Researchers from Ohio State University have reported that statins may reduce the risk of developing acute graft-versus-host disease (GVHD) among patients who undergo allogeneic stem cell transplants. These results were reported at the 2008 annual meeting of the American Society of Clinical Oncology in Chicago, May 30-June 2.
An allogeneic stem cell transplant is a procedure that utilizes high doses of chemotherapy and/or radiation therapy to kill more cancer than standard doses of treatment. However, the high doses of therapy also cause severe and extensive side effects. One of the most prominent and risky side effects caused by the high doses of therapy is low levels of blood cells. There are three main types of blood cells: red blood cells, which supply oxygen and nutrients to cells; white blood cells, which provide protection against infection; and platelets, which help the blood to clot. Because low levels of any of these types of cells can cause life-threatening consequences, particularly low levels of white blood cells, donors supply hematopoietic stem cells, which are immature blood cells found in the circulating blood. These donated stem cells are infused into the patients following therapy to replenish the levels of blood cells and reduce potential associated side effects. In addition, the donated stem cells tend to mount an attack on the patient’s cancer cells, providing an effect referred to as the graft-versus-leukemia effect. Unfortunately, the donated stem cells can also mount an attack on a patient’s normal tissue, resulting in a condition referred to as graft-versus-host-disease, which can be either acute or chronic-and can be life-threatening. Despite 40 years of intensive research, GVHD remains a major stumbling block to the success of allogeneic stem cell transplantation.
Researchers recently conducted a small study that included 10 patients with leukemia who had received statins, or cholesterol-lowering agents, for one month prior to allogeneic stem cell transplantation and then for three months following the transplant.
- Only one patient developed significant acute GVHD.
- Half of the patients developed chronic GVHD
The researchers concluded that it appears as if statins may help reduce the risk of developing acute GVHD and that future studies further evaluating statins in this role are warranted. Patients who are to undergo an allogeneic stem cell transplant may wish to speak with their physician regarding their individual risks and benefits of participation in a clinical trial evaluating statins or other methods by which to reduce GVHD. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.eCancerTrials.com.
Reference: Hamadani M, Awan FT, Elder P, et al. Statins reduce acute graft-versus-host disease in patients with acute leukemia undergoing allogeneic stem cell transplantation. Journal of Clinical Oncology. 2008;26: abstract number 7040.