Improvement Noted in Management of Transplant Recipients with Cancer
HERSHEY, Pa., June 1 /PRNewswire/ -- The management of immunosuppression in post-transplant patients with cancer is challenging. Clinicians must balance the need to treat the malignancy effectively while simultaneously monitoring the impact of chemotherapeutic agents on a patient's immune system.
Data relevant to improving management of such patients will be presented today at the American Transplant Congress in Toronto, Canada, from a cooperative study conducted by the Departments of Surgery and Pathology and the Division of Internal Medicine, Department of Medicine at the Penn State Milton S. Hershey Medical Center in Hershey, Pennsylvania.
Tadahiro Uemura, M.D., Ph.D. and his colleagues studied the immunosuppression status of 52 patients with post-transplant de novo malignancy, assessing the cell-mediated immunity of patients by taking advantage of the ability of the Cylex immune cell function assay (ImmuKnow(R)). They compared outcomes of patients who were and were not monitored using this assay over a follow-up period of nine months post-transplant. Their paper is entitled "Monitoring of immune function for treatment of post-transplant de novo malignancy." The 52 patients included 40 kidney transplants, 10 liver transplants, and two kidney and pancreas transplants. Uemura is an assistant professor, Division of Transplantation in the Department of Surgery at Penn State Hershey Medical Center.
The ImmuKnow cell function test measures cell-mediated immunity (CMI) by assaying the concentration of adenosine triphosphate (ATP) from CD4 cells following stimulation. The assay is intended for use in the detection of CMI in an immunosuppressed population.
According to Uemura and his collaborators, in patients previously diagnosed with cancer, levels of CMI were more precisely targeted toward 340 ng ATP/ml (within the "moderate" range of the ImmuKnow assay). However, for patients undergoing chemotherapy or radiation therapy for new malignancy post-transplant, there was a significant decrease in CMI despite a concurrent decrease in the levels of immunosuppressive medications. This suggests that patients' immune competencies change dramatically during active treatment of their cancer.
"It is clear that we can use the ImmuKnow cell function assay to manage immunosuppression more precisely in patients with new malignancy, post-transplant," stated Zakiyah Kadry, M.D., chief, Division of Transplantation, Department of Surgery and surgical director of the liver transplant program at Penn State Hershey Medical Center. "The test provides us with the ability to assess patients' immune status more accurately than the traditional monitoring of patients' levels of immunosuppressive drugs." she continued. Dr. Kadry is the senior author of this presentation.
About Penn State Milton S. Hershey Medical Center
Penn State Hershey Medical Center is one of the leading teaching and research hospitals in the country. The 501-bed Medical Center is a provider of high-level, patient-focused medical care. Annually the Medical Center admits more than 26,000 patients, accepts more than 766,000 outpatient visits, receives nearly 48,000 patients for emergency room visits and performs more than 23,000 surgical procedures. The Medical Center campus also includes Penn State College of Medicine (Penn State University's medical school), Penn State Hershey Cancer Institute, and Penn State Hershey Children's Hospital -- the region's only children's hospital.
|SOURCE Penn State Milton S. Hershey Medical Center|
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