Kirk Schultz
Faculty of Medicine scientists have identified a protein that could be used to diagnose chronic graft-versus-host disease (cGvHD), a serious, long-term complication that affects some patients after a blood and bone marrow transplant.
cGvHD occurs when immune cells in donated blood and marrow cells recognize the recipient’s cells as foreign and launch an immune attack against them. CGvHD can damage the skin, liver, lungs and digestive tract, leading to greater risk for cardiovascular disease, diabetes, obesity, and endocrine (hormone) abnormalities. Early diagnosis is key to preventing the life-long impact of cGvHD, but currently no such test exists.
“If we can diagnose it earlier and better, then treatments can be used to stop it before it becomes a chronic, disabling disease,” says principal investigator Kirk Schultz, a Professor in the Department of Pediatrics and a scientist at BC Children’s Hospital. “A child with leukemia can be cured with a blood and marrow transplant but then has to suffer a life-long disease, cGvHD, which causes a major decrease in their life expectancy and quality of life.”
In the study, published in the journal Blood, researchers compared blood samples from two groups of adult patients, 170 who developed cGvHD and 180 who did not. They analyzed the samples to identify proteins in the blood that could be an early sign of the disease, finding elevated levels of the inflammatory protein CXCL10. This protein appears to impact a patient’s normal immune cells, preventing the body from fighting cGvHD.
Over 1,500 children and adults receive a blood and marrow transplant each year in Canada, often because it’s the only effective treatment for some forms of leukemia. CGvHD affects approximately 30 to 50 per cent of blood and bone marrow transplant recipients.
Although testing a transplant patient for this protein could provide the early diagnosis physicians urgently need, further study is necessary before a diagnostic test for cGvHD can be put into clinical use.
This research was made possible by support from BC Children’s Hospital Foundation, Canadian Institutes of Health Research, CIHR/Wyeth Clinical Research Chair in Transplantation. The study was carried out through the Chronic GvHD Consortium, which is funded through the Rare Diseases Clinical Research Network (RDCRN), an initiative of the Office of Rare Diseases Research (ORDR), National Center for Advancing Translational Sciences (NCATS) and the National Cancer Institute.