The outcome of bone marrow transplant could be determined in just one week by measuring levels of a protein called tumor necrosis factor (TNF). The inflammatory marker can help doctors identify which patients will develop graft vs. host disease (GVHD), the most commonly observed complication following the surgery.
The early identification of related complication can enable the attending physician to initiate appropriate preventive treatment. Bone marrow transplant is a life-saving treatment for children and adults with hematological malignancies and other similar blood or immune system disorders.
Bone marrow transplantation is a surgical procedure in which the patient's diseased bone marrow is replaced with a healthy one, derived from a donor. This enables high doses of chemotherapy to be directed to cancer cells. The possibility of the recipient's immune cells rejecting the new bone marrow poses a severe threat to the graft survival. The patient's skin, gastrointestinal and liver cells can be destroyed, sometimes, even leading to death.
The researchers studied the measurement of TNF levels in 170 patients, out of which 94 had established GVHD (the graft attacks the patient tissue). All these patients were found to have elevated levels of TNF levels, 1 week after their transplant. In addition, the patients had a poor survival rate (62%).
'This suggests we could target patients to prevent graft vs. host disease based on their post-transplant level of TNF. If we can develop a test that can reliably predict this complication, we can then look at treating it before any symptoms develop. This is one small step in a long road to making transplants safer and more effective,' said John Levine, study author.
'TNF is known to play a role in a variety of inflammatory or autoimmune diseases, including septic shock, rheumatoid arthritis and Crohn's disease. Anti-TNF drugs are already FDA-approved and available on the market. We are currently conducting a clinical trial using one of these drugs, etanercept, in clinical trials to see if it can prevent or treat GVHD,' concluded Dr. Carrie Kitko, yet another study author.