they have accomplished includes a proposal to the 'My Science Inquiry' launched by the House of Commons Science and Technology Committee. Sandy Starr, deputy director of PET gave oral evidence to the committee advocating for this conversation to be had by government, as it is already an ongoing debate within the scientific community. PET also held their annual conference in 2016, which focused on the 14-day limit on human embryo research, and that featured Baroness Mary Warnock, who was chair of the committee that originally proposed the limit in 1984.

There are a number of reasons why research on embryos between 14 and 28 days, often referred to as the 'black box' period of development, is now ready to be initiated. Several of these are emphasised in my paper.

Firstly, the 'black box' period is when the basic body plan and the formation of critical cell types, tissues, and some organs is initiated. These include germ cells, which are not only essential for the next generation, but are also the early progenitors of the nervous system, blood cells and the heart, and the placenta. It is known that even a subtle defect can have a devastating effect on subsequent development. While we know something about how these develop in model organisms such as the mouse, there are clear differences with human embryos, making it difficult to infer results between species. We also can't yet rely on new stem cell-based models of early human embryos without first carrying out detailed comparisons with the real thing.

It could be argued that 28 days is not long enough. Whilst this is certainly a thought-provoking point, we are already able to obtain embryonic tissues from 28 days and beyond and older fetal tissue to use in scientific research eg, from an aborted fetus. It is also important to consider the need for a 'limit'. If there is not one at all, there is no compromise, discontent, and it could complicate the regulatory system.

In conversations surrounding the 14-day limit there are differing ethical opinions. I argue that in order for those trying for a baby to have legitimate reproductive autonomy, they should have the appropriate assistance and opportunity to produce, at the very least, a healthy child. I also focus on the need to differentiate between 'research' embryos and 'reproductive implanted embryos' ie, the research embryos in question are those whose location will remain in a petri dish.

It is absolutely crucial to outline the importance of a robust regulatory body. In the UK, we are lucky to have the Human Fertilisation and Embryology Authority (HFEA), which means there is government oversight making sure fertility clinics and research centres comply with the law, this extends to human embryo research. For example, in 2016, Dr Kathy Niakan was not just the first person in the UK to be granted a license from the HFEA to use genome editing techniques on human embryos, but the first anywhere to have this type of research sanctioned by a regulatory body. (See BioNews 835).

With any significant legislative change that will directly impact the population, significant public debate must be instigated. Public opinion must be widely surveyed and considered, because any decisions like this should not just be one made by a select few individuals. This can be seen with another significant change in the HFE Act, the addition of mitochondrial donation regulations in 2015, which is an example where public engagement was very important. It gave the Government license to make the changes in the Act, knowing that there was broad support for the use of the methods to avoid mitochondrial disease.

As I conclude in the paper, just because something has once worked does not mean it should stay the same or not strive to be improved. The 14-day limit has become limiting and the conversation around extension must continue.

Go here to read the rest:
The 14-day limit should be extended to 28 days - BioNews

The NCD for Allogeneic Hematopoietic Stem Cell Transplantation (allo HSCT) for the treatment of Myelodysplastic Syndromes (MDS), released by CMS in August 2010, concluded that, absent convincing evidence that allo HSCT improves patient health outcomes, additional research from clinical trials would be appropriate under the Coverage with Evidence Development aspect of CMS coverage authority. The NCD specifies that allo HSCT for the treatment of MDS is covered only when provided to Medicare beneficiaries enrolled in an approved clinical study

Allo HSCT is a procedure in which a portionof a healthy donor's stem cell or bone marrow is obtained and prepared for intravenous infusion. In accordance with the Stem Cell Therapeutic and Research Act of 2005 (US Public Law 109-129) a standard dataset is collected for all allogeneic transplant patients in the United States by the Center for International Blood and Marrow Transplant Research. The elements in this dataset, comprised of two mandatory forms plus one additional form, encompass the information we require for a study under CED.

