Fed to spend $45B to sustain bond purchases

The Federal Reserve will spend $45 billion a month to sustain an aggressive drive to keep long-term interest rates low. And it set a goal of keeping a key short-term rate near zero until unemployment drops below 6.5 percent.

The policies are intended to help an economy that the Fed says is growing only modestly with 7.7 percent unemployment in November.

The Fed said in a statement issued Wednesday that it will direct the money into long-term Treasurys to replace an expiring bond-purchase program. The new purchases will expand its investment portfolio, which has reached nearly $3 trillion.

The central bank will continue buying $40 billion a month in mortgage bonds. All told, its monthly bond purchases will remain $85 billion. They are intended to reduce already record-low long-term rates to encourage borrowing and accelerate growth.

Quiz: The year in business
The Fed kept its target for its benchmark short-term interest rate at a record low near zero, where it has been for the last four years. The Fed said Wednesday that it would link any future rate change to lower unemployment, as long as inflation is expected to stay below 2.5 percent.

Before Wednesday, the Fed had said it planned would keep the rate low until at least mid-2015.

The Fed said it can pursue the aggressive stimulus programs because inflation remains below its target.

The statement was issued after the Fed's two-day policy meeting and approved on an 11-1 vote. Jeffrey Lacker, president of Federal Reserve Bank of Richmond, objected for the eighth time this year.

The Fed's final meeting of the year is being held against the backdrop of the looming “fiscal cliff,” the sharp tax increases and spending cuts that will hit the economy in January if Congress and President Barack Obama are unable to reach an agreement this month to avert them.

Bernanke has said that the Fed's efforts will not be able to rescue the economy if the budget negotiations fail and the country does go over the fiscal cliff.

Fears of the cliff have led some U.S. companies to delay expanding, investing and hiring. Manufacturing has slumped. Consumers have cut back on spending. Unemployment remains elevated. If higher taxes and government spending cuts were to last for much of 2013, most experts say the economy would sink into another recession.

The latest bond-buying program would replace an expiring program called Operation Twist. With Twist, the Fed sold $45 billion a month in short-term Treasurys and used the proceeds to buy the same amount in longer-term Treasurys.

Twist didn't expand the Fed's investment portfolio, it just reshuffled the holdings. But the Fed has run out of short-term securities to sell. So to maintain its pace of long-term Treasury purchases and to keep long-term rates low, it must spend more and increase its portfolio.

The Fed's portfolio totals nearly $2.9 trillion — more than three times its size before the 2008 financial crisis.

The Fed has launched three rounds of bond purchases since the financial crisis hit. In announcing a third program in September, the Fed said it would keep buying mortgage bonds until the job market improved substantially.

Skeptics note that rates on mortgages and many other loans are already at or near all-time lows. So any further declines in rates engineered by the Fed might offer little economic benefit.

Inside and outside the Fed, a debate has raged over whether the Fed's actions have helped support the economy over the past four years, whether they will ignite inflation later and whether they should be extended.

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States pressed to guarantee Medicaid expansion

WASHINGTON — The Obama administration stepped up pressure on states Monday to guarantee insurance for all their low-income residents in 2014 under the new healthcare law, warning governors that the federal government would not pick up the total cost of partially expanding coverage.

"We continue to encourage all states to fully expand their Medicaid programs and take advantage of the generous federal matching funds to cover more of their residents," Health and Human Services Secretary Kathleen Sebelius wrote in a letter to governors.

But Sebelius indicated that governors who do not open their Medicaid programs to all eligible low-income residents would forfeit some of the federal aid promised by the Affordable Care Act.

"The law does not provide for a phased-in or partial expansion," the Department of Health and Human Services said in guidance accompanying Sebelius' letter.

Medicaid has become a major issue in the implementation of the law since the U.S. Supreme Court ruled in June that states can decide whether to expand their Medicaid programs in 2014.

The law originally required the states to open Medicaid to all Americans who earn less than 138% of the federal poverty level, a major change for a program that now largely covers poor children and mothers.

To ease the expansion, the law initially provides full federal funding to cover the new population. Currently, Medicaid costs are split between state and federal governments.

Nonetheless, several Republican governors have said they won't expand Medicaid, citing cost concerns. That prompted speculation that some states might partially expand Medicaid programs. But Obama administration officials said Monday the law did not authorize full federal funding for a more limited expansion.

A state that opens Medicaid to only some new low-income residents would qualify for reduced federal aid, requiring the state to come up with the remainder of the funding.

How the guidance will affect state decisions remains unclear.

