Rate of Childhood Obesity Falls in Several Cities


Jessica Kourkounis for The New York Times


At William H. Ziegler Elementary in Northeast Philadelphia, students are getting acquainted with vegetables and healthy snacks.







PHILADELPHIA — After decades of rising childhood obesity rates, several American cities are reporting their first declines.




The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students.


“It’s been nothing but bad news for 30 years, so the fact that we have any good news is a big story,” said Dr. Thomas Farley, the health commissioner in New York City, which reported a 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011.


The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation’s most intractable health problems, may actually be reversing course.


The first dips — noted in a September report by the Robert Wood Johnson Foundation — were so surprising that some researchers did not believe them.


Deanna M. Hoelscher, a researcher at the University of Texas, who in 2010 recorded one of the earliest declines — among mostly poor Hispanic fourth graders in the El Paso area — did a double-take. “We reran the numbers a couple of times,” she said. “I kept saying, ‘Will you please check that again for me?’ ”


Researchers say they are not sure what is behind the declines. They may be an early sign of a national shift that is visible only in cities that routinely measure the height and weight of schoolchildren. The decline in Los Angeles, for instance, was for fifth, seventh and ninth graders — the grades that are measured each year — between 2005 and 2010. Nor is it clear whether the drops have more to do with fewer obese children entering school or currently enrolled children losing weight. But researchers note that declines occurred in cities that have had obesity reduction policies in place for a number of years.


Though obesity is now part of the national conversation, with aggressive advertising campaigns in major cities and a push by Michelle Obama, many scientists doubt that anti-obesity programs actually work. Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.


Philadelphia has undertaken a broad assault on childhood obesity for years. Sugary drinks like sweetened iced tea, fruit punch and sports drinks started to disappear from school vending machines in 2004. A year later, new snack guidelines set calorie and fat limits, which reduced the size of snack foods like potato chips to single servings. By 2009, deep fryers were gone from cafeterias and whole milk had been replaced by one percent and skim.


Change has been slow. Schools made money on sugary drinks, and some set up rogue drink machines that had to be hunted down. Deep fat fryers, favored by school administrators who did not want to lose popular items like French fries, were unplugged only after Wayne T. Grasela, the head of food services for the school district, stopped buying oil to fill them.


But the message seems to be getting through, even if acting on it is daunting. Josh Monserrat, an eighth grader at John Welsh Elementary, uses words like “carbs,” and “portion size.” He is part of a student group that promotes healthy eating. He has even dressed as an orange to try to get other children to eat better. Still, he struggles with his own weight. He is 5-foot-3 but weighed nearly 200 pounds at his last doctor’s visit.


“I was thinking, ‘Wow, I’m obese for my age,’ ” said Josh, who is 13. “I set a goal for myself to lose 50 pounds.”


Nationally, about 17 percent of children under 20 are obese, or about 12.5 million people, according to the Centers for Disease Control and Prevention, which defines childhood obesity as a body mass index at or above the 95th percentile for children of the same age and sex. That rate, which has tripled since 1980, has leveled off in recent years but has remained at historical highs, and public health experts warn that it could bring long-term health risks.


Obese children are more likely to be obese as adults, creating a higher risk of heart disease and stroke. The American Cancer Society says that being overweight or obese is the culprit in one of seven cancer deaths. Diabetes in children is up by a fifth since 2000, according to federal data.


“I’m deeply worried about it,” said Francis S. Collins, the director of the National Institutes of Health, who added that obesity is “almost certain to result in a serious downturn in longevity based on the risks people are taking on.”


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HSBC to pay record $1.9B fine

British-owned bank HSBC is paying $1.9B to settle a US money-laundering probe. The bank was investigated for involvement in the transfer of funds from Mexican drug cartels and sanctioned nations like Iran. (Dec. 11)









HSBC has agreed to pay a record $1.92 billion fine to settle a multi-year probe by U.S. prosecutors, who accused Europe's biggest bank of failing to enforce rules designed to prevent the laundering of criminal cash.