A prospective clinical study seeking Medicare payment for treating a beneficiary with allogeneic HSCT for MDS pursuant to CED must meet one or more aspects of the following questions:

Potentially, the results of trials may provide sufficient evidence of clinical utility that a future NCD on this topic will provide coverage for such testing for all Medicare beneficiaries.

Decision Memo

Study Title: A Multi-Center Biologic Assignment Trial Comparing Allogeneic Hematopoietic Cell Transplant to Hypomethylating Therapy or Best Supportive Care in Patients w/Intermediate-2 & High Risk Myelodysplastic Syndrome (BMT CTN #1102)Sponsor: Medical College of WisconsinClinicalTrials.gov Number: NCT02016781CMS Approval Date: 12/11/2013

Study Title: Assessment of Allogeneic Hematopoietic Stem Cell Transplantation in Medicare Beneficiaries with Myelodysplastic Syndrome and Related Disorders" - A Sub-study Protocol For A Research Database For Hematopoietic Stem Cell Transplantation, Other Cellular Therapies and Marrow Toxic InjuriesSponsor: Center for International Blood and Marrow Transplant ResearchClincialTrials.gov Number: NCT01166009CMS Approval Date: 12/13/2010

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Allogeneic Hematopoietic Stem Cell Transplant for MDS | CMS

A post-hoc analysis of the practice-changing TRANSCEND NHL 001 trial (NCT02631044) revealed that exposure to anti-CD19 therapy in patients with relapsed/refractory large B-cell lymphoma (LBCL), did not impact response to lisocabtagene maraleucel (liso-cel; Breyanzi).1

Data were presented during the 2021 Transplantation & Cellular Therapy Meeting and showed that among 12 patients who had previously received anti-CD19 therapy, 2 patients achieved a complete response (CR) as their best response to that treatment, 3 patients reported a partial response (PR), and 1 achieved stable disease. Five patients experienced disease progression, while 1 patients response status was unknown.

Results from the analysis showed that 92% (n = 11/12) experienced an objective response to liso-cel per independent review committee (IRC) assessment and Lugano criteria; this included 6 CRs (50%) and 5 PRs with the CAR T-cell therapy. Moreover, 5 patients experienced a duration of response (DOR) to liso-cel of 9 months or longer (range, 0.8-27.4), with 4 patients continuing to respond at the time of data cutoff.

The response rates reported in this subgroup proved to be comparable to those observed in the overall TRANSCEND NHL 001 study population. Of the 256 patients determined to be efficacy evaluable, which included those who were given at least 1 dose of liso-cel and had PET-positive disease per IRC, the objective response rate was 73% (95% CI, 66.8%-78.0%), with a CR rate of 53% (95% CI, 46.8%-59.4%).2 The median DOR had not been reached (95% CI, 8.6not reached [NR]). Moreover, the median progression-free survival (PFS) was 6.8 months in this population (95% CI, 3.3-14.1) and the median overall survival (OS) was 21.1 months (95% CI, 13.3-NR).

In this post-hoc analysis of a small subset of patients from TRANSCEND, patient response to liso-cel and liso-cel pharmacokinetics were not impacted by prior exposure to anti-CD19 therapy, Scott R. Solomon, MD, of the Blood and Marrow Transplant Program, Leukemia and Cellular Immunotherapy Program at the Northside Hospital Cancer Institute, and colleagues, wrote in a poster highlighting the data. Additional analyses on a larger number of patients with prior anti-CD19 therapy are warranted to confirm these findings.

An investigational, CD19-targeted, defined composition, 4-1BB CAR T-cell product, liso-cel is given at equal target doses of CD8 and CD4 T cells; the product has showcased safety and efficacy in patients with aggressive, relapsed/refractory LBCL in the TRANSCEND NHL 001 trial. Data from the trial led to theFebruary 2021 FDA approval of liso-cel for use in adult patients with certain types of large B-cell lymphoma who have not responded to, or who have relapsed after, at least 2 other types of systemic treatment.

