Wednesday, May 21, 2008

The Neuroblastoma Stem Cell?

Well, for those of you interested in hearing clever Sydney, Graham, and Ainsley stories you are probably going to be terribly disappointed this week. However, if you are interested in the absolute cutting edge of neuroblastoma research or the adventures of little David then this is going to be right up your alley. I am hoping to give other parents and families a good overview of the research that I am seeing. You certainly won't hear it all. There is simply too much. In fact, if I participate in everything that I physically can I will still only be able to see about half of the presentations. In other words, there is a ton that is happening concurrently.

I guess the best place to start is with where I am. The convention is being held at the Makuhari Messe International Conference Hall in Chiba, Japan. It is probably the largest convention center that I have eve witnessed. There are about 15 conference halls in 3 different buildings. Each of this buildings dwarfs the professional baseball stadium next door - by about 5 times. I have not heard the numbers yet but I assume that there are probably greater than about 500 people participating. Sitting in the lobby I saw the faces of all of those people that we have seen gracing the top of just about every neuroblastoma medical article ever written. Sure, I have seen all of the usual suspects from the states - Maris, Cohn, Matthay, Seeger, Reynolds, Twist, Parks (to name a few) - but I am also seeing many of the international names as well. The truly neat thing about this conference compared to the one that I attended in Los Angeles two years ago is the number of foreign investigators. There is a much larger population of foreign researchers at this conference. I think this is very important because we get to see much of the research - in action - that we were not aware of in the states. This means many more opportunities for collaboration and new connections. Frankly, that is what excites me. You see, the North American group is pretty tight nit and even they do not know all of what is happening in a similar lab across the state - much less the country. Now look at the rest of the world. With language and physical barriers it is rare that this group gets to meet, discuss and, hopefully, have revelations together.

So, this afternoon I sit in a workshop on "The Neuroblastoma Stem Cell?" (3 hours worth). This workshop is aimed at presenting all of the work that has been done on neuroblastoma stem cells all over the world to try and discover what we really know. Do they exist? Does it matter if we do? What do we know that we can take advantage of?

David Kaplin from Sick Kids in Toronto has given the overview. The reason that everyone thinks neuroblastoma stem cells are so important is because of the whole theory of how neuroblastoma tumor cells come to be, grow, and more importantly - how they die.. What they have discovered is that there are indeed tumor initiating cells. This subset of cells is really good at growing neuroblastoma. Believe it or not - many neuroblastoma cells don't have this characteristic. While there are a lot of neuroblastoma cells there is actually a smaller subset that seems to be doing all of the multiplying. For example, you can put regular neuroblastoma cells into a mouse and it won't grow neuroblastoma. However, you put one of these tumor initiating cells in and they grow beautifully. While we don't know that they are true stem cells, we do know that they can grow neuroblastoma really well. So, if we can stop these cells we can keep the tumors from multiplying. Thses are the ones we have to learn to kill to prevent relapse. This is the bee hive hypothesis. You can kill all the bees you want but if you don't kill the queen the hive will keep coming back. It is only when you kill the queen that the hive will die.

Well, I had best be off. While you all are perky and chipper it is hours past my bedtime. My brain needs resting. There is much more to come.

Purpose is just that way.

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