The U.S. Justice Department on Tuesday charged the bank with failing to maintain an effective program against money laundering and conduct due diligence on certain accounts.






In documents filed in federal court in Brooklyn, it also charged the bank with violating sanctions laws by doing business with Iran, Libya, Sudan, Burma and Cuba.

HSBC Holdings Plc admitted to a breakdown of controls and apologised for its conduct.

"We accept responsibility for our past mistakes. We have said we are profoundly sorry for them, and we do so again. The HSBC of today is a fundamentally different organisation from the one that made those mistakes," said Chief Executive Stuart Gulliver.

"Over the last two years, under new senior leadership, we have been taking concrete steps to put right what went wrong and to participate actively with government authorities in bringing to light and addressing these matters."

The bank agreed to forfeit $1.256 billion and retain a compliance monitor to resolve the charges through a deferred-prosecution agreement.

The settlement offers new information about failures at HSBC to police transactions linked to Mexico, details of which were reported this summer in a sweeping U.S. Senate probe.

The Senate panel alleged that HSBC failed to maintain controls designed to prevent money laundering by drug cartels, terrorists and tax cheats, when acting as a financier to clients routing funds from places including Mexico, Iran and Syria.

The bank was unable to properly monitor $15 billion in bulk cash transactions between mid-2006 and mid-2009, and had inadequate staffing and high turnover in its compliance units, the Senate panel's July report said.

HSBC on Tuesday said it expected to also reach a settlement with British watchdog the Financial Services Authority. The FSA declined to comment.

U.S. and European banks have now agreed to settlements with U.S. regulators totalling some $5 billion in recent years on charges they violated U.S. sanctions and failed to police potentially illicit transactions.

No bank or bank executives, however, have been indicted, as prosecutors have instead used deferred prosecutions - under which criminal charges against a firm are set aside if it agrees to conditions such as paying fines and changing behaviour.

HSBC's settlement also includes agreements or consent orders with the Manhattan district attorney, the Federal Reserve and three U.S. Treasury Department units: the Office of Foreign Assets Control, the Comptroller of the Currency and the Financial Crimes Enforcement Network.

HSBC said it would pay $1.921 billion, continue to cooperate fully with regulatory and law enforcement authorities, and take further action to strengthen its compliance policies and procedures. U.S. prosecutors have agreed to defer or forego prosecution.

The settlement is the third time in a decade that HSBC has been penalized for lax controls and ordered by U.S. authorities to better monitor suspicious transactions. Directives by regulators to improve oversight came in 2003 and again in 2010.

Last month, HSBC told investors it had set aside $1.5 billion to cover fines or penalties stemming from the inquiry and warned that costs could be significantly higher.

Analyst Jim Antos of Mizuho Securities said the settlement costs were "trivial" in terms of the company's book value.

"But in terms of real cash terms, that's a huge fine to pay," said Antos, who rates HSBC a "buy".

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CPS head, lawmaker vow to work on truancy after Tribune series









A top state lawmaker and the head of the Chicago Public schools on Monday vowed to support a high-level task force aimed at combating the crisis in K-8 grade absenteeism and truancy exposed by a recent Tribune series.

Speaking at a drop-out prevention forum, House Majority Leader Barbara Flynn Currie and district CEO Barbara Byrd-Bennett pledged to tackle a daunting problem that they acknowledged has not been addressed in the past, essentially foreclosing the futures of tens of thousands of Chicago students.

“While the district has not fully owned this problem in the past, we will own it now,” Byrd-Bennett told the gathering of educators, politicians and community leaders at the Union League Club of Chicago. “We must work to shut down the drop-out pipeline.”

Byrd-Bennett said she would expand a small “Check & Connect” pilot program that pairs trained mentors with roughly 450 truant elementary students and has shown signs of promise in its second year.