The multicenter, pivotal, phase 1 trial enrolled adult patients aged 18 years or older with relapsed/refractory LBCL; this included those with diffuse large B-cell lymphoma (DLBCL); high-grade B-cell lymphoma with rearrangements of MYC and either BCL-2, BCL-6, or both; DLBCL transformed from an indolent lymphoma; primary mediastinal B-cell lymphoma; and follicular lymphoma. To be eligible for enrollment, patients had to have an ECOG performance status of 0-2, creatinine clearance of greater than 30 mL/min/1.73 m2, and a left ventricular ejection fraction of at least 40%.

Those who underwent prior hematopoietic stem cell transplantation and those with secondary central nervous system lymphoma were permitted. Notably, no lower threshold for absolute lymphocyte count, absolute neutrophil count, platelets, or hemoglobin, were established.

In the trial, patients were screened and then underwent leukapheresis where bridging therapy was permitted while the product was being manufactured. Once disease was reconfirmed via PET imaging, patients went on to receive lymphodepleting chemotherapy with fludarabine at 30 mg/m2 and cytarabine at 300 mg/m2, delivered over the course of 3 days. Two to 7 days after the chemotherapy, patients received liso-cel.

A total of 269 participants were assigned to 1 of 3 target dose levels of the CAR T-cell product: 50 106 CAR T cells (1 or 2 doses), 100 106, and 150 106; this was given as a sequential infusion of 2 components, CD8 and CD4 CAR T cells, at equal target doses.

The co-primary end points of the trial included adverse effects (AEs), dose-limiting toxicities, and ORR per Lugano criteria and IRC. Key secondary end points comprised CR rate by IRC, DOR, PFS, OS, and cellular kinetics.

For the post-hoc analysis, investigators looked at a subset of patients from the trial who had previously received CD19-targeted therapy before liso-cel to evaluate impact of the CAR T-cell product on safety and efficacy outcomes, as well as cellular kinetics.

The median age of the 12 patients in the subgroup of interest was 60.5 years, and 83% were male. Half of the patients had an ECOG performance status of 0, while the remainder had a status of 1. The median number of previous lines of treatment was 4. Fifty-eight percent of patients previously underwent transplantation and 67% were refractory to chemotherapy. Regarding histology, 58% had DLBCL not otherwise specified, 33% had DLBCL that was transformed from follicular lymphoma, and 8% had high-grade B-cell lymphoma.

Additional data showed that previous anti-CD19 therapy did not impact cellular kinetic parameters. Liso-cel demonstrated long-term persistence at 3 months in the majority, or 83% (n = 5/6), of those who received prior CD19-targeted treatment; persistence at 1 year was observed in 50% of patients (n = 2/4), which was comparable to those who did not receive previous CD19-targeted treatment.

Regarding safety, all patients in this subgroup experienced treatment-emergent AEs (TEAEs), 58% (n = 7) of which were grade 3 or higher. The most reported grade 3 or higher TEAEs included neutropenia (58%), thrombocytopenia (42%), and anemia (33%). Sixty-seven percent of patients reported all-grade cytokine release syndrome (CRS) and 42% experienced all-grade neurological effects with liso-cel. However, all toxicity rates proved to be comparable to those experienced by the overall study population and all CRS or neurological effects were either grade 1 or 2.

These findings suggest that liso-cel can be considered for the treatment of patients who have received prior anti-CD19 therapies, concluded Solomon.

References:

1. Solomon S, Mehta A, Abramson JS, et al. Experience of prior anti-CD19 therapy in patients with relapsed or refractory large B-cell lymphoma receiving lisocabtagene maraleucel (liso-cel), an investigational anti-CD19 chimeric antigen receptor T cell product. Presented at: 2021 Transplantation & Cellular Therapy Meeting; February 9-13, 2021; Virtual.

