According to results presented at the 2006 annual meeting of the American Society of Hematology (ASH), mesenchymal stem cells appear to ease graft-versus-host disease among patients who have received a stem cell transplant.

Allogeneic stem cell transplant is type of a therapeutic approach used for the treatment of various types of cancer. With this approach high doses of chemotherapy and/or radiation therapy are utilized and followed by the infusion of donor stem cells. These high doses are associated with greater side effects-particularly low levels of blood cells-than more moderate doses of therapy. Allogeneic stem cell transplants are used to restore blood cell levels following high-dose therapy and thus reduce the associated risk of life-threatening infection, bleeding, or anemia. This approach involves the infusion of a donor’s hematopoietic stem cells, which are immature blood cells that mature into the necessary blood cells once they are circulating in a patient’s body.

Another potential benefit of allogeneic stem cell transplant is that the donor stem cells can mount an attack against a patient’s cancer cells. Unfortunately, the donor stem cells may also mount an attack against a patient’s healthy cells, resulting in a condition called graft-versus-host disease (GVHD), which may be life-threatening. Graft-versus-host disease is often treated with steroids, though it sometimes does not respond to steroids or stops responding. In this event it is referred to as steroid-refractory GVHD. Because steroid-refractory GVHD is a serious condition with a high death rate, researchers are evaluating ways to treat it or reduce its symptoms.

Researchers from Europe recently conducted a study to evaluate the infusion of stem cells among patients with steroid-refractory GVHD. This study included 52 patients who had undergone a bone marrow transplant and had developed steroid-refractory GVHD. Patients were treated with mesenchymal stem cells from a donor. Mesenchymal stem cells are specific types of stem cells that are collected from bone marrow (spongy material inside) and will develop into bone, muscle, cartilage, and connective tissue. They are thought to help suppress the donor’s immune cells and reduce the risk of GVHD.

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  • 68% of patients responded; children responded slightly better than adults.
  • Early treatment with mesenchymal stem cells provided better responses than later treatment.
  • Of the 52 patients, 22 are alive, 11 patients have no GVHD, and 11 patients have a chronic form of GVHD.

The researchers concluded that treatment with mesenchymal stem cells appears to effectively treat steroid-refractory GVHD that would otherwise have been fatal in a majority of patients who underwent allogeneic stem cell transplants. A subsequent clinical trial to further evaluate this strategy is planned.

Patients with steroid-refractory GVHD may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating this or other promising treatment strategies. Two sources of information about ongoing clinical trials include the www.eCancerTrials.com and the National Cancer Institute (www.cancer.gov).

Reference: LeBlanc K, et al. Mesenchymal Stem Cells for Treatment of Severe Acute Graft-Versus-Host Disease. Proceedings from the 2006 annual meeting of the American Society of Hematology. December 2006. Abstract #753.

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