But these “incremental and tiny steps ... are not enough for the magnitude of our problem,” Byrd-Bennett added. “We need to find new ways to work together and engage other government agencies.”

The Tribune series, published last month, found that nearly 32,000 K-8 students -- or roughly one in 8 -- missed four weeks or more of class during the 2010-11 school year as the cash-strapped district did little to stem the devastating problem.

The elementary grade absences were especially severe for African-American children and those with learning and emotional disabilities. For children born into poverty, the flood of missed days threatens to swallow any hope for a better life, while the empty seats undermine efforts to boost achievement and cost the district millions in attendance-based funding, the Tribune found.

“I was shocked when I read the series in the Chicago Tribune ... showing the extent of the truancy problem,” said Currie, D-Chicago.

In response to the Tribune series, state Rep. Linda Chapa LaVia, D-Aurora, has introduced a House resolution to create a task force on K-8 grade school absenteeism that will include representatives from the governor's office, the Chicago's mayor office, city police and other agencies and community groups.

The resolution is currently awaiting action in the house rules committee and likely will be voted on in January. Currie said Monday: “That resolution I confidently predict will pass.”

dyjackson@tribune.com



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‘Skyfall’ launches back to top spot with $10.8M






LOS ANGELES (AP) — The James Bond blockbuster “Skyfall” has risen back to the No. 1 spot at the weekend box office, taking in $ 10.8 million.


That brought its domestic total to $ 261.4 million and its worldwide haul to a franchise record of $ 918 million.






The top 20 movies at U.S. and Canadian theaters Friday through Sunday, followed by distribution studio, gross, number of theater locations, average receipts per location, total gross and number of weeks in release, as compiled Monday by Hollywood.com are:


1. “Skyfall,” Sony, $ 10,780,201, 3,401 locations, $ 3,170 average, $ 261,400,281, five weeks.


2. “Rise of the Guardians,” Paramount, $ 10,400,618, 3,639 locations, $ 2,858 average, $ 61,774,192, three weeks.


3. “The Twilight Saga: Breaking Dawn — Part 2,” Summit, $ 9,156,265, 3,646 locations, $ 2,511 average, $ 268,691,029, four weeks.


4. “Lincoln,” $ 8,916,813, 2,014 locations, $ 4,427 average, $ 97,137,447, five weeks.


5. “Life of Pi,” Fox, $ 8,330,764, 2,946 locations, $ 2,828 average, $ 60,948,293, three weeks.


6. “Playing For Keeps,” FilmDistrict, $ 5,750,288, 2,837 locations, $ 2,027 average, $ 5,750,288, one week.


7. “Wreck-It Ralph,” Disney, $ 4,859,368, 2,746 locations, $ 1,770 average, $ 164,402,934, six weeks.


8. “Red Dawn,” FilmDistrict, $ 4,236,105, 2,754 locations, $ 1,538 average, $ 37,240,920, three weeks.


9. “Flight,” Paramount, $ 3,130,305, 2,431 locations, $ 1,288 average, $ 86,202,541, six weeks.


10. “Killing Them Softly,” Weinstein Co., $ 2,806,901, 2,424 locations, $ 1,158 average, $ 11,830,638, two weeks.


11. “Silver Linings Playbook,” Weinstein Co., $ 2,171,665, 371 locations, $ 5,854 average, $ 13,964,405, four weeks.


12. “Anna Karenina,” Focus, $ 1,544,859, 422 locations, $ 3,661 average, $ 6,603,042, four weeks.


13. “The Collection,” LD Entertainment, $ 1,487,655, 1,403 locations, $ 1,060 average, $ 5,455,328, two weeks.


14. “Argo,” Warner Bros., $ 1,482,346, 944 locations, $ 1,570 average, $ 103,160,015, nine weeks.


