[MOL] Drug Helps Bone Marrow Transplants [00321] Medicine On Line


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[MOL] Drug Helps Bone Marrow Transplants



Good Morning All,

Thought the following information may be of some use.

.c The Associated Press

 By DANIEL Q. HANEY

AP Medical Editor

BOSTON (AP) -- A new, highly selective immune-suppressing drug may allow
cancer victims to receive bone marrow transplants from poorly matched
donors
without suffering life-threatening complications.

The drug suppresses only that part of the immune system that causes
these
complications. Doctors say this could allow patients to receive marrow
transplants without the need for drugs that broadly suppress the body's
immune defenses. These broad drugs raise the risk of infections and
other
health problems.

In Thursday's New England Journal of Medicine, researchers reported that
the
approach worked surprisingly well in the first experimental use on
terminally
ill cancer patients. They predicted it may also make it easier to
transplant
hearts, kidneys and other organs.

``This is starting to crack open the door on a new way of manipulating
the
immune system,'' said Dr. Eva C. Guinan of Boston's Dana-Farber Cancer
Institute, where the approach was developed and tested.

She said the treatment could make more transplants possible by
eliminating
the need for near-perfect matches between donors and recipients, and it
could
make transplants safer by potentially making lifelong immune suppression
drugs unnecessary.

Bone marrow manufactures new blood cells and sometimes must be replaced
in
leukemia and other marrow cancers. To minimize complications, doctors
seek a
close genetic match between donor and recipient.

The new treatment, called CTLA4-Ig, blocks development of a dangerous
complication called graft versus host disease, which occurs when foreign
tissue is placed in the body. The drug stops only the category of white
blood
cells that promote this response, leaving intact the rest of the immune
function of the newly transferred marrow. Doctors treat the donated
marrow
with CTLA4-Ig outside the body before transplanting it.

Doctors tested the new approach on 12 young victims of advanced leukemia
for
whom only poorly matched marrow was available. No severe graft versus
host
disease occurred. Five have survived for five to 29 months, while the
rest
died of treatment complications and cancer relapse.


``This is the step to the next century,'' said Dr. Lee M. Nadler of
Dana-Farber. ``This is the first specific immune suppression that has
every
been done.''

Journal deputy editor Robert S. Schwartz, who helped pioneer immune
suppression for organ transplants in the 1950s, called the results
impressive. However, in an editorial, he cautioned that this ``must be
balanced against the small number of patients, the high death rate and
the
lack of information about immunologic reconstitution in the survivors.''

Guinan said the approach may also be widely used for those who need
marrow
transplants for other reasons, such as curing the blood diseases sickle
cell
anemia and thalassemia.

CTLA4-Ig is being developed commercially by Repligen Corp. of Needham,
Mass.
It plans to sponsor a larger study by the end of the year.

AP-NY-06-02-99 1701EDT

God Bless All,
marty
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