Alan Weil, president of the National Academy for State Health Policy, said state leaders probably would not make final decisions until they worked out 2014 budgets next year. "A lot of what we have seen so far is posturing," he said.

But the administration's announcement drew quick criticism from the Republican Governors Assn.

"The Obama administration's refusal to grant states more flexibility on Medicaid is as disheartening as it is short-sighted," said Louisiana Gov. Bobby Jindal, the group's chairman. Jindal has said he will not expand Medicaid in his state.

In contrast, the administration's move was applauded by the National Assn. of Public Hospitals and Health Systems, whose members care for millions of the nation's uninsured, often without compensation. Dr. Bruce Siegel, the association president, said it "takes an important step toward significantly reducing the ranks of the uninsured."

The Obama administration is facing additional resistance from several Republican governors who have said they won't set up insurance exchanges — a cornerstone of the law that will allow Americans who don't get health benefits at work to shop for insurance plans that meet new minimum standards. The federal government can set up exchanges for states that refuse to do so.

Also Monday, Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington got conditional federal approval to operate their own exchanges. The six were the first to apply, and administration officials said approval for other states, including California, would probably follow.

noam.levey@latimes.com

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'Lincoln' leads Critics' Choice Awards nominees

LOS ANGELES (AP) — Film critics love "Lincoln." The historical drama earned a record-breaking 13 nominations for the Critics' Choice Movie Awards.

The Broadcast Film Critics Association announced the nominees for its 18th annual awards ceremony Tuesday in Los Angeles.

"Lincoln" beat the 12 nods earned by 2010's "Black Swan" with bids for director Steven Spielberg, star Daniel Day-Lewis and supporting actors Sally Field and Tommy Lee Jones, as well as cinematography, adapted screenplay, costume design, makeup, editing, art direction, score and acting ensemble.

"Les Miserables" follows with 11 nominations and "Silver Linings Playbook" has 10. "Life of Pi" earned nine nods. "Argo," ''Skyfall" and "The Master" each have seven.

Winners will be announced Jan. 10, 2013, at a ceremony set to be broadcast live on the CW network.

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Online:

www.criticschoice.com

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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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Bank of America voted least popular; satisfaction at 11-year low

Customers last year were not pleased with Bank of America and its many fees, giving the institution its lowest satisfaction score since 2000.

The score of 66 on a scale of 100 is 3% lower than the bank’s tally in 2010, according to the American Customer Satisfaction Index.

The Charlotte, N.C., company now trails all of its major banking rivals and is the only institution with a grade that’s lower than its pre-recession level. It’s the least popular bank for the fourth year in a row.

JPMorgan Chase leads the pack of big banks, rising 6% to a score of 74. It beat out Wells Fargo, which has led the board since 2009 but last year slipped 3% to 71. Citigroup dipped 4% to 70.

The overall banking sector saw consumer satisfaction with checking, savings and loan services swell 2.7% to 77. But, taken on their own, smaller institutions do better with customers, scoring 79.

Larger banks, with collected most of the $30 billion in overdraft fees charged in 2011, are losing more customers to more petite rivals and credit unions.

The influx of clients has caused satisfaction with credit unions to take a 5.7% hit, but the sector’s 82 score still outperforms other types of banking.

The ACSI report also covers health insurance, which as an industry landed a 72 tally. The Blue Cross and Blue Shield Assn. led the pack, followed by WellPoint, UnitedHealth and finally Aetna.

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Latin music star Jenni Rivera believed dead in plane crash

Fans of Mexican-American singing star Jenni Rivera held a vigil Sunday night in Lynwood

MEXICO CITY — Mexican American singer Jenni Rivera, the "diva de la banda" whose commanding voice burst through the limits of regional Latin music and made her a cross-border sensation and the queen of a business empire, was believed to have died Sunday when the small jet carrying her and members of her entourage crashed in mountainous terrain.

Rivera, a native of Long Beach, was 43. Mexico's ministry of transportation did not confirm her death outright, but it said that she had been aboard the plane and that no one had survived the crash. Six others, including two pilots, also were on board.

"Everything suggests, with the evidence that's been found, that it was the airplane that the singer Jenni Rivera was traveling in," said Gerardo Ruiz Esparza, Mexico's secretary of communications and transportation. Of the crash site, Ruiz said: "Everything is destroyed. Nothing is recognizable."

Word of the accident ricocheted around the entertainment industry, with performer after performer expressing shock and grief. Fans gathered outside Rivera's four-acre estate in Encino.

