Some people with blood cancer can be cured through stem cell transplants.
People are given very high doses of chemotherapy, and can also have whole body radiotherapy. Although this has a good chance of killing the cancer cells, it also kills the stem cells in the bone marrow, which give rise to the different types of blood cells. So after high dose treatment, stem cells or bone marrow from a matched donor (also called a donor or an allogenic transplant) are given into a vein to replace those that the cancer treatment has killed. Donor cells make their way to the bone marrow and go on to produce healthy blood cells.
Graft versus host disease (GVHD) is a complication that can happen after a stem cell transplant from another person. It is still hard to predict who will develop GvHD after a stem cell transplant, but around 20 to 80% of will develop some degree of GVHD.
GvHD occurs when the white blood cells in the donated stem cells or bone marrow attack the recipient’s cells in the body. Areas affected can vary, but are mainly skin, liver and gut. Symptoms of GvHD can also vary in severity, and include rash, jaundice and diarrhoea. People who have GvHD are usually given drugs that suppress the immune system, such as corticosteroids.
Although GvHD can be severe and may even be life-threatening, there is also a beneficial aspect to this immune response, which is a necessary part of the curative effect of stem cell transplants. Donor cells are able to unleash an immune cascade that destroys any residual leukaemia cells very effectively. This is known as the graft versus tumour (GvT) or graft versus leukaemia effect (GvL).
Our research is looking for new treatments for GvHD, and finding ways to optimise current treatments. And we want to find ways to boost the GvT/GvL effect, whilst dampening down GvHD.