What is Stem Cell: [StemCells] Radiation for Marrow complications

New Interventional Radiology Treatment Shows Hope For People With
Complications From Bone Marrow, Stem Cell Transplants

Article Date: 19 Mar 2008 - 0:00 PDT

The standard treatment to treat graft-versus-host disease (GVHD)
after bone marrow or cord blood transplant is intravenous (IV)
steroids that alter the immune response; however, it is not always
effective and failure results in very high mortality. In a study
released, 15 patients who failed standard treatment were given a high
dose of steroids directly to the affected organ. By delivering the
steroids via catheter to the arteries that are supplying the organs
affected by GVHD, a much higher, more effective dose can be given
because the rest of the body is spared from the steroid's side
effects.

"Overall, fewer than 30 percent of patients with steroid-resistant
GVHD respond completely or partially to the standard IV treatment,
and their chance of living one year is 15 percent or less. This
interventional radiology treatment can be life-saving for these
people," said Joshua L. Weintraub, M.D., chief of the Division of
Vascular and Interventional Radiology at Mount Sinai Medical Center
in New York City.

According to Weintraub, there were no immediate drug or procedure-
related complications, and the treatment appears to be safe and
effective in combating GVHD -- with about 40 percent of the patients
showing complete response to the intra-arterial treatment at less
than a year follow-up. The study was presented during the Society of
Interventional Radiology's 33rd Annual Scientific Meeting in
Washington, D.C.

GVHD is a common complication of an allogeneic bone marrow transplant
(one using blood-forming cells donated by a family member or
unrelated donor) or cord blood transplant. With GVHD, the immune
cells from the donated marrow or cord blood (the graft) attack the
body of the transplant patient (the host). GVHD, which can be mild to
life-threatening, can affect many different parts of the body,
particularly the skin, liver and intestines. In this study the
affected organs were the liver and small and large bowels.

Studies from the 1990s show that steroid resistance is common -- 80
percent of people fail to have a sustained, complete response rate or
only have a partial response, which means the immune cells are still
attacking the organ to varying degrees. "Until now, there has been no
good therapy for steroid-resistant patients with GVHD. This small
study -- the first of its kind in the United States--shows a new,
viable option; however, larger studies with longer follow-up results
are needed," added Weintraub.

Abstract 187, "Intra-arterial Steroid Injection Therapy for Systemic
Steroid Resistant Graft-Versus-Host Disease," can be found at
http://www.SIRmeeting.org.

About Graft-Versus-Host Disease

Graft-versus-host disease (GVHD) is a common side effect of an
allogeneic bone marrow transplant (one using blood-forming cells
donated by a family member or unrelated donor) or cord blood
transplant. The differences between a donor's marrow and recipient's
tissues often cause T cells (a type of white blood cell) from the
donor's marrow to recognize the recipient's body tissues as foreign,
according to the National Institutes of Health. GVHD is the term used
when a donor's immune cells attacks the recipient's body -- causing
damage. Acute GVHD starts within three months after transplant, while
chronic GVHD begins more than three months after transplant (and can
last as long as three years). NIH notes that rates of GVHD vary from
30-40 percent for related donors and recipients to 60-80 percent for
unrelated donors and recipients. Following a bone marrow transplant,
the recipient is prescribed drugs that suppress the immune system to
help with reducing the chances or severity of GVHD.

Bone marrow transplants are usually reserved for individuals with
life-threatening diseases of the blood, bone marrow or certain types
of cancer.

About the Society of Interventional Radiology

Interventional radiologists are physicians who specialize in
minimally invasive, targeted treatments. They offer the most in-depth
knowledge of the least invasive treatments available coupled with
diagnostic and clinical experience across all specialties. They use X-
ray, MRI and other imaging to advance a catheter in the body, usually
in an artery, to treat at the source of the disease internally. As
the inventors of angioplasty and the catheter-delivered stent, which
were first used in the legs to treat peripheral arterial disease,
interventional radiologists pioneered minimally invasive modern
medicine.

Today many conditions that once required surgery can be treated less
invasively by interventional radiologists. Interventional radiology
treatments offer less risk, less pain and less recovery time compared
to open surgery. Visit http://www.SIRweb.org.

Society of Interventional Radiology
http://www.sirweb.org

http://www.medicalnewstoday.com/articles/100995.php

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StemCells subscribers may also be interested in these sites:

Children's Neurobiological Solutions
http://www.CNSfoundation.org/

Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123

The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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