15. “End of Watch,” Open Road Films, $ 751,623, 1,259 locations, $ 597 average, $ 39,989,766, 12 weeks.


16. “Hitchcock,” Fox Searchlight, $ 712,544, 181 locations, $ 3,937 average, $ 1,661,670, three weeks.


17. “Talaash,” Reliance Big Pictures, $ 449,195, 161 locations, $ 2,790 average, $ 2,397,909, two weeks.


18. “Taken 2,” Fox, $ 387,227, 430 locations, $ 901 average, $ 137,700,304, 10 weeks.


19. “Pitch Perfect,” Universal, $ 305,765, 387 locations, $ 790 average, $ 63,517,408, 11 weeks.


20. “The Sessions,” Fox, $ 218,973, 197 locations, $ 1,112 average, $ 4,948,342, eight weeks.


___


Online:


http://www.hollywood.com


___


Universal and Focus are owned by NBC Universal, a unit of Comcast Corp.; Sony, Columbia, Sony Screen Gems and Sony Pictures Classics are units of Sony Corp.; Paramount is owned by Viacom Inc.; Disney, Pixar and Marvel are owned by The Walt Disney Co.; Miramax is owned by Filmyard Holdings LLC; 20th Century Fox and Fox Searchlight are owned by News Corp.; Warner Bros. and New Line are units of Time Warner Inc.; MGM is owned by a group of former creditors including Highland Capital, Anchorage Advisors and Carl Icahn; Lionsgate is owned by Lions Gate Entertainment Corp.; IFC is owned by AMC Networks Inc.; Rogue is owned by Relativity Media LLC.


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Vital Signs: Smoking Tied to Less Dense Bones for Girls

Smoking in teenage girls is associated with slower development of bone mineral density, a new study reports.

The scientists studied 262 healthy girls ages 11 to 19, using questionnaires and interviews to assess their smoking habits. The researchers also measured the girls’ bone density at the hip and lumbar spine three times at one-year intervals.

Smokers entered adolescence with the same lumbar and hip bone density as nonsmokers, but by age 19, they were about a year behind on average. After adjusting for other factors that affect bone health — height, weight, hormonal contraceptive use and more — the researchers found that even relatively low or irregular rates of smoking were independently associated with lower bone density.

The study, published last week in The Journal of Adolescent Health, used a sample that fell below national averages for calcium intake and physical activity, so the results may not be generalizable to wider populations.

The lead author, Lorah D. Dorn, a professor of pediatrics at Cincinnati Children’s Hospital, pointed out that this is only one study and that more research is needed. Still, she said, “It tells me that for care providers — clinicians and parents — this needs to be something they’re vigilant about.”

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McDonald's sales rebound in November









McDonald’s took Wall Street by surprise Monday morning, with a November same store sales report that beat expectations and showed particular strength in the U.S. business.

The news follows a weak performance in October that had some investors speculating about the future of the world’s largest restaurant company.

The Oak Brook-based burger giant reported U.S. same store sales up 2.5 percent on the strength of its breakfast business, value offerings, beverages and limited-time offers like the cheddar bacon onion sandwich. In Europe, same store sales grew 1.4 percent, and 0.6 percent in the chain’s Asia/Pacific, Middle East and Africa division.

Overall, same store sales increased 2.4 percent, beating expectations of a roughly flat performance. Company stock rose nearly 1 percent in early morning trading, to $89.35.

"We are strengthening our focus on the global priorities that are most impactful to our customers -- optimizing our menu, modernizing the customer experience and broadening accessibility to our brand to move our business forward," McDonald's CEO Don Thompson said in a statement.

While the sales report is likely to be a boon for the burger giant, investors don’t expect company performance to return to normal levels until early 2013. Winter is typically the slow period for fast food chains, with summer typically being the busiest season.