2. Abramson JS, Palomba ML, Gordon LI, et al. Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study. Lancet. 2020;396(10254):839-852. doi:10.1016/S0140-6736(20)31366-0

Read more here:
Responses to Liso-Cel Not Influenced by Prior Treatment With Anti-CD19 Agents in R/R Large B-Cell Lymphoma - Targeted Oncology

CLEVELAND, Ohio What do you do when someone close to you has cancer?

Sometimes, late at night, I just hug Otto and cry, said Shanna Loede.

Otto is not her husband. Thats Matt Loede, who has been in a battle with lymphoma (a form of blood cancer) for nearly two years.

There have been 25 rounds of chemotherapy. And 25 rounds of radiation. And two stem-cell transplants. And nearly three months spent in the hospital since Matt was first diagnosed in April of 2019.

As if that wasnt enough, Matt recently spent five days in the hospital with COVID-19.

Matt is Shannas husband of eight years. He also has worked for several local sports radio stations, written for a number of sports websites in his 23-year career. He currently writes for the sports website Outkick.

OK, but who is Otto?

Hes the familys mixed terrier, a very huggy dog.

Otto knows to stay close when the sadness and fear try to squeeze the life out of hope and the tears flow with her prayers for her husband.

One piece of advice from Shanna: Its OK to have some nights when you just cry. Having someone (or a pet to hug) really helps.

HOW MUCH WORSE CAN IT GET?

Matts problems began with severe stomach pain and convulsions. Doctors first thought he had pancreatitis. Tests revealed lymphoma that had spread to his stomach and pancreas. At first, the hope was some early treatments would bring it under control.

That turned out to be wrong.

You find out theres a lot you cant control about this type of cancer, said Matt. Its like a tumor in the blood. But its not something they can just go in and cut out.

The Loedes hit what they thought was a low point in early January. A second round of stem cell transplants didnt work. The cancer had spread to his throat.

It was a special treatment, said Shanna. I had read so much about it. There was so much hope. It sounded like the saving grace for lymphoma. I probably overestimated it.

Doctors explained they had run out of the usual treatments.

There is no cure for me, said Matt. I know that hit Shanna hard when she heard the news.

That was one of the worst days. A few weeks later, Matt developed a cough. Then he had a sore throat and headaches.

One of Shannas biggest fears was Id get the virus, he said.

She panicked when taking his temperature. It was 104.

They rushed to University Hospital, where he had been undergoing treatments at the Seidman Cancer Center. Only now, he was in the COVID-19 section of the hospital. It was isolation for five days.

The fever broke within a few hours. But given how Matts body had been ravaged by nearly two years of chemotherapy and radiation, Shanna feared I was going to lose him.

But that didnt happen.

He didnt even need a ventilator, said Shanna. Matt has recovered well. Thats one of the things I tell people in this situation. Count your blessing, look for the miracles.

Shanna is the Director of Training and Development for University Hospitals. In the COVID world, she works from her small upstairs office in their Parma home. Matt is downstairs.

Another blessing, she said. Seidman gives Matthew great care, and Im affiliated with UH. Working from home allows us to be together more.

Shanna and Matt Loede love each other and Snoopy as they work together to fight Matt's blood cancer. Photo by Terry Pluto, cleveland.com.

IT REALLY IS DAY-TO-DAY

Shanna said she is a planner. She is 38, Matt is 45. Under normal circumstances, it would be easy to look way down the highway of life.

I like to think a lot about the future, she explained. Now, it really is day-to-day. Matthew is the love of my life. I try not to think, How long will I have him? Instead, I try to focus on the present. Thats new for me.

The doctors have never told the Loedes Matt has six months to live. But they have been candid about how its a battle to combat the spread. He is now heading into different clinical trials.

Theres not much Shanna can do on the medical front other than be there for her husband.

I cook his favorite food, she said.

Whats that?

Asian meatballs and rice, she said. Matthew is a pretty simple guy. He does like his mothers pierogies, but I cant make them like her.

