Protein Level Predicts Deadly Transplant Disease

A new study shows that a protein level could determine one week after a bone marrow transplant which patients are likely to develop serious complications, making them candidates for preventive treatment before any symptoms occur.

Researchers at the University of Michigan Comprehensive Cancer Center (Ann Arbor, MI, USA) measured the level of a protein called tumor necrosis factor (TNF) seven days after patients received a bone marrow transplant. The study looked at 170 patients, 94 of whom went on to develop graft vs host disease (GVHD), a condition in which the transplanted immune system attacks the patient's normal tissue. Those 94 patients had elevated levels of the TNF-receptor protein a week after their transplant, before they showed any symptoms of disease. The study also found that patients whose TNF level was elevated at seven days had a lower survival rate: 62% were alive after a year, compared to 85% of those with a lower TNF. The findings were presented at the annual meeting of the American Society for Blood and Marrow Transplant in Honolulu (Hawaii, USA) in February 2006.

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, to see if it can prevent or treat GVHD, says study author Carrie Kitko, M.D., a pediatric fellow at the University.

While bone marrow transplants offer hope for people with certain cancers that no longer respond to conventional treatment, as many as half of the patients who undergo the procedure develop GVHD, in which transplanted immune cells attack the patient's skin, liver, and gastrointestinal cells, triggering a massive inflammatory reaction that can kill the patient.



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University of Michigan Comprehensive Cancer Center