Baird analyst David Tarantino raised his fourth quarter earnings estimate by a penny Monday morning following the sales announcement. He wrote that while company performance "could remain soft" through the first quarter of 2013, "the November sales report supports our thesis that McDonald's can achieve better performance in 2013 as a whole, with results aided by planned initiatives (including increased emphasis on value plus premium offerings across markets), fewer cost pressures, and less negative currency translation."

The chain has taken a tough stance on slipping U.S. sales. The company’s October sales, which slipped 2.2 percent, marked the first decline in more than nine years. Days later, McDonald’s said U.S. president Jan Fields had resigned and would be replaced by Jeff Stratton.

eyork@tribune.com | Twitter: @emilyyork

MCD Chart

MCD data by YCharts

MCD Chart

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Plane believed to carry singer Jenni River found in Mexico









The wreckage of a small plane believed to be carrying Mexican-American singing superstar Jenni Rivera was found in northern Mexico on Sunday and there are no apparent survivors, authorities said.

Transportation and Communications Minister Gerardo Ruiz Esparza said that "everything points toward" it being the U.S.-registered Learjet 25 carrying Rivera and six other people from Monterrey en route to Toluca, Mexico. The plane had gone missing after takeoff early Sunday.

"There is nothing recognizable, neither material nor human" in the wreckage," Ruiz Esparza told the Televisa network.

Authorities had not confirmed that Rivera was among the dead.

Jorge Domene, spokesman for Nuevo Leon's government, said the plane left Monterrey about 3:30 a.m. after Rivera gave a concert there and aviation authorities lost contact with the craft about 10 minutes later. It had been scheduled to arrive in Toluca, outside Mexico City, about an hour later.

Also aboard the plane were her publicist, lawyer, makeup artist and the flight crew.

The Long Beach, Calif., native's career has been soaring. The 43-year-old singer is best known for her interpretations of regional Mexican music, norteno and banda. She also is one of NBCUniversal's brightest bilingual television stars.

Her reality show on the Telemundo cable channel, mun2, "I Love Jenni," has been one of the channel's highest rated shows. The program is in its second year.

ABC television network was reportedly considering casting Rivera as a star of a prime-time sitcom in development about a strong-willed single Latina mother.

The so-called "Diva de la Banda" was beloved by fans on both sides of the border for such songs as "De Contrabando" and "La Gran Senora."

She recently won two Billboard Mexican Music Awards: Female Artist of the Year and Banda Album of the Year for "Joyas prestadas: Banda."

The singer, businesswoman and actress appeared in the indie film Filly Brown, as the incarcerated mother of Filly Brown, and has her own reality shows including "I Love Jenni" and "Jenni Rivera Presents: Chiquis and Raq-C" and her daughter's "Chiquis 'n Control."

Rivera had given a concert before thousands of fans in Monterrey on Saturday night. After the concert she gave a press conference during which she spoke of her emotional state following her recent divorce from former Major League Baseball pitcher Esteban Loaiza, who played for teams including the Chicago White Sox, New York Yankees and Los Angeles Dodgers.

"I can't get caught up in the negative because that destroys you. Perhaps trying to move away from my problems and focus on the positive is the best I can do. I am a woman like any other and ugly things happen to me like any other woman," she said Saturday night. "The number of times I have fallen down is the number of times I have gotten up."

The mother of five children and grandmother of two had announced in October that she was divorcing Loaiza after two years of marriage. It was her third marriage.

Rivera is the sister of Mexican singer Lupillo Rivera. Patricia Chavez of Lupillo Rivera's office in the United States told The Associated Press that "for now we don't have any information that would be useful."

The Los Angeles Times contributed to this report.



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Amazon’s Android Appstore explodes, downloads increase 500% over last year






Amazon’s (AMZN) Appstore is on fire. While the marketplace may not boost as many apps as Google’s (GOOG) Play Store, it has seen substantial growth in the past year. In fact, the company announced on Thursday that its Appstore has seen downloads increase more than 500% since last year. Amazon also revealed that the number of developers utilizing in-app purchasing doubled in the third quarter and that 23 of the top 25 grossing apps now incorporate the technology.