Shanna raves about her neighbors, who have shoveled snow and brought food over to the house. Their church family from Cleveland Baptist prays for and with them.

There is a couple at church where the husband has had lymphoma for eight years, she said. They are a great help to us...and weve found we can help others going through cancer.

During the Christmas season, you can see Matt and Shanna Loede have lots of visitors. Photo courtesy of Matt Loede.

STRANGE DREAMS

Dreams can be a window to our minds and our fears.

Shanna said twice she had this dream: Matt walks through the door and says, I have six months to live.

But she hasnt had it for a year.

A few times, Matt has dreamed he was watching is own funeral. He saw the casket. He saw lots of people in line to pay their last respects.

I guess it was after the pandemic with all the people there, he said with a laugh.

But Shanna and Matt both said, Going through this makes you very aware of your own mortality.

CLOSER OR FARTHER APART

Matt said he hasnt spent much time on the Why me? question with God. Theres no answer coming. Hes at a place where he knows he has cancer. He is either going through it with God or without God.

If you say you believe and your faith is real, then you have to practice what you preach, said Matt. You dont just quit (with God) when you go though those periods of 12-to-48 hours after chemo where your muscles, your head, everything aches.

Shanna said thats when she feels helpless. Its a time to pray and wait.

I have felt closer to God and to Matthew during all of this, she said.

Matt loves Charlie Brown. Their home is filled with stuffed characters from the Charles Schulz comic strip. Snoopy seems to be everywhere.

At first, (all the stuffed animals) drove me a little crazy, said Shanna. But now, Im accustomed to them. They bring him comfort, and Ill never argue against something bringing him happiness right now.

Good Grief, is Matt like Charlie Brown?

I never thought of until now, she said. But yes. He is loyal, has a BIG heart and is a resilient optimist.

Good Grief! Snoopy & Friends are taking over the Loede household. Photo courtesy of Matt Loede.

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See more here:
Someone close has cancer, what to do? A prayer and a dog helps Terry Plutos Faith & You - cleveland.com

The Latest Updated market research study on Global Canine Stem Cell Therapy Market with data Tables, charts, Premium insights & Graphs is available now to provide complete guidance of the Market. The report highlights the growing trends, top market players, current & future market scenario analysis, and growth drivers evaluated by Industry Experts and Professionals. The Canine Stem Cell Therapy Market size was valued at US$ 118.5 Mn in 2018 and is expected to grow at a CAGR of 9.3% for the forecast period ending 2026 reaching a Market value of US$ 240.7 Mn. With an all-round approach for data accumulation, the market scenarios comprise major players, cost, and pricing operating in the specific geographies. Statistical surveying used are SWOT analysis, PESTLE analysis, predictive analysis, and real-time analytics. Graphs are clearly used to support the data format for a clear understanding of facts and figures.

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Canine Stem Cell Therapy Market is Estimated to Perceive Exponential Growth till 2026 NeighborWebSJ - NeighborWebSJ

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AbbottSWP PharmaceuticalHandewei PharmaceuticalPfizerSaike PharmaceuticalSanjin PharmaceuticalJinrui Pharmaceutical

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Canine Stem Cell Therapy Industry Market 2021 Growth By Manufacturers, Type And Application, Forecast To 2027:Abbott, SWP Pharmaceutical, Handewei...

SAKAI, Japan Just like humans, mans best friend deals with all sorts of chronic and degenerative conditions as they age. For dogs however, scientists have fewer ways of reversing life-threatening illnesses compared to human patients. Now, a team in Japan has successfully developed a technique which creates new stem cells from a dogs blood. Their study opens the door for new therapies which can regenerate a dogs body just like stem cells do in people.

In humans, these baby cells have the potential to grow into a variety of specialized cells, an ability called pluripotency. After scientists transplant these stem cells into a patient, they guide their differentiation into the specific kind of cells which completes their task. The new cells can then regenerate damaged tissues, reversing the effect of various diseases. While stem cell research for humans is a widely studied topic, researchers say little work is done with pets.

