Preventing a major complication of blood cancer treatment – graft-versus-host disease

Background

Blood cancers, like leukaemia and lymphoma, develop when blood cells aren’t made properly. In Australia, over 6,400 new cases of lymphoma and 4,200 cases of leukaemia are expected to be diagnosed in 2019. Blood cancers are usually treated with high dose chemotherapy or radiation which knocks out the immune system. About half blood cancer patients will also undergo a donor stem cell transplant. While transplantation is a curative therapy for some people with blood cancer, there is a risk of developing graft-versus-host disease.

Following donor stem cell transplantation, the immune system is restored and the donor immune cells can attack the cancer. However, donor immune cells (graft) can also attack organs (liver, gut, skin and lungs) in the person with blood cancer (host) resulting in graft-versus-host disease.

Graft-versus-host disease is a debilitating and painful disease that attacks the organs, including the liver, skin and gut. It occurs in around half of people who receive a donor stem cell transplant and can cause organ damage and failure, and in some cases can cause death.

Current treatments for graft-versus-host disease broadly suppress the immune system, which can lead to cancer relapse or infection.

The research

Dr Debbie Watson will develop a potential new treatment strategy using manipulated stem cell transplantation combined with drugs that block development of graft-versus-host disease.

In the laboratory, the researchers will manipulate donor stem cells to specifically remove the immune cells that attack organs and cause graft-versus-host disease, while retaining those immune cells that attack the cancer and respond to infection. In pre-clinical testing, the researchers will combine this manipulated stem cell transplant strategy with drugs that block development of graft-versus-host disease.

The team will then investigate the effects of this new treatment strategy on responses to cancer and infection.