Battling cancer is always a balancing act. The methods we use – surgery, chemotherapy and radiation – can help remove the tumors but they often come at a price to the patient. In cases where the cancer has spread to the bone the treatments have a limited impact on the disease, but their toxicity can cause devastating problems for the patient. Now, in a CIRM-supported study, researchers at UC Irvine (UCI) have developed a method they say may be able to change that.
Bone metastasis –
where cancer starts in one part of the body, say the breast, but spreads to the
bones – is one of the most common complications of cancer. It can often result
in severe pain, increased risk of fractures and compression
of the spine. Tackling them is difficult because some cancer cells can
alter the environment around bone, accelerating the destruction of healthy bone
cells, and that in turn creates growth factors that stimulate the growth of the
cancer. It is a vicious cycle where one problem fuels the other.
Now researchers at
UCI have developed a method where they combine engineered mesenchymal stem cells (taken from the bone marrow) with
targeting agents. These act like a drug delivery device, offloading
different agents that simultaneously attack the cancer but protect the bone.
In a news release Weian Zhao, lead author of the study, said:
“What’s powerful about this
strategy is that we deliver a combination of both anti-tumor and anti-bone
resorption agents so we can effectively block the vicious circle between
cancers and their bone niche. This is a safe and almost nontoxic treatment
compared to chemotherapy, which often leaves patients with lifelong issues.”
published in the journal EBioMedicine,
has already been shown to be effective in mice. Next, they hope to be able to
do the safety tests to enable them to apply to the Food and Drug Administration
for permission to test it in people.
The team say if this
approach proves effective it might also be used to help treat other bone-related
diseases such as osteoporosis and multiple myeloma.
It’s never easy to tell someone that they are too late, that they missed the deadline. It’s particularly hard when you know that the person you are telling that to has spent years working on a project and now needs money to take it to the next level. But in science, as in life, it’s always better to tell people what they need to know rather than what they would like to hear.
And so, we have posted
a notice on our website for researchers thinking about applying for funding
that, except in a very few cases, they are too late, that there is no money
available for new projects, whether it’s Discovery, Translational or Clinical.
Here’s that notice:
that the budget allocation of funds for new awards under the CIRM clinical
program (CLIN1, CLIN2 and CLIN3) may be depleted within the next two to three
months. CIRM will accept applications for the monthly deadline on June 28, 2019
but will suspend application submissions after that date until further notice.
All applicants should note that the review of submitted applications may be
halted at any point in the process if funds are depleted prior to completion of
the 3-month review cycle. CIRM will notify applicants of such an occurrence.
Therefore, submission and acceptance of an application to CIRM does not
guarantee the availability of funds or completion of a review cycle.
of applications for the CIRM/NHLBI Cure Sickle Cell Initiative (CLIN1 SCD,
CLIN2 SCD) are unaffected and application submissions for this program will
We do, of course, have enough money set aside to continue
funding all the projects our Board has already approved, but we don’t have
money for new projects (except for some sickle cell disease projects).
In truth our funding has lasted a lot longer than anyone
anticipated. When Proposition 71 was approved the plan was to give CIRM $300
million a year for ten years. That was back in 2004. So what happened?
Well, in the early years stem cell science was still very
much in its infancy with most of the work being done at a basic or Discovery
level. Those typically don’t require very large sums so we were able to fund
many projects without hitting our $300m target. As the field progressed,
however, more and more projects were at the clinical trial stage and those need
multiple millions of dollars to be completed. So, the money went out faster.
To date we have funded 55 clinical trials and our
early support has helped more than a dozen other projects get into clinical
trials. This includes everything from cancer and stroke, to vision loss and
diabetes. It’s a good start, but we feel there is so much more to do.
Followers of news about CIRM know there is talk about a possible ballot initiative next year that would provide another $5.5 billion in funding for us to help complete the mission we have started.
Over the years we have built a pipeline of promising
projects and without continued support many of those projects face a difficult
future. Funding at the federal level is under threat and without CIRM there
will be a limited number of funding alternatives for them to turn to.
Telling researchers we don’t have any money to support their
work is hard. Telling patients we don’t have any money to support work that
could lead to new treatments for them, that’s hardest of all.
At first glance, a scientific conference is not the place you would think about going to learn about how to run a political or any other kind of campaign. But then the ISSCR Annual Meeting is not your average conference. And that’s why CIRM is there and has been going to these events for as long as we have been around.
For those who don’t know, ISSCR is the International Society
for Stem Cell Research. It’s the global industry representative for the field
of stem cell research. It’s where all the leading figures in the field get
together every year to chart the progress in research.
But it’s more than just the science that gets discussed. One of the panels kicking off this year’s conference was on ‘Why is it Important to Communicate with Policy Makers, the Media and the Public?” It was a wide-ranging discussion on the importance of learning the best ways for the scientific community to explain what it is they do, why they do it, and why people should care.
Morrison, a former President of ISSCR, talked about his experience
trying to pass a bill in Michigan that would enable scientists to do embryonic
stem cell research. At the time CIRM was spending millions of dollars funding
scientists in California to create new lines of embryonic stem cells; in
Michigan anyone doing the same could be sent to prison for a year. He said the
opposition ran a fear-based campaign, lying about the impact the bill would
have, that it would enable scientists to create half man-half cow creatures
(no, really) or human clones. Learning to counter those without descending to
their level was challenging, but ultimately Morrison was successful in
overcoming opposition and getting the bill passed.
Temple, of the Neural Stem Cell Institute, talked about testifying
to a Congressional committee about the importance of fetal tissue research and
faced a barrage of hostile questions that misrepresented the science and
distorted her views. In contrast Republicans on the committee had invited a group
that opposed all fetal tissue research and fed them a bunch of softball
questions; the answers the group gave not only had no scientific validity, they
were just plain wrong. Fortunately, Temple says she had done a lot of
preparation (including watching two hours Congressional hearings on C-SPAN to understand how these hearings
worked) and had her answers ready. Even so she said one of the big lessons she
stressed is the need to listen to what others are saying and respond in ways
that address their fears and don’t just dismiss them.
Other presenters talked about their struggles with different
issues and different audiences but similar experiences; how do you communicate
clearly and effectively. The answer is actually pretty simple. You talk to
people in a way they understand with language they understand. Not with dense
scientific jargon. Not with reams of data. Just by telling simple stories that
illustrate what you did and who it helped or might help.
The power of ISSCR is that it can bring together a roomful
of brilliant scientists from all over the world who want to learn about these
things, who want to be better communicators. They know that much of the money
for scientific research comes from governments or state agencies, that this is
public money, and that if the public is going to continue to support this
research it needs to know how that money is being spent.
That’s a message CIRM has been promoting for years. We know
that communicating with the public is not an option, it’s a responsibility.
That’s why, at a time when the very notion of science sometimes seems to be
under attack, and the idea of public funding for that science is certainly
under threat, having meetings like this that brings researchers together and
gives them access to new tools is vital. The tools they can “get” at ISSCR are
ones they might never learn in the lab, but they are tools that might just mean
they get the money needed to do the work they want to.
We often talk about the important role that patient advocates play in helping advance research. That was demonstrated in a powerful way last week when the CIRM Board approved almost $12 million to fund a clinical trial targeting a rare childhood disorder called cystinosis.
The award, to Stephanie Cherqui and her team at UC San Diego (in collaboration with UCLA) was based on the scientific merits of the program. But without the help of the cystinosis patient advocate community that would never have happened. Years ago the community held a series of fundraisers, bake sales etc., and used the money to help Dr. Cherqui get her research started.
That money enabled Dr. Cherqui to get the data she needed to apply to CIRM for funding to do more detailed research, which led to her award last week. There to celebrate the moment was Nancy Stack. Her testimony to the Board was a moving celebration of how long they have worked to get to this moment, and how much hope this research is giving them.
Hello my name is Nancy Stack and I am the founder and president of the Cystinosis Research Foundation. Our daughter Natalie was diagnosed with cystinosis when she was an infant.
a rare disease that is characterized by the abnormal accumulation of cystine in
every cell in the body. The build-up of
cystine eventually destroys every organ in the body including the kidneys,
eyes, liver, muscles, thyroid and brain.
