Graft Versus Host Disease
- Scientists from
Mount Sinai Health system have identified 2 key proteins ST2 and REG3a
which are found one week after bone marrow transplant
- This will aid in
early identification of graft versus host disease among blood cancer
patients who receive a bone marrow transplant
- 'MAGIC algorithm'
designed by the scientists can be used for determining the risk of disease
(GvHD) is a cause of concern when blood cancer patients receive bone marrow transplant
, as the recipient's
body could treat the newly transplanted cells as foreign and mount an immune
response. Doctors have never been able to accurately determine if there would
be graft rejection but a research team from the Mount Sinai Health System has
identified a method of prediction that will aid in determining which patients
will develop this condition, in a study published in the Journal of Clinical
study that was conducted across 11 cancer centers, analyzed the blood sample of
nearly 1300 patients undergoing bone marrow transplant.
‘The ‘Magic Algorithm’ could prove to be an effective tool against fatality in graft versus host disease.’
findings of the study were
- ST2 and REG3a are
two proteins found in the blood of the bone marrow transplant patients a
week after the transplant. These proteins could be used to predict whether
the dangerous graft-versus-host disease would occur.
- This aided in
prediction long before symptoms were developed.
research team developed an algorithm, called MAGIC, which was used to identify
the risk of developing this disease.
of Pediatrics, Dr. James L.M. Ferrara from The Tisch Cancer Institute said that
the MAGIC algorithm provides doctors with a map of how the transplant patients
would react to transplantation, saving many lives. This can be used for early
identification and intervention which could save many lives.
doctors at Mount Sinai are structuring clinical trials to identify if
immunotherapeutic drugs would aid patients in lowering the severity of the
disease once the proteins are identified in the blood stream. The scientists
hope that drug interventions would lower the intensity of the graft rejection
disease and result in fewer deaths.
of MAGIC, Dr. John Levine who is also a Professor of Pediatrics and Medicine at
the Tisch Cancer Institute (Mount Sinai) said that the test that has been
developed will aid in making bone marrow transplant safer and will allow
personalization of medications in order to prevent graft versus host disease.
The scientists are eagerly waiting for the success of the clinical trials that
are being planned in order to begin using the immune therapy drugs as a
standard form of care for patients who undergo a bone marrow transplant.
Graft Versus Host
a blood cancer patient needs to undergo a bone marrow transplant, the tissue of
the donor is analyzed and checked before transplant to ensure that it is a
close match with the recipient. The risk of rejection is lowered when the donor
tissue and cells match with that of the recipient.
of Graft Versus Host Disease
Symptoms of Graft Versus Host Disease
- When the donor and the recipient are
related, the risk is between 30-40%
- When the donor and the recipient are not
related, the risk is between 60-80%
are two different types of Graft versus host disease. In the acute form of the
disease, the symptoms begin within the first six months of the transplantation.
The symptoms associated with this form are jaundice, nausea, abdominal cramps,
liver problems, skin rash, redness and itching.
chronic form of graft versus host disease is characterized by symptoms that
begin after 3 months from the time of transplant and last for the rest of the
lifetime of the patient. The symptoms
include dry mouth, dry eyes, changes in vision, sensitivity to food rich in
spices, chronic pain in the joint and stiffness, breathlessness due to damage
to the lung, muscle weakness, fatigue, discoloration, skin tightening or
thickening. This could also be associated with weight loss and vaginal dryness.
imaging and laboratory tests are used to monitor symptoms associated with this
disease condition. To confirm the diagnosis, a biopsy of the skin as well as
the mucous membrane is analyzed.
prognosis of a patient suffering from graft versus host disease depends on how
severe the disease is. The outlook is better for patients who have received
bone marrow transplant from closely matched donors. In severe forms of the disease, the lungs, digestive tract, liver
or other parts of the body may be affected. Some people with the disease may be
treated successfully but it could be fatal in many others.
current study which has identified that the presence of two proteins as early
markers of the disease could aid in faster detection and better care. The MAGIC
algorithm designed by the scientists will aid doctors in identifying the best
method of treatment for the patient which could revolutionize bone marrow
transplant post-operative care.
- Graft-versus-host disease - (https://medlineplus.gov/ency/article/001309.htm)