A better treatment for graft-versus-host disease? It's possible

February 9, 2015 | by Darrin Joy

Cancer patients face a daunting journey marked by challenges and uncertainties. For those undergoing bone marrow, or stem cell, transplantation, one complication poses a particular threat — chronic graft-versus-host disease (GVHD). Now, one researcher may have found a better way to control that threat.

Alex Herrera, M.D. Alex Herrera received the George Santos Award from the journal Biology of Blood and Marrow Transplantation for an article on his study of a new treatment for graft versus host disease.

GVHD results when immune system cells from a donor cause inflammation in the patient receiving them. The donor’s cells, now strangers in a strange land, react to the patient as they would a foreign invader, attacking the body’s cells. Chronic GVHD can affect a number of organs, causing a wide range of symptoms, and can ultimately result in life-threatening organ damage or infection due to the medications used to treat it.

Standard therapy for chronic GVHD uses drugs called corticosteroids, such as prednisone and dexamethasone. These medicines suppress the immune system, keeping the donor’s aggressive immune system cells at bay. However, the medicines bring their own set of concerns, such as toxicity, reduced immunity to infections and limited effectiveness that may diminish further over time.

Alex Herrera, M.D., of City of Hope has been studying a new strategy to help patients conquer chronic GVHD and recently published his findings in the journal Biology of Blood and Marrow Transplantation.

Herrera, a bone marrow transplant fellow in the Department of Hematology & Hematopoietic Cell Transplantation, and his colleagues examined a new approach to controlling chronic GVHD. The team’s method combines bortezomib, a targeted therapy that modulates the immune system, with prednisone. Because bortezomib works through a completely different mechanism than prednisone, the researchers theorized their combined effects could offer transplant patients more hope for controlling chronic GVHD.

Findings from the study suggest they’re on the right track. “There was minimal toxicity associated with the regimen, and we saw promising responses among the patients evaluated for response to the drug combination,” Herrera said.

The article even earned Herrera the 2014 George Santos Award, which honors the journal’s best clinical science article by a new investigator. Herrera will receive the award at the American Society of Bone Marrow Transplantation’s Tandem BMT Meetings, taking place Feb. 11 to 15 in San Diego.

He cautioned that this study is too small to be certain that results will prove better than standard therapy, but said it opens the door for further clinical trials to confirm the findings.

“We are hopeful this will lead to further studies to develop novel therapies for the treatment of chronic GVHD in our transplant patients in the future,” he said.

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