The average age of death from cystinosis and its complications is 28
years of age.
children and adults with cystinosis, there are no healthy days. They take
between 8-12 medications around the clock every day just to stay alive –
Natalie takes 45 pills a day. It is a
relentless and devastating disease.
complications abound and our children’s lives are filled with a myriad of
symptoms and treatments – there are g-tube feedings, kidney transplants, bone
pain, daily vomiting, swallowing
difficulties, muscle wasting, severe gastrointestinal side effects and for some
the Foundation in 2003. We have worked
with and funded Dr. Stephanie Cherqui since 2006. As a foundation, our resources are limited
but we were able to fund the initial grants for Stephanie’s Stem Cell studies. When CIRM awarded a grant
to Stephanie in 2016, it allowed her to complete the studies, file the IND and
as a result, we now have FDA approval
for the clinical trial. Your support has changed the course of this
When the FDA
approved the clinical trial for cystinosis last year, our community was filled
with a renewed sense of hope and optimism.
I heard from 32 adults with cystinosis – all of them interested in the
clinical trial. Our adults know that
this is their only chance to live a full life. Without this treatment, they
will die from cystinosis. In every
email I received, there was a message of hope and gratitude.
I received an
email from a young woman who said this, “It’s a new awakening to learn this
morning that human clinical trials have been approved by the FDA. I reiterate
my immense interest to participate in this trial as soon as possible because my
quality of life is at a low ebb and the trial is really my only hope. Time is
And a mom of a 19 year old young man who wants to be the first
patient in the trial wrote and said this, “On the day the trial was announced I started to cry tears of pure
happiness and I thought, a mother somewhere gets to wake up and have a child who
will no longer have cystinosis. I felt so happy for whom ever that mom would
be….I never imagined that the mom I was thinking about could be me. I am so
humbled to have this opportunity for my son to try to live disease free.
My own daughter ran into my arms that day and we cried tears of
joy – finally, the hope we had clung to was now a reality. We had come full
circle. I asked Natalie how it felt to
know that she could be cured and she said, “I have spent my entire life thinking
that I would die from cystinosis in my 30s but now, I might live a full life
and I am thinking about how much that changes how I think about my future. I never
planned too far ahead but now I can”.
As a mother, words can’t possible convey what it feels like to know that my child has a chance to live a long, healthy life free of cystinosis – I can breathe again. On behalf of all the children and adults with cystinosis, thank you for funding Dr. Cherqui, for caring about our community, for valuing our children and for making this treatment a reality. Our community is ready to start this trial – thank you for making this happen.
CIRM will be celebrating the role of patient advocates at a free event in Los Angeles tomorrow. It’s at the LA Convention Center and here are the details. And did I mention it’s FREE!
Tue, June 25, 2019 – 6:00 PM – 7:00 PM PDT
Petree Hall C., Los Angeles Convention Center, 1201 South Figueroa Street Los Angeles, CA 90015
And on Wednesday, USC is holding an event highlighting the progress being made in fighting diseases that destroy vision. Here’s a link to information about the event.
From even before we were created by the passage of Proposition 71 back in 2004, the voices of patients and patient advocates have been at the heart of CIRM’s existence. Today they are every bit as vital to the work we do, and even more essential if we are to be able to continue doing that work.
In 2004, the patient advocate community recognized that the research we fund could help them or a loved one battling a deadly disease or disorder. And over the last 15 years that’s exactly what we have done, trying to live up to our mission of accelerating stem cell treatments to patients with unmet medical needs. And with 54 clinical trials already under our belt we have made a good start.
But it’s just a start. We still have a lot to do. The problem is we are quickly running out of money. We expect to have enough money to fund new projects up to the end of this year. After that many great new ideas and promising projects won’t be able to apply to us for support. Some may get funding from other sources, but many won’t. We don’t want to let that happen.
That’s why we are holding a Patient Advocate event next Tuesday, June 25th from 6-7pm in Petree Hall C., at the Los Angeles Convention Center at 1201 South Figueroa Street, LA 90015.
The event is open to everyone and it’s FREE. We have created an Eventbrite page where you can get all the details and RSVP if you are coming. And if you want to get there a little early that’s fine too, we’ll be there from 5pm onwards so you’ll have a chance to ask us any questions you might have beforehand.
It’s going to be an opportunity to learn about the real progress being made in stem cell research, thanks in no small part to CIRM’s funding. We’ll hear from the researchers who are saving lives and changing lives, and from the family of one baby alive today because of that work.
We will hear about the challenges facing CIRM and the field, but also about a possible new ballot initiative for next year that could help re-fund CIRM, giving us the opportunity to continue our work.