“Amazon offers the best end-to-end solution for app and game developers,” said Aaron Rubenson, Director of Amazon Appstore for Android. “Developers can use Amazon Web Services’ building blocks as the infrastructure for their games. To enhance customer engagement, they can add features like GameCircle’s Leaderboards, Achievements, Friends, and Whispersync. Amazon’s In-App Purchasing allows developers to generate additional income. Finally, since discovery can be a major challenge for app developers, we’re providing more and more ways to help developers reach customers on Amazon, Kindle Fire devices, and in our Appstore. We’re working hard to make lives easier for developers, and to give them more ways to grow their business.”






The success of Amazon’s Appstore is directly related to the success of its Kindle Fire line of tablets. Unlike most Android devices, the Kindle Fire does not include access to Google Play and instead must rely solely on Amazon’s offering for content and applications.


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Bond movie “Skyfall” beats “Lincoln” at box office






(Reuters) – James Bond showed remarkable staying power as the latest installment of the spy series, “Skyfall,” captured the box office title and collected $ 11 million in its fifth week in U.S. and Canadian movie theaters, outgunning Steven Spielberg‘s “Lincoln” and “The Twilight Saga: Breaking Dawn – Part 2,” the final installment of the blockbuster vampire series.


“Skyfall,” the 23rd film in the series featuring Agent 007, also led movies at the box office when it first opened on November 2 and is already the best-selling movie in the 49-year old series. This weekend, it became the highest grossing movie in Sony Pictures‘ history with $ 918 million in ticket sales worldwide. The film distributed by Sony‘s Hollywood studio, has collected nearly $ 262 million in domestic sales, according to the movie tracking site Hollywood.com.






The animated “Rise of the Guardians” from Dreamworks Animation was second with $ 10.5 million in ticket sales. The movie, which was made for $ 145 million, opened with a disappointing $ 23.8 million when it first hit movie theaters on November 21. Since then, it has been steadily working its way toward becoming a solid family hit this season.


“Rise of the Guardians, which features Santa Claus, the Easter Bunny and other childhood favorites who join together to save the world, was one of two family movies in a season traditionally heavy in family films. The other, Disney’s “Wreck-it Ralph,” collected $ 4.9 million for seventh place.


“Breaking Dawn – Part 2,” the box office leader for the past three weeks, tallied $ 9.2 million in ticket sales. The five-movie series, released by Lions Gate Entertainment, is based on Stephenie Meyer‘s best-selling book about young vampire love and has collected more than $ 1.3 billion in overall domestic ticket sales.


“Lincoln,” which chronicles the 16th president’s successful fight to pass a constitutional amendment outlawing slavery, had total ticket sales of $ 9.1 million, according to studio estimates provided by the box office division of Hollywood.com.


“Life of Pi,” director Ang Lee’s movie about a boy who escapes a shipwreck but then shares his lifeboat with a tiger, sold $ 8.3 million in tickets to finish in fifth place. The movie, released by the Fox studio, is based on a best-selling 2001 novel by Yann Martel.


Hollywood studios shied away from scheduling major movies this weekend, steering clear of the expected blockbuster “The Hobbit: An Unexpected Journey,” which Warner Brothers will release on December 14. The movie, based on the J.R.R. Tolkien fantasy novel about wizards and dwarves, features many of the same actors from the blockbuster “The Lord of the Rings” trilogy.


The only new major release, the romantic comedy “Playing for Keeps” starring Gerard Butler and Jessica Biel, opened with a lackluster $ 6 million, which was on target with forecasts by industry experts.


(Reporting by Ronald Grover and Andrea Burzynski; Editing by Bill Trott and Jackie Frank)


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A Breakthrough Against Leukemia Using Altered T-Cells





PHILIPSBURG, Pa. — Emma Whitehead has been bounding around the house lately, practicing somersaults and rugby-style tumbles that make her parents wince.