The new study, led by Associate Professor Shingo Hatoya from Osaka Prefecture University, focuses on induced pluripotent stem cells (iPSCs) in canine blood samples. Study authors say iPSCs are a type of stem cell which can be programmed from a developed cell. Scientists can do this by introducing specific genes into the cell. The genes code for specific proteins (transcription factors) which trigger the change from a developed cell into a pluripotent stem cell.

Another good thing about iPSCs is they multiply rapidly, providing a sustainable supply of usable stem cells for medical treatments.

We successfully established an efficient and easy generation method of canine iPSCs from peripheral blood mononuclear cells Dr. Hatoya in a university release.

The study authors call this a breakthrough in veterinary science. Hatoya hopes in the near future, it may be possible to perform regenerative medicinal treatments in dogs.

This isnt the first time scientists have experimented with iPSCs from canine blood cells. Researchers say these attempts used viral vectors to deliver the stem cell-triggering transcription factors.

In the new study, the Japanese team tested a different combination of factors to create pluripotency. Most importantly, researchers say they had to control how the reprogrammed cells multiplied in the host.

Scientists use viral vectors, which encode these transcription factors, to infect cells and convert them into iPSCs. Unfortunately, since these vectors merge with the hosts genetic material, these pluripotency factors can actually cause tumors if they are transplanted into a dog.

To avoid this, researchers created footprint-free stem cells using a special type of viral vector. This particular vector generates iPSCs without mixing with the hosts genes. It can also be automatically silenced by microRNAs in the cells. The OPU team grew these cells in a special environment which contained a small-molecule cocktail that enhances pluripotency. The results successfully produced cells which developed germ layers the basis of all organs.

Study authors say their findings provide a clear path to easy stem cell treatments for dogs. However, they add that their research may also have a ripple effect in the human medical world as well.

We believe that our method can facilitate the research involving disease modeling and regenerative therapies in the veterinary field, Dr. Hatoya says. Dogs share the same environment as humans and spontaneously develop the same diseases, particularly genetic diseases.

The team believes finding a cure for diseases in mans best friend may also open the door to curing illnesses still plaguing mankind.

The study appears in the journal Stem Cells and Development.

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Breakthrough stem cell therapy may reverse life-threatening conditions in dogs - Study Finds

Regenerative therapies such as stem cells and platelet-rich plasma already play an important role in managing osteoarthritis (OA). Nonetheless, veterinarians have found that response to even these therapies is less than ideal in many cases, prompting researchers to continuously seek novel therapies for this all-too-common musculoskeletal disorder. One of the newest to be unveiled is called bone marrow mononuclear cell (BMNC) therapy. One researcher who presented at the 2020 American Association of Equine Practitioners Convention, held virtually, reported that the equine industry is in critical need for therapies that resolve joint inflammation but preserve tissue healing, and BMNC appears a promising candidate.

Much more than stem cells classically sought for cartilage healing, bone marrow is rich in macrophage progenitor cells, explained James B. Everett, DVM, MS, previously of the Virginia-Maryland College of Veterinary Medicine, who now works at the Equine Surgical Center at ThorSport Farm,in Murfreesboro, Tennessee. Macrophages are a type of white blood cell that play a role in tissue repair and cartilage integrity, and produce the anti-inflammatory mediators, including interleukin-10 (IL-10).

Everett said macrophages in the synovial (joint) membrane are essential for joint health, clearing aggressors, secreting key molecules required for optimal joint function, and forming a shield that protects tissues undergoing repair, similar to a wound scab. However, when the amount of tissue damage overwhelms these housekeeping functions, macrophages stimulate inflammation as a means of recruiting more cells, especially more macrophages, to cope with increased demands for repair.

If this response is efficiently accomplished, macrophages then produce, among other things, high concentrations of IL-10 and resolve the inflammatory process, returning the joint to a healthy state, he said.

