Cell grafts can help people fighting leukemia—but they risk a dangerous immune reaction. An experimental way to filter donors’ cells might offer a solution.
chronic GVHD. Memory T cells are immune cells that have learned, from exposure, to recognize a particular pathogen. They’re a sort of immuno-veteran compared to “naive” T cells, which have not developed any special detection skills. The naive T cells were the actual troublemakers.
Their clinical trial for cancer patients began in 2009, starting with a cohort of 35 participants in Seattle and at Yale, where Shlomchik worked at the time. In 2015, Shlomchik’s lab moved to the University of Pittsburgh. And in May 2016, Cathy Doyle received her leukemia diagnosis at a doctor’s office just 13 miles down the road.from Bleakley and Shlomchik’s initial cohort were already positive by the time Doyle completed chemo and was ready for her transplant.
And overall, among the 138 patients, while rates of acute GVHD were unaffected, rates of chronic GVHD went down. Several months post-transplant, when doctors would expect about half of people to deal with chronic GVHD, less than 10 percent did. Over three years of observation, they reported no severe cases of chronic GVHD. “I think we're seeing a really clear consistent signal,” says Bleakley.
Other experimental approaches deplete T cells completely or use drugs to keep them from reacting with the recipient’s body. So far, none of these approaches have beaten the standard treatment—a bone marrow graft with no T cell filtering—in randomized trials.
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