That’s where you, the patients and patient advocates and members of the public come in. Without you we wouldn’t be here. Without you we will disappear. Without us the field of stem cell research loses a vital source of support and funding, and potentially-life saving therapies fall by the wayside.
We all have a huge stake in this. So we hope to see you next Tuesday, at the start of what may be the next chapter in the life of CIRM.
What do you do when the supposed solution to a problem actually turns out to be a part of the problem? That’s the situation facing people who want to direct patients to scientifically sound clinical trials. Turns out the site many were going to may be directing patients to therapies that are not only not scientifically sound, they may not even be safe.
The site in question
is the www.clinicaltrials.gov
website. That’s a list of all the clinical trials registered with the National
Institutes of Health. In theory that should be a rock-solid list of trials that
have been given the go-ahead by the Food and Drug Administration (FDA) to be tested
in people. Unfortunately, the reality is very different. Many of the trials
listed there have gone through the rigorous testing and approval process to
earn the right to be tested in people. But some haven’t. And figuring out which
is which is not easy.
The issue was highlighted by a terrific article on STAT News this week. The article’s title succinctly sums up the piece: “Stem cell clinics co-opt clinical-trials registry to market unproven therapies, critics say.”
The story highlights how clinics that are offering unproven and
unapproved stem cell therapies can register their “clinical trial” on the site,
even if they haven’t received FDA approval to carry out a clinical trial.
Leigh Turner, a bioethicist at the University of Minnesota and a long-time foe of these clinics, said:
“You can concoct this bogus appearance
of science, call it a clinical study, recruit people to pay to participate in
your study, and not only that: You can actually register on clinicaltrials.gov
and have the federal government help you promote what you’re doing. That struck
me as both dangerous and brilliant.”
At CIRM this is a problem we face almost every day. People call or email us asking for help finding a stem cell therapy for everything from cancer and autism to diabetes. If we are funding something or if there is one underway at one of our Alpha Stem Cell Clinics we can direct them to that particular trial. If not, the easiest thing would be to direct them to the clinicaltrials.gov site. But when you are not sure that all the programs listed are legitimate clinical trials, that’s not something we always feel comfortable doing.
As the STAT piece points out, some of the “trials” listed on the site
are even being run by companies that the FDA is trying to shut down because of
serious concerns about the “therapies” they are offering. One was for a Florida
clinic that had blinded four people. Despite that, the clinic’s projects remain
on the site where other patients can find them.
Being listed on clinicaltrials.gov gives clinics offering unproven therapies
an air or legitimacy. So how can you spot a good trial from a bad one? It’s not
One red flag is if the trial is asking you to pay for the treatment.
That’s considered unethical because it’s asking you to pay to be part of an
experiment. Only a very few legitimate clinical trials ask patients to pay, and
even then, only with permission from the FDA.
Another warning sign is anything that has a laundry list of things it
can treat, everything from arthritis to Alzheimer’s. Well-designed clinical
trials tend to be targeted at one condition not multiple ones.
We have put together some useful tools for patients considering taking
part in a clinical trial. Here is a link
to a video and infographic that tell people the questions they need to ask,
and things they need to consider, before signing up for any clinical trial.
So why does the NIH continue to allow these clinics to “advertise”
their programs on its website? One reason is that the NIH simply doesn’t have
the bandwidth to check every listing to make sure they are legit. They have
tried to make things better by including a warning, stating:
“Listing a study
does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for
details. Before participating in a study, talk to your health care provider and
learn about the risks
and potential benefits.”
The bottom line is
that if you are in the market for a stem cell therapy you should approach it
the way you would any potentially life-changing decision: caveat emptor, buyer
There’s a large body of research that shows that many people learn better through visuals. Studies show that much of the sensory cortex in our brain is devoted to vision so our brains use images rather than text to make sense of things.
That’s why we think it just makes sense to use visuals, as much as we can, when trying to help people understand advances in stem cell research. That’s precisely what our colleagues at U.C. San Diego are doing with a new show called “Stem Cell Science with Alysson Muotri”.
Alysson is a CIRM grantee
who is doing some exciting work in developing a deeper understanding of autism.
He’s also a really good communicator who can distill complex ideas down into
easy to understand language.
The show features Alysson,
plus other scientists at UCSD who are working hard to move the most promising
research out of the lab and into clinical trials in people. Appropriately the
first show in the series follows that path, exploring
how discoveries made using tiny Zebrafish could hopefully lead to stem cell
therapies targeting blood diseases like leukemia. This first show also highlights
the important role that CIRM’s Alpha Stem Cell Clinic Network will play in
bringing those therapies to patients.
You can find a sneak preview of the show on YouTube. The series proper will be broadcast on California local cable via the UCTV channel at 8:00 pm on Thursdays starting July 8, 2019.
And if you really
have a lot of time on your hands you can check out the more
than 300 videos CIRM has produced on every aspect of stem cell research
from cures for fatal diseases to questions to ask before taking part in a
But then came news that another big name celebrity, in this case Star Trek star William Shatner, was going to one of these clinics for an infusion of what he called “restorative cells”.
It’s a reminder that
for every step forward we take in trying to educate the public about the
dangers of clinics offering unproven therapies, we often take another step back
when a celebrity essentially endorses the idea.
So that’s why we are
taking our message directly to the people, as often as we can and wherever we
In June we are going
to be holding a free, public event in Los Angeles to coincide with the opening
of the International Society for Stem Cell Research’s Annual Conference, the
biggest event on the global stem cell calendar. There’s still time to register for that by the way. The event is from 6-7pm on
Tuesday, June 25th in Petree Hall C., at the Los Angeles Convention
Center at 1201 South Figueroa Street, LA 90015.
It’s going to be an
opportunity to learn about the real progress being made in stem cell research,
thanks in no small part to CIRM’s funding. We’re honored to be joined by UCLA’s
Dr. Don Kohn, who has helped cure dozens of children born with a fatal immune
system disorder called severe combined immunodeficiency, also known as “bubble
baby disease”. And we’ll hear from the family of one of those children whose
life he helped save.
And because CIRM is
due to run out of money to fund new projects by the end of this year you’ll
also learn about the very real concerns we have about the future of stem cell
research in California and what can be done to address those concerns. It promises
to be a fascinating evening.
But that’s not all. Our
partners at USC will be holding another public event on stem cell research, on
Wednesday June 26th from 6.30p to 8pm. This one is focused on
treatments for age-related blindness. This features some of the top stem cell
scientists in the field who are making encouraging progress in not just slowing
down vision loss, but in some cases even reversing it.
We know that we face
some serious challenges in trying to educate people about the risks of going to
a clinic offering unproven therapies. But we also know we have a great story to
tell, one that shows how we are already changing lives and saving lives, and
that with the support of the people of California we’ll do even more in the
years to come.
When you have a great story to tell the best and most effective way to get it out to the widest audience is still the media, both traditional mainstream and new social media. Recently we have seen three great examples of how that can be done and, hopefully, the benefits that can come from it.
First, let’s go old
school. Earlier this month Caroline Chen wrote a wonderful
in-depth article about clinics that are cashing in on a gray area in stem
cell research. The piece, a collaboration between the New Yorker magazine and
ProPublica, focused on the use of amniotic stem cell treatments and the gap
between what the clinics who offer it are claiming it can do, and the reality.
Here’s one paragraph
profiling a Dr. David Greene, who runs a company providing amniotic fluid to
clinics. It’s a fine piece of writing showing how the people behind these
therapies blur the lines between fact and reality, not just about the cells but
also about themselves:
“Greene said that amniotic stem cells derive their healing power from an ability to develop into any kind of tissue, but he failed to mention that mainstream science does not support his claims. He also did not disclose that he lost his license to practice medicine in 2009, after surgeries he botched resulted in several deaths. Instead, he offered glowing statistics: amniotic stem cells could help the heart beat better, “on average by twenty per cent,” he said. “Over eighty-five per cent of patients benefit exceptionally from the treatment.”
backpedals on that claim, saying:
“I don’t claim that this is a treatment. I don’t claim that it cures anything. I don’t claim that it’s a permanent fix. All I discuss is maybe, potentially, people can get some improvements from stem-cell care.”
This week CBS2
TV in Chicago did their own investigative story about how the number of local
clinics offering unproven and unapproved therapies is on the rise. Reporter Pam
Zekman showed how misleading newspaper ads brought in people desperate for
something, anything, to ease their arthritis pain.
