HERSHEY, Pa., June 1 The management of immunosuppressionin post-transplant patients with cancer is challenging. Clinicians mustbalance the need to treat the malignancy effectively while simultaneouslymonitoring the impact of chemotherapeutic agents on a patient's immune system.
Data relevant to improving management of such patients will be presentedtoday at the American Transplant Congress in Toronto, Canada, from acooperative study conducted by the Departments of Surgery and Pathology andthe Division of Internal Medicine, Department of Medicine at the Penn StateMilton S. Hershey Medical Center in Hershey, Pennsylvania.
Tadahiro Uemura, M.D., Ph.D. and his colleagues studied theimmunosuppression status of 52 patients with post-transplant de novomalignancy, assessing the cell-mediated immunity of patients by takingadvantage of the ability of the Cylex immune cell function assay(ImmuKnow(R)). They compared outcomes of patients who were and were notmonitored using this assay over a follow-up period of nine monthspost-transplant. Their paper is entitled "Monitoring of immune function fortreatment of post-transplant de novo malignancy." The 52 patients included 40kidney transplants, 10 liver transplants, and two kidney and pancreastransplants. Uemura is an assistant professor, Division of Transplantation inthe Department of Surgery at Penn State Hershey Medical Center.
The ImmuKnow cell function test measures cell-mediated immunity (CMI) byassaying the concentration of adenosine triphosphate (ATP) from CD4 cellsfollowing stimulation. The assay is intended for use in the detection of CMIin an immunosuppressed population.
According to Uemura and his collaborators, in patients previouslydiagnosed with cancer, levels of CMI were more precisely targeted toward 340ng ATP/ml (within the "moderate" range of the ImmuKnow assay). However, forpatients undergoing chemotherapy or radiation therapy for new malignancypost-transplant, there was a significant decrease in CMI despite a concurrentdecrease in the levels of immunosuppressive medications. This suggests thatpatients' immune competencies change dramatically during active treatment oftheir cancer.
"It is clear that we can use the ImmuKnow cell function assay to manageimmunosuppression more precisely in patients with new malignancy,post-transplant," stated Zakiyah Kadry, M.D., chief, Division ofTransplantation, Department of Surgery and surgical director of the livertransplant program at Penn State Hershey Medical Center. "The test provides uswith the ability to assess patients' immune status more accurately than thetraditional monitoring of patients' levels of immunosuppressive drugs." shecontinued. Dr. Kadry is the senior author of this presentation.
About Penn State Milton S. Hershey Medical Center
Penn State Hershey Medical Center is one of the leading teaching andresearch hospitals in the country. The 501-bed Medical Center is a provider ofhigh-level, patient-focused medical care. Annually the Medical Center admitsmore than 26,000 patients, accepts more than 766,000 outpatient visits,receives nearly 48,000 patients for emergency room visits and performs morethan 23,000 surgical procedures. The Medical Center campus also includes PennState College of Medicine (Penn State University's medical school), Penn StateHershey Cancer Institute, and Penn State Hershey Children's Hospital -- theregion's only children's hospital.
SOURCE Penn State Milton S. Hershey Medical Center