Comment Anti-Cancer Effects of GVHD (Score 1) 83
I had a stem cell transplant, SCT, (commonly referred to as a bone marrow transplant) 10 years ago to treat a bone marrow failure disease called Myelodysplasia (MDS). My older brother was the donor with a 5 out of 6 HLA match. About 3 months post transplant I started to experience GVHD (affecting liver, skin, eyes, lungs) which was controlled using a combination of immunosuppressants, cyclosporine and prednisone (a steroid). GVHD tends to have a more pronounced effect on the large, high surface area organs such as the skin, liver and lungs. High doses of the two drugs would be administered initially and then the dosage gradually reduced until evidence (monitoring of the liver enzymes) of GVHD returning. If the GVHD had returned the drug dosage would be returned to it's high level and the gradual weaning process started again. I went through 3 such cycles over the course of 2 years before the GVHD "burned" itself out. I have been off the immunosuppressants for about 8 years now. Long term use of cyclosporine causes kidney damage and prednisone has a host of side effects including water retention, calcium loss, glaucoma, voracious appetite and weight gain, insomnia and extreme mood changes. Very nasty side effects but they are wonder drugs at controlling the potentially life threatening GVHD.
It is common knowledge that some mild GVHD is beneficial as an "anti-cancer" effect. The donor immune response, GVHD, as well as attacking the host tissues also destroys residual cancer cells remaining after the transplant process. Studies done removing donor T-cells prior to stem cell transplantation showed reduced incidence and severity of GVHD but this was accompanied by a marked increase in morbidity due to disease relapse. I am curious as to how the procedure described in the article impacts the "anti-cancer" effect of GVHD and possibility of disease relapse?