reSearch: attacking graft vS. hoSt diSeaSe Graft vs. host disease (GVHD) is a complication that sometimes occurs after a blood


stem cell or bone marrow transplant. The donor’s cells see the recipient’s body as “foreign” and attack it, causing damage. GVHD can be acute or chronic. Acute GVHD usually occurs within the first few months after transplant, while chronic GVHD generally develops after an acute case, and can hang on for months or years, according to William Drobyski, MD, a Medical College of Wisconsin hematologist. Finding the best possible donor match is important in preventing GVHD, but it is no guarantee.


Treatment for GVHD usually involves steroids. However, this therapy isn’t always


enough, and research into how best to treat GVHD is ongoing. In addition to participating in national research trials, Dr. Drobyski and his team have


n williaM drobySki, Md


been studying the approved arthritis drug tocilizumab to treat GVHD. Their research pointed to the release of an inflammatory molecule (called interleukin-6) in patients with GVHD, which has been shown to cause damage in conditions like arthritis and inflammatory bowel disease. Tocilizumab is an interleukin-6 receptor inhibitor, which means it reduces the inflammation that occurs because of interleukin-6 overproduction. A pilot study has shown promising results. A more formal trial of using tocilizumab to treat GVHD is planned.


experience and expertiSe Make the difference During its three-decade history, the BMT Program at Froedtert & The Medical College ofWisconsin has been a


world leader. “We have a long history in the field of cellular therapy and marrow transplantation,” Dr. Hari explained. “We were


among the first in the world to perform bone marrow transplants and have pioneered numerous transplant techniques.” The program has sustained outstanding outcomes for BMT patients. One year survival of patients after transplantation


is considered a key measure of the overall quality of the program. “For patients transplanted each year from 2006 to 2009 we have outcomes exceeding national averages, placing us among


the best in the country,” Dr. Hari said. The BMT Program is a recognized leader in donated (allogeneic) blood and marrow transplant techniques. Physicians


perform not only tissue-matched relative transplants, but also unrelated donor and mismatched donor transplants. (When tissue is less than a half match, it might be used when no other donors are available and a particular disease warrants the treatment.) The BMT Program offers novel techniques available through clinical trials and a complete range of transplant therapies.


Other treatments include umbilical cord blood, a potential treatment option for patients who do not have a matched


relative donor and cannot find a suitable unrelated donor, in cooperation with Children’s Hospital of Wisconsin. The BