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Wednesday, December 23, 1998 Published at 17:02 GMT


Transplant risk to be scrutinised

Transplant surgery can lead to complications

Scientists are to develop a "risk index" to predict which patients are likely to develop a serious complication when they undergo a life-saving bone marrow transplant.

Graft versus host disease occurs when new blood forming cells donated to the patient reject the patient's own cells as foreign.

At present, the disease can even occur in the best matched transplants.

Dr Peter Middleton and Dr Anne Dickinson, of the University of Newcastle Department of Haematology, will lead the project, backed by a grant from the Leukaemia Research Fund.

Dr Middleton said: "We need to improve upon the selection process so that we can be sure we have the right bone marrow match for our patients."

Bone marrow transplant is a standard treatment for patients who do not respond to chemotherapy. The intensive treatment involves replacing the patient's blood forming cells with healthy ones from a matched donor.

However, despite a complex matching procedure, some patients reject the new cells or they develop graft versus host disease, which can become a life threatening side effect of the treatment.

Dr Dickinson said: "Preliminary results suggest that certain patients may be genetically predisposed to develop graft versus host disease.

"Having this information before transplant will allow clinicians to reduce the risk and modify therapy on an individual patient basis."

The compatibility of host and donor cells is based on how many of six blood proteins that activate the immune system they share.

Transplants can take place if host and donor have four out of six blood proteins in common.

However, in patients with a higher risk of graft versus host disease a greater number of blood proteins must match before a transplant can be considered.

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