She interviewed two
patients who went to one of those clinics, and ended up out of pocket, and out
“They said they would regenerate the cartilage,” Patricia Korona recalled. She paid $4500 for injections in her knee, but the pain continued. Later X-rays were ordered by her orthopedic surgeon.
“He found bone on bone,” Korona said. “No cartilage grew, which tells me it failed; didn’t work.”
John Zapfel paid $14,000 for stem cell injections on each side of his neck and his shoulder. But an MRI taken by his current doctor showed no improvement.
“They ripped me off, and I was mad.” Zapfel said.
TV and print reports
like this are a great way to highlight the bogus claims made by many of these
clinics, and to shine a light on how they use hype to sell hope to people who
are in pain and looking for help.
At a time when
journalism seems to be increasingly under attack with accusations of “fake news”
it’s encouraging to see reporters like these taking the time and news outlets
devoting the resources to uncover shady practices and protect vulnerable
But the news isn’t
all bad, and the use of social media can help highlight the good news.
That’s what happened
yesterday in our latest CIRM
Facebook Live “Ask the Stem Cell Team” event. The event focused on the
future of stem cell research but also included a really thoughtful look at the
progress that’s been made over the last 10-15 years.
We had two great
guests, UC Davis stem cell researcher and one of the leading bloggers on the
field, Paul Knoepfler PhD; and David
Higgins, PhD, a scientist, member of the CIRM Board and a Patient Advocate
for Huntington’s Disease. They were able to highlight the challenges of the
early years of stem cell research, both globally and here at CIRM, and show how
the field has evolved at a remarkable rate in recent years.
subject of the “bogus clinics” came up – Paul has become a national expert on
these clinics and is quoted in the New Yorker article – as did the subject of
the frustration some people feel at what they consider to be the too-slow pace
of progress. As David Higgins noted, we all think it’s too slow, but we are not
going to race recklessly ahead in search of something that might heal if we
might also end up doing something that might kill.
A portion of the
discussion focused on funding and, in particular, what happens if CIRM is no
longer around to fund the most promising research in California. We are due to
run out of funding for new projects by the end of this year, and without a
re-infusion of funds we will be pretty much closing our doors by the end of
2020. Both Paul and David felt that could be disastrous for the field here in
California, depriving the most promising projects of support at a time when
they needed it most.
It’s probably not
too surprising that three people so closely connected to CIRM (Paul has
received funding from us in the past) would conclude that CIRM is needed for
stem cell research to not just survive but thrive in California.
A word of caution
before you watch: fashion conscious people may be appalled at how my pocket handkerchief
took on a life of its own.
For years researchers have struggled to create human blood stem cells in the lab. They have done it several times with animal models, but the human kind? Well, that’s proved a bit trickier. Now a CIRM-funded team at UC San Diego (UCSD) think they have cracked the code. And that would be great news for anyone who may ever need a bone marrow transplant.
Why are blood stem cells important? Well, they help create our red and white blood cells and platelets, critical elements in carrying oxygen to all our organs and fighting infections. They have also become one of the most important weapons we have to combat deadly diseases like leukemia and lymphoma. Unfortunately, today we depend on finding a perfect or near-perfect match to make bone marrow transplants as safe and effective as possible and without a perfect match many patients miss out. That’s why this news is so exciting.
Researchers at UCSD found that the process of creating new blood stem cells depends on the action of three molecules, not two as was previously thought.
Here’s where it gets
a bit complicated but stick with me. The team worked with zebrafish, which use
the same method to create blood stem cells as people do but also have the
advantage of being translucent, so you can watch what’s going on inside them as
it happens. They noticed that a molecule
called Wnt9a touches down on a receptor called Fzd9b and brings along with it
something called the epidermal growth factor receptor (EGFR). It’s the
interaction of these three together that turns a stem cell into a blood cell.
In a news release, Stephanie Grainger, the first author of the
study published in Nature Cell Biology, said this discovery could help lead to new
ways to grow the cells in the lab.
“Previous attempts to develop blood stem cells in a
laboratory dish have failed, and that may be in part because they didn’t take
the interaction between EGFR and Wnt into account.”
If this new approach helps the team generate blood stem cells in the lab these could be used to create off-the-shelf blood stem cells, instead of bone marrow transplants, to treat people battling leukemia and/or lymphoma.