Sylvester Comprehensive Cancer Center

UM Hires Top Physician-Scientist to Lead Stem Cell Transplant Program

07.02.2008

The University of Miami Leonard M. Miller School of Medicine has hired a top-tier, innovative physician and researcher from the University of Texas M.D. Anderson Cancer Center to lead the adult stem cell transplant program at the University of Miami Sylvester Comprehensive Cancer Center. Krishna Komanduri, M.D., will be the director of the UM/Sylvester Stem Cell Transplantation Program and associate director of translational research at the Miami Transplant Institute at Jackson Memorial Hospital.

At M.D. Anderson’s Department of Stem Cell Transplantation and Cellular Therapy, Dr. Komanduri was a physician-scientist who cared for stem cell transplant recipients and performed research in human T cell immunology. His research focus is in immune reconstitution after stem cell transplantation and human T-cell immunity to pathogenic viruses and fungi, and in characterizing how subsets of T cells may mediate post-transplant complications. Dr. Komanduri’s lab was among the first to apply novel techniques in functional immune assessment by flow cytometry to study virus-specific T-cells and those capable of recognizing foreign tissues.

“My plan,” says Dr. Komanduri “is to build a leading clinical program in stem cell transplantation.” He then intends to set his sights on creating a transplant research program that “advances the state of the art of stem cell transplantation, making the program among the best in the nation.”

The stem cell transplant program is “truly at the intersection of research and treatment,” says W. Jarrard Goodwin, M.D., director of UM/Sylvester. “There is no better example of our UM/Sylvester motto —- that research cures cancer.” Dr. Goodwin emphasizes that “Dr. Komanduri is an exceptional physician scientist and exactly the right person to lead this program in the future.”

For patients with high-risk or relapsed multiple myeloma, lymphoma and many subsets of leukemia, stem cell transplantation, performed by infusing donor grafts containing both stem cells and T cells following the administration of chemotherapy to the recipient with cancer, remains the standard of care. While stem cell transplantation offers the best chance of cure for these patients, scientific challenges remain. Stem cell grafts obtained from either the peripheral blood or marrow contains T cells, which normally play a key role in protecting healthy individuals and cancer patients from infections. T cells contained in donor stem cell products may also attack residual cancer cells, performing a critical function in maintaining remissions in stem cell transplant recipients.

However, the benefits may stop there for some patients. Those same T-cells that have helped rebuild the stem cell transplant patient’s immunity and attack the residual cancer may also turn on healthy tissue in the recipient. That phenomenon, called graft vs. host disease, is a primary area of interest for Dr. Komanduri.

Work in his laboratory is aimed at trying to understand how various components of the immune system work together. The goal is to coax the T cells into maintaining their beneficial immunologic functions, without attacking the host. By engineering stem cell grafts to contain an optimal combination of blood-forming stem cells and subsets of T cells with desired properties, stem cell transplantation would become safer and more effective, and be available to a wider range of patients, including those who currently lack sufficiently matched donors to allow them to be safely transplanted. Ian K. McNiece, Ph.D., director of experimental and clinical therapies in the Interdisciplinary Stem Cell Institute at the Miller School, says he is “very excited about the potential of working with Dr. Komanduri to build our bone marrow transplant program into a world renowned program.” His arrival will open up new opportunities for cellular therapies at UM, adds Dr. McNiece, and “offer cutting edge treatment to our patients.”

Joseph Rosenblatt, M.D., associate director of clinical and translational research at UM/Sylvester, says Dr. Komanduri was the cancer center’s first choice for the position, following a national search. “He has been a pioneer,” says Dr. Rosenblatt in describing Dr. Komanduri’s work with T-cell reconstitution. Dr. Rosenblatt says Dr. Komanduri is “a nationally recognized academic and clinical leader, an individual of distinction who will be able to develop a nationally prominent program which will integrate novel science with expanded clinical indications.”

Dr. Komanduri’s hope is that the work done to better understand the relationship between T cells and the host will then also help physicians better manage organ transplant rejection. Andreas G. Tzakis, M.D., Ph.D., director of the Miami Transplant Institute, says increased research has led to a convergence of applications between bone marrow and solid organ transplantation. He believes the addition of Dr. Komanduri will not only “elevate the Stem Cell Transplantation Program to one of the best in the world,” but also create protocols that will “allow our patients to reduce their reliance on immunosuppressive drugs following solid transplants, such as heart, lung, liver or pancreas transplantation.”

Robert B. Levy, M.D., professor of microbiology and immunology and medicine at the Miller School, believes Dr. Komanduri brings enormous clinical experience together with research skills in immunology and transplantation that will benefit faculty, students and patients. “Dr. Komanduri is poised to move the University of Miami into the rapidly progressing and exciting arena of allogenic hematopoietic cell transplants at a critical stage in the history of cell transplantation,” says Dr. Levy. He adds that this work will “provide a platform for the development of newly emerging gene and cellular strategies which may be applied for the treatment of a broad array of diseases.”

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