"She was the Diana Ross of Mexican music," said Gustavo Lopez, an executive vice president at Universal Music Latin Entertainment, an umbrella group that includes Rivera's label. Lopez called Rivera "larger than life" and said that based on ticket sales, she was by far the top-grossing female artist in Mexico.

"Remember her with your heart the way she was," her father, Don Pedro Rivera, told reporters in Spanish on Sunday evening. "She never looked back. She was a beautiful person with the whole world."

Rivera had performed a concert in Monterrey, Mexico, on Saturday night — her standard fare of knee-buckling power ballads, pop-infused interpretations of traditional banda music and dizzying rhinestone costume changes.

At a news conference after the show, Rivera appeared happy and tranquil, pausing at one point to take a call on her cellphone that turned out to be a wrong number. She fielded questions about struggles in her personal life, including her recent separation from husband Esteban Loaiza, a professional baseball player.

"I can't focus on the negative," she said in Spanish. "Because that will defeat you. That will destroy you.... The number of times I have fallen down is the number of times I have gotten up."

Hours later, shortly after 3 a.m., Rivera is believed to have boarded a Learjet 25, which took off under clear skies. The jet headed south, toward Toluca, west of Mexico City; there, Rivera had been scheduled to tape the television show "La Voz" — Mexico's version of "The Voice" — on which she was a judge.

The plane, built in 1969 and registered to a Las Vegas talent management firm, reached 11,000 feet. But 10 minutes and 62 miles into the flight, air traffic controllers lost contact with its pilots, according to Mexican authorities. The jet crashed outside Iturbide, a remote city that straddles one of the few roads bisecting Mexico's Sierra de Arteaga national park.

Wreckage was scattered across several football fields' worth of terrain. An investigation into the cause of the crash was underway, and attempts to identify the remains of the victims had begun.

Rivera, a mother of five and grandmother of two, was believed to have been traveling with her publicist Arturo Rivera, who was not related to her, as well as with her lawyer, hairstylist and makeup artist; reports of their names were not consistent. Their identities were not confirmed by authorities. The pilots were identified as Miguel Perez and Alejandro Torres.

In the world of regional Latin music — norteño, cumbia and ranchera are among the popular niches — Rivera was practically royalty.

Her father was a noted singer of the Mexican storytelling ballads known as corridos. In the 1980s he launched the record label Cintas Acuario. It began as a swap-meet booth and grew into an influential and taste-making independent outfit, fueling the careers of artists such as the late Chalino Sanchez. Jenni Rivera's four brothers were associated with the music industry; her brother Lupillo, in particular, is a huge star in his own right.

Born on July 2, 1969, Rivera initially showed little inclination to join the family business. She worked for a time in real estate. But after a pregnancy and a divorce, she went to work for her father's record label and found her voice, literally and figuratively.

She released her first studio album in 2003, when she was 34.

Her path had not been easy, but rather than running from it, she wrote it into her music — domestic violence; struggles with weight; raising her children alone, or "sin capitan," without a captain. She was known for marathon live shows that left audiences exhilarated and exhausted; by the fifth hour of one recent performance, she was drinking straight from a tequila bottle and launching into a cover of "I Will Survive."

In a witty and sometimes baffling stew of Spanish and English, she sang about her three husbands, about drug traffickers, in tribute to her father, in tribute to her gynecologist.

She became, in a most unlikely way, a feminist hero among Latin women in Mexico and the United States and a powerful player in a genre of music dominated by men and machismo. Regional Mexican music styles had long been seen as limiting to artists, but Rivera shrugged off the labels and brought traditional-laced music — some of which sounded perilously close to polka — to a massive pop audience.

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Singer feared dead in Mexican plane crash

MONTERREY, Mexico (AP) — Mexico's music world mourned Jenni Rivera, the U.S.-born singer presumed killed in a plane crash whose soulful voice and openness about her personal troubles had made her a Mexican-American superstar.

Authorities have not confirmed her death, but Rivera's relatives in the U.S. say they have few doubts that she was on the Learjet 25 that disintegrated on impact Sunday in rugged territory in Nuevo Leon state in northern Mexico.

"My son Lupillo told me that effectively it was Jenni's plane that crashed and that everyone on board died," her father, Pedro Rivera, told dozens of reporters gathered in front of his Los Angeles-area home. "I believe my daughter's body is unrecognizable."

He said that his son would fly to Monterrey Monday.

Messages of condolence poured in from fellow musicians and celebrities.

