New treatment could address complications of bone marrow transplants

Researchers have discovered potential treatments for two different types of common complications after bone marrow transplants.

Bone marrow transplantation is a treatment that potentially cures leukemia and other blood cancers by transferring a type of stem cell from a donor to a patient.

However, a common complication of bone marrow transplants is something called graft-versus-host disease (GvHD), in which the donated cells treat the recipient’s cells as an unknown threat or attack.

Acute GvHD occurs immediately after transplantation and often affects the skin, intestines, and liver. Chronic GvHD can occur at any time after transplantation and usually affects the skin, mouth, lungs, intestines, muscles, or joints.

In one recent study, researchers gave mice receiving bone marrow transplants a drug called defibrotide, which is commonly used to treat blocked blood vessels in the liver. Researchers found that the drug protected cells lining blood vessels that are typically damaged in patients with acute GvHD.

“Treatment with defibrotide reduced acute GvHD and significantly improved survival,” said Senthilnathan Palaniyandi, assistant professor of medicine at the University of Missouri School of Medicine. “Through its anti-inflammatory and endothelial protective effects, this treatment reduced the severity of acute GvHD without compromising the transplanted immune cells that fight leukemia.”

In another study, researchers targeted chronic GvHD. They found that introducing different types of BTK/ITK kinase inhibitors reduced the severity of chronic GvHD and improved mouse survival.

“We have discovered that a combination of kinase inhibitors is effective in treating skin diseases caused by chronic GvHD,” said Ellis Fischel, chief of the Division of Hematology and Medical Oncology at the University of Missouri School of Medicine and MU Health Care. says Gerhard Hildebrandt, director of the Center.

“Mice treated with a combination of kinase inhibitors showed a significant reduction in chronic complications associated with bone marrow transplantation.”

These findings demonstrate that drugs that protect the cells lining blood vessels are effective in reducing acute GvHD, and that kinase inhibition holds promise as a treatment for chronic GvHD.

“A better understanding of how to manage GvHD is essential for clinically effective bone marrow transplantation at Ellis Fischel Cancer Center and around the world,” Hildebrandt said. “Our lab is one of a small number of labs dedicated to solving the puzzle of GvHD to make bone marrow transplants more effective…”

The first study was Transplantation and cell therapy. The second one to appear is Bone marrow transplantation.

sauce: University of Missouri