It is hard to believe, but last spring Emma, then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.


Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the AIDS virus to reprogram Emma’s immune system genetically to kill cancer cells.


The treatment very nearly killed her. But she emerged from it cancer-free, and seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.


Emma had been ill with acute lymphoblastic leukemia since 2010, when she was 5, her parents, Kari and Tom, said. She is their only child.


She is among just a dozen patients with advanced leukemia to have received the experimental treatment, which was developed at the University of Pennsylvania. Similar approaches are also being tried at other centers, including the National Cancer Institute and Memorial Sloan-Kettering Cancer Center in New York.


“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.


Three adults with chronic leukemia treated at the University of Pennsylvania have also had complete remissions, with no signs of disease; two of them have been well for more than two years, said Dr. David Porter. Four adults improved but did not have full remissions, and one was treated too recently to evaluate. A child improved and then relapsed. In two adults, the treatment did not work at all. The Pennsylvania researchers are presenting their results on Sunday and Monday in Atlanta at a meeting of the American Society of Hematology.


Despite the mixed results, cancer experts not involved with the research say it has tremendous promise, because even in this early phase of testing it has worked in seemingly hopeless cases.


“I think this is a major breakthrough,” said Dr. Ivan Borrello, a cancer expert and associate professor of medicine at the Johns Hopkins University School of Medicine.


Dr. John Wagner, director of pediatric blood and marrow transplantation at the University of Minnesota, called the Pennsylvania results “phenomenal,” and said they were “what we’ve all been working and hoping for but not seeing to this extent.”


A major drug company, Novartis, is betting on the Penn team, and has committed $20 million to building a research center on the Penn campus to bring the treatment to market.


HervĂ© Hoppenot, president of Novartis Oncology, called the research “fantastic” and said it had the potential — if the early results hold up — to revolutionize the treatment of leukemia and related blood cancers. Researchers say the same approach, reprogramming the patient’s immune system, may also be used eventually against tumors like breast and prostate cancer.


To perform the treatment, doctors remove millions of the patient’s T-cells — a type of white blood cell — and insert new genes that enable the T-cells to kill cancer cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turns malignant in leukemia.


The altered T-cells — called chimeric antigen receptor cells — are then dripped back into the patient’s veins, and if all goes well they multiply like crazy and start destroying the cancer.


The T-cells home in on a protein called CD-19 that is found on the surface of most B-cells, whether they are healthy or malignant.


A sign that the treatment is working is that the patient becomes terribly ill, with raging fevers and chills — a reaction that oncologists call “shake and bake,” Dr. June said. Its medical name is cytokine-release syndrome, or cytokine storm, referring to the natural chemicals that pour out of cells in the immune system as they are being activated, causing fevers and other symptoms. The storm can also flood the lungs and cause perilous drops in blood pressure — effects that nearly killed Emma.


Steroids sometimes ease the reaction, but did not help Emma. Her temperature hit 105. She wound up on a ventilator, unconscious and swollen almost beyond recognition, surrounded by friends and family who had come to say goodbye.


But at the eleventh hour, a battery of blood tests gave the researchers a clue as to what might help save Emma: Her level of one of the cytokines, interleukin-6 or IL-6, had shot up a thousandfold. Doctors had never seen such a spike before and thought it might be what was making her so sick. Dr. June knew that a drug could lower IL-6 — his daughter takes it, for rheumatoid arthritis. It had never been used for a crisis like Emma’s, but there was little to lose. Her oncologist, Dr. Stephan A. Grupp, ordered the drug. The response, he said, was “amazing.”


Within hours, Emma began to stabilize. She woke up a week later, on May 2, the day she turned 7; the intensive-care staff sang “Happy Birthday.”


Since then, the research team has used the same drug, tocilizumab, in several other patients.


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