Mexican songstress and actress Lucero wrote on her Twitter account: "What terrible news! Rest in peace ... My deepest condolences for her family and friends." Rivera's colleague on the Mexican show "The Voice of Mexico," pop star Paulina Rubio, said on her Twitter account: "My friend! Why? There is no consolation. God, please help me!"

Born in Long Beach, California, Rivera was at the peak of her career as perhaps the most successful female singer in grupero, a male-dominated regional style influenced by the norteno, cumbia and ranchero styles.

A 43-year-old mother of five children and grandmother of two, the woman known as the "Diva de la Banda" was known for her frank talk about her struggles to give a good life to her children despite a series of setbacks.

She was recently divorced from her third husband, was once detained at a Mexico City airport with tens of thousands of dollars in cash, and she publicly apologized after her brother assaulted a drunken fan who verbally attacked her in 2011.

Her openness about her personal troubles endeared her to millions in the U.S. and Mexico.

"I am the same as the public, as my fans," she told The Associated Press in an interview last March.

Rivera sold 15 million records, and recently won two Billboard Mexican Music Awards: Female Artist of the Year and Banda Album of the Year for "Joyas prestadas: Banda." She was nominated for Latin Grammys in 2002, 2008 and 2011.

Transportation and Communications Minister Gerardo Ruiz Esparza said "everything points toward" the wreckage belonging to the plane carrying Rivera and six other people to Toluca, outside Mexico City, from Monterrey, where the singer had just given a concert.

"There is nothing recognizable, neither material nor human" in the wreckage found in the state of Nuevo Leon, Ruiz Esparza said. The impact was so powerful that the remains of the plane "are scattered over an area of 250 to 300 meters. It is almost unrecognizable."

A mangled California driver's license with Rivera's name and picture was found in the crash site debris.

No cause was given for the plane's crash, but its wreckage was found near the town of Iturbide in Mexico's Sierra Madre Oriental, where the terrain is very rough.

The Learjet 25, number N345MC, took off from Monterrey at 3:30 a.m. local time and was reported missing about 10 minutes later. It was registered to Starwood Management of Las Vegas, Nevada, according to FAA records. It was built in 1969 and had a current registration through 2015.

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

Though drug trafficking was the theme of some of her songs, she was not considered a singer of "narco corridos," or ballads glorifying drug lords like other groups, such as Los Tigres del Norte. She was better known for singing about her troubles in love and disdain for men.

Her parents were Mexicans who had migrated to the United States. Two of her five brothers, Lupillo and Juan Rivera, are also well-known singers of grupero music.

She studied business administration and formally debuted on the music scene in 1995 with the release of her album "Chacalosa". Due to its success, she recorded two more independent albums, "We Are Rivera" and "Farewell to Selena," a tribute album to slain singer Selena that helped expand her following.

At the end of the 1990s, Rivera was signed by Sony Music and released two more albums. But widespread success came for her when she joined Fonovisa and released her 2005 album titled "Partier, Rebellious and Daring."

Besides being a singer, she is also a businesswoman and actress, appearing in the indie film Filly Brown, which was shown at the Sundance Film Festival, as the incarcerated mother of Filly Brown.

She was filming the third season of "I love Jenni," which followed her as she shared special moments with her children and as she toured through Mexico and the United States. She also has the reality shows: "Jenni Rivera Presents: Chiquis and Raq-C" and her daughter's "Chiquis 'n Control."

In 2009, she was detained at the Mexico City airport when she declared $20,000 in cash but was really carrying $52,167. She was taken into custody. She said it was an innocent mistake and authorities gave her the benefit of the doubt and released her.

In 2011, her brother Juan assaulted a drunken fan at a popular fair in Guanajuato. In the face of heavy criticism among her fans and on social networks, Rivera publicly apologized for the incident during a concert in Mexico City, telling her fans: "Thank you for accepting me as I am, with my virtues and defects."

On Saturday night, Rivera had given a concert before thousands of fans in Monterrey. 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 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."

Rivera had announced in October that she was divorcing Loaiza after two years of marriage.

There have been several high-profile crashes involving Learjets, known as swift, longer-distance passenger aircraft popular with corporate executives, entertainers and government officials.

A Learjet carrying pro-golfer Payne Stewart and five others crashed in northeastern South Dakota in 1999. Investigators said the plane lost cabin pressure and all on board died after losing consciousness for lack of oxygen. The aircraft flew for several hours on autopilot before running out of fuel and crashing in a corn field.

Former Blink 182 drummer Travis Barker was severely injured in a 2008 Learjet crash in South Carolina that killed four people.

