Protein Predicts Marrow Transplant Trouble

High levels of TNF point to a potentially fatal complication, study finds

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SATURDAY, Feb. 18, 2006 (HealthDay News) -- Measuring levels of a specific protein seven days after bone-marrow transplant helps predict which patients are likely to develop the serious and potentially deadly complication called graft vs. host disease (GVHD), researchers report.

The protein, called tumor necrosis factor (TNF), is known to be elevated in people who develop GVHD, which occurs when the transplanted bone marrow immune cells attack the patient's skin, liver and gastrointestinal cells, resulting in a massive inflammatory response that can cause death.

This University of Michigan study included 170 bone-marrow transplant patients, including 94 who developed GVHD. Bone-marrow transplants are typically given to children or adults with certain kinds of cancer -- such as leukemia or lymphoma -- or with some blood or immune disorders.

The researchers pointed out that the 94 patients had elevated TNF levels a week after their transplant, but before they showed any signs of GVHD.

They also found that patients with elevated TNF levels seven days after transplant had a 20 percent lower survival rate: just 62 percent of these patients were alive a year after their transplant, compared with 85 percent of patients with lower TNF levels.

"This suggests we could target patients to prevent graft vs. host disease based on their post-transplant level of TNF," study author Dr. John Levine, associate professor of pediatrics and internal medicine, said in a prepared statement. "If we can develop a test that can reliably predict this complication, we can look at treating it before any symptoms develop. This is one small step in a long road to making transplants safer and more effective."

The findings were presented Friday at the annual meeting of the American Society for Blood and Marrow Transplant in Honolulu.

More information

The National Marrow Donor Program has more about bone-marrow transplantation.

SOURCE: University of Michigan Health System, news release, Feb. 17, 2006

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