Everett emphasized that not all inflammation is bad. This acute inflammation is essential to establish a resolving response, and anti-inflammatory therapies can negatively interfere.

As presented by Everetts colleague Bruno Menarim, DVM, PhD, in a separate session, studies show that BMNCs promote the endogenous resolution of experimentally induced inflammation. To see if these promising features translated to naturally occurring inflammation in live horses, Everetts research team studied 19 horses, dividing them into three treatment groups:

The selected horses were diagnosed with OA in a single joint, and the team injected those joints once with the saline, triamcinolone, or BMNCs. The BMNCs were autologous, meaning veterinarians collected them from each patients own bone marrow aspirate. They processed the aspirate in-house, and the isolated mononuclear cells, composed predominantly of macrophages, were ready to inject into the affected joint within three hours of aspiration.

We found that while objectively assessed lameness (via Lameness Locator) decreased in all three groups, it was only significant in the BMNC-treated horses, said Everett. Further, the treatment was well-tolerated with no adverse events appreciated in this study.

He said that using BMNCs can help reduce the need for chronic use of non-steroidal anti-inflammatory drugs and corticosteroids, which produces potentially harmful consequences. Further, BMNCs preserve the production of molecules such as interleukins and cytokines that are essential for restoring joint homeostasis. Corticosteroids often inhibit these molecules.

The researchers noted that these results support a larger clinical trial using BMNCs in clinical cases of equine OA.

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Novel Bone Marrow 'Ingredient' To Help Arthritic Horses The Horse - TheHorse.com

Chile ranks no. 1 in Latin America as the country with the most potential to attract foreign investors, according to the 2021 Milken Institute Global Opportunity Index. The annual assessment uses 96 variables including macroeconomic outlook, potential for future innovation and development, access to financial services, and conformance to international standards to offer a forward-looking analysis of the potential for foreign investment in 145 countries.

New this year, the accompanying report focuses on Latin America, a region ripe for investment where an influx in capital could supplement domestic savings, help job creation, and foster innovation.

Latin America performs well compared to other emerging and developing economies in two key areas: 1) having a highly qualified and diverse workforce and 2) the breadth and depth of the regions financial systems.

The Global Opportunity Index measures a countrys attractiveness to foreign investors based on five broad categories that give investors the tools to determine their own appetite for risk, said Claude Lopez, PhD, report author and head of the Research Department at the Milken Institute. These factors include, for example, understanding whether existing institutions promote business activity, the strength of their macroeconomic frameworks, the reliability of their courts, and the degree of transparency in their institutions.

Key findings from the 2021 Global Opportunity Index include:

By placing at the top of the index, these countries signal the resilience of their institutions, added Lopez. This indicates a level of confidence in their ability to recover post-pandemic, making them a potentially safer bet for investors in a time of global uncertainty.

How We Evaluate Countries:

To create the index, the Milken Institute evaluated overall investment opportunity through 96 variables organized into five categories and 14 sub-categories. The five major categories included: Business Perception, Financial Services, International Standards & Policy, Economic Fundamentals, and Institutional Framework. The variables within these categories measured all angles of a countries investment potential, including economic openness and performance, transparency, and workforce talent and diversity. Data sources include the World Bank, the International Monetary Fund, and the Global Health Data Exchange.

The Global Opportunity Index 2021: Focus on Latin America is co-authored by Oscar Contreras, Joseph Bendix, Benjamin Smith, and Claude Lopez. The full report can be downloaded here.

2021 Milken Institute Global Opportunity Index

OVERALL 1. Sweden 2. United Kingdom 3. United States 4. Netherlands 5. Switzerland

LATIN AMERICA 1. Chile 2. Uruguay 3. Costa Rica 4. Mexico 5. Panama

About the Milken Institute

The Milken Institute is a nonprofit, nonpartisan think tank that helps people build meaningful lives in which they can experience health and well-being, pursue effective education and gainful employment, and access the resources required to create ever-expanding opportunities for themselves and their broader communities. For more information, visit https://milkeninstitute.org/.

Media Contact: Enxhi Myslymi, [emailprotected], + 1 (203) 721-4840.

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World Cancer Day 2021: Leukemia is a type of blood cancer

World Cancer Day: It is true that most of the cancers get diagnosed at a later stage and the precious time is lost to give a patient a quality life ahead. But effective screening methods implemented in the early diagnosis of blood cancer can help save lives. India ranks third highest in reporting blood cancer cases, after US and China. Almost a lakh of new cases of blood disorder are reported each year. There are several different types of blood cancer depending upon the type of blood cells it affects primarily.

There are three types of blood cancers - leukemia, lymphoma and myeloma. Leukemia occurs when one can suffers from rapid production of abnormal cancer cells in the bone marrow. Thus, due to the abnormal cancer cells, the bone marrow's ability of the production of red blood cells and platelets gets affected. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15.

Having a risk factor, or even several risk factors, does not always mean that a person will get the disease, and many people get cancer without having any known risk factors.

While, in most of the cases, the exact cause of Leukemia is not known, but certain risk factors can attribute to the risk of Leukemia, like:

a. Radiation exposure - High-dose radiation exposure (such as being a survivor of an atomic bomb blast or nuclear reactor accident) increases the risk of developing acute myeloid leukemia (AML). Radiation treatment for cancer has also been linked to an increased risk of AML. The risk varies based on the amount of radiation given and what area is treated.

b. Previous chemotherapy for cancer

c. Smoking and drinking

Family history of leukemia - Although most cases of AML are not thought to have a strong genetic link, having a close relative (such as a parent, brother, or sister) with AML increases your risk of getting the disease. Someone who has an identical twin who got AML before they were a year old has a very high risk of also getting AML.

Genetic Disorder - e.g. Down syndrome, Fanconi anaemia

Exposure to certain chemicals - For example, long-term exposure to benzene is a risk factor for acute myeloid leukemia, a type of blood cancer. Benzene is a solvent used in the rubber industry, oil refineries, chemical plants, shoe manufacturing, and gasoline-related industries, and is also found in cigarette smoke, gasoline and motor vehicle exhaust, and some glues, cleaning products, detergents, art supplies, and paints.

World Cancer Day 2021: Leukemia can lead to shortness of breathPhoto Credit: iStock

Awareness, early diagnosis and treatment are the key:

Early diagnosis and awareness of symptoms allows for more treatment options and can improve survival rates in Leukemia. Some early cancers may show signs and symptoms but that may not always be the case. Initially, doctors make a note of family history and conduct a complete physical examination of the patient. Blood tests may include complete blood count with evaluations of liver and kidney function tests. Bone marrow examination is eventually done to diagnose blood cancers. Diagnostic imaging tests such as CT scan, PET scan, MRI, and/or X-rays may be performed to assess the extent of the disease at diagnosis, and also to assess response after treatment. There is no way to prevent Leukemia at large, but avoiding tobacco and exposure to pesticides and industrial chemicals might help in reducing the risk of Cancer. It is important to also ensure that people with cancer have access to safe and effective treatment that also includes pain relief.

There are several treatment options for blood cancer. The type of treatment depends upon the type and stage of blood cancer, age of the patients and the other underlying medical conditions. Most blood cancers generally include chemotherapy, radiation therapy, stem cell transplant (bone marrow and cord blood transplant), and immunotherapy.

Symptoms to watch for:

To spread awareness on early diagnosis, people need to be educated on various symptoms of blood cancer and seek timely intervention

(Dr. Sunil Bhat, MBBS, MD (Pediatrics) Mazumdar Shaw Cancer Centre, Narayana Health City, Bengaluru)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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World Cancer Day 2021: Know The Symptoms And Risk Factors Of Leukemia - NDTV Doctor