That same year, a Learjet slammed into rush-hour traffic in a posh Mexico City neighborhood, killing Mexico's No. 2 government official, Interior Secretary Juan Camilo Mourino, and eight others on the plane, plus five people on the ground.

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Associated Press Writer Galia Garcia-Palafox and Olga R. Rodriguez contributed to this report from Mexico City.

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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 virus that causes AIDS 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 about 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, said her parents, Kari and Tom. 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 were 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, the 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 Pennsylvania team and has committed $20 million to building a research center on the university’s campus to bring the treatment to market.

Hervé Hoppenot, the president of Novartis Oncology, called the research “fantastic” and said it had the potential — if the early results held up — to revolutionize the treatment of leukemia and related blood cancers. Researchers say the same approach, reprogramming the patient’s immune system, may also eventually be used 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 technique employs a disabled form of H.I.V. because it is very good at carrying genetic material into T-cells. The new genes program the T-cells to attack B-cells, a normal part of the immune system that turn 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 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 they 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 11th 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.

In patients with lasting remissions after the treatment, the altered T-cells persist in the bloodstream, though in smaller numbers than when they were fighting the disease. Some patients have had the cells for years.

Dr. Michel Sadelain, who conducts similar studies at the Sloan-Kettering Institute, said: “These T-cells are living drugs. With a pill, you take it, it’s eliminated from your body and you have to take it again.” But T-cells, he said, “could potentially be given only once, maybe only once or twice or three times.”

The Pennsylvania researchers said they were surprised to find any big drug company interested in their work, because a new batch of T-cells must be created for each patient — a far cry from the familiar commercial strategy of developing products like Viagra or cholesterol medicines, in which millions of people take the same drug.

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Tensions rise in latest labor battle in Michigan

NEW YORK--Unions may be agitating more in some areas of the country, but in Michigan, they’re on the crux of losing a big battle with the state’s Republican legislature and governor that could cause “endless strife” in the state, according to Democrats such as Congressman John Dingell.

At issue is a right-to-work law passed in the legislature last week, which would allow people to join unions without being required to pay dues. Union advocates say it encourages free-ridership in which people benefit from unions but do not support them financially; conservatives call it a way to give employees more freedom.

Protesters filled Michigan’s capitol Monday as a congressional delegation of some of the state’s most prominent leaders met with Republican Gov. Rick Snyder to ask him to veto the bill.

“This is incredibly divisive – we’re hearing from people around the country asking what in the world is going on in Michigan?” said Sen. Debbie Stabenow, on a conference call. “This is about whether we’re going to have good wages, and a good standard of living in Michigan,” she said.

It’s difficult to determine just how right-to-work laws affect a state’s economy – liberals and conservatives put forth their own studies showing it either cripples a state’s economy or boosts it. Conservatives say the 23 states with right-to-work laws have less labor unrest and stronger businesses than those without. Liberals say the economies in states with right-to-work laws, including Nevada, have higher unemployment and lower wages.

Either way, it’s surprising to most that this law would pass so easily in Michigan, once a union stronghold where the United Autoworkers were a powerful force. Labor groups in the state had tried to pass a constitutional amendment prohibiting such laws in the November election, but were defeated 57% to 43%.

But Michigan, like other states such as Wisconsin, Indiana and Ohio that have passed anti-labor laws in recent years, has a Republican-controlled legislature, which just shows that the effects of the 2010 election, in which the tea party was swept into office, still resonate, said Paul Secunda, a professor of labor law at Marquette University in Wisconsin.

“This is an extention of the polarization that we see in the political world,” he said. “Where you have Republicans in control of state government without any meaningful opposition, the Koch brothers and others who want to see unions dismantled and destroyed for political reasons are able to do so.”

President Obama has largely stayed out of local labor issues, and Democrats aren’t always a help, Secunda said. One of the largest labor strikes this year was in Chicago, where Obama’s former chief-of-staff, Rahm Emanuel, battled teacher’s unions.

Democratic members of the congressional delegation have urged Snyder to have a cooling-off period before he signs the legislation, as protests continue at his house and at the statehouse. Sen. Carl Levin,  and Congressmen John Dingell, John Conyers, Sandy Levin, Gary Peters and others urged him to put the right-to-work bill to a public vote before approving it. The governor has said he would listen “seriously” to their concerns, according to the conference call.

“People are going to be bitter about the sneaking, dishonest way in which this was handled,” said Congressman John Dingell. “There’s a real peril here of endless controversy and strife.”

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