Drug may Help the Outcome of Stem Cell Transplantation

A recent study looks at the potential of adding a new drug regiment in order to improve the outcome of stem cell transplantation.

According to researchers from Dana-Farber Cancer Institue, they treated patients with bortezomib in a new phase 2 trial that had lower rates of several acute GVHD and treatment-related mortality. Findings also showed that the participants had better one-year overall survival than what has historically been seen regarding such patients and this treatment.

"This regimen appears to improve not just GVHD prevention but more importantly, overall and relapse-free survival for myeloablative transplant recipients lacking matched sibling donors," said John Koreth, MBBS, DPhil, of Dana-Farber, the lead author and study PI, via a press release. The senior author is Edwin P. Alyea, III, MD, also of Dana-Farber.

The study notes the following regarding stem cell transplantation, courtesy of a press release: "Stem cell transplantation following myeloablation (high-dose chemotherapy to wipe out the patient's bone marrow and immune system) is a curative therapy in advanced or aggressive hematologic malignancies. However, recipients who lack preferred matched sibling donors have worse outcomes, with higher treatment-related mortality and severe GVHD, and poorer survival.

"Bortezomib, a proteasome inhibitor drug, is a mainstay of treatment for multiple myeloma. In addition to killing cancer cells, bortezomib dampens some immune responses, suggesting it may have a role in mitigating GVHD, the result of donor immune cells attacking the transplant recipient's normal tissues."

Thirty-four patients were enrolled in the 2 trial with a bortezomib-based regiment. All of the patients also had myeloablative stem cell transplants.

The study notes that the treatment was well-tolerated by all patients and none of them needed to miss doses. Though previous studies have shown that unrelated and mismatched donor transplants can cause severe acute GVHD rates of 28 percent and 37 percent within one year, the study showed this rate was only 12 percent 180 days after the transplant for the recipients. By two years, only 8.8 percent of the patients had died from treatment-realted mortality.

More information regarding the study can be found here.