BOSTON In a study that seems to pivot on a paradox, scientists at Dana-Farber Cancer Institute have used an immune system stimulant as an immune system suppressor to treat a common, often debilitating side effect of donor stem cell transplantation in cancer patients. The effect, in some cases, was profound.
The phase I study, published in the Dec. 1 issue of the New England Journal of Medicine, involved allogeneic (donor) stem cell transplant patients with chronic graft-versus-host disease (GVHD), a multi-system inflammatory condition that arises when donor immune system cells launch an attack on a patient's own tissues, leading to varied symptoms such as skin rash and thickened or scarred skin, lung inflammation, or hepatitis, among others. The patients received once-daily injections of interleukin-2 (IL-2), a drug traditionally used to spur an immune system attack, but which, at low doses, investigators had reason to believe, could have the opposite effect in this case: blunting a harmful activation of the immune system and subduing GVHD.
After eight weeks on the regimen, 12 of 23 participants showed clear physical benefits, including softened skin and underlying tissue, reduced redness of skin, improved mobility and gait, improved liver function, and resolution of neuropathy, a degenerative nerve condition. The responding patients who went on to receive longer-term daily IL-2 continued to show improvements, including alleviations of skin conditions that had previously been considered irreversible in chronic GVHD, while simultaneously reducing their other immune-suppressing medications. In fact, four of 10 patients on longer-term IL-2 treatment have completely tapered off glucocorticoids (steroid hormones), and two of them have stopped all other immune suppression medications as well. This group of patients has been able to reduce the use of glucocorticoids by an average of 60 percent.
None of the patients in the tria
|Contact: Teresa Herbert|
Dana-Farber Cancer Institute