Combined kidney and bone marrow transplantation allows patients to discontinue anti-rejection drugs

An experimental treatment protocol involving combined kidney and bone marrow transplantation has enabled several patients to accept their transplanted kidney without immunosuppressive drugs, reports a researcher from Massachusetts General Hospital (MGH). Speaking at a press briefing today at the Congress of the International Transplantation Society, Megan Sykes, MD, head of the bone marrow transplantation section of the MGH Transplantation Biology Research Center (TBRC), described how infusing the recipients with bone marrow from their donors immediately after the transplant surgery induced a state of mixed chimerism, a blending of donor and recipient immune systems.

All of the patients Sykes described had developed kidney failure as a result of multiple myeloma, a cancer of the bone marrow. Traditionally, such patients had no good treatment options. They were not eligible for kidney transplantation because of their cancer, and the kidney failure made them unable to tolerate the toxic aspects of standard bone marrow transplantation, which has been used for some myeloma patients. For many years Sykes and her colleagues at MGH -- along with collaborators at BioTransplant Incorporated of Charlestown, Mass. -- have been studying mixed chimerism and its application for both treatment of blood-cell cancers and for inducing tolerance, a state in which an organ recipient's immune system no longer recognizes the donor's tissues as foreign.

MGH TBRC researchers and Thomas R. Spitzer, MD, director of the MGH Bone Marrow Transplant Unit, developed a less toxic bone marrow transplantation protocol in which the recipient's immune system is only suppressed instead of totally destroyed. Utilizing this approach, called non-myeloablative bone marrow transplantation, the first patient received a combined transplant in September 1998. As reported the following year, the patient's immunosuppression was tapered off after the procedure and discontinued on the 73r

Contact: Sue McGreevey
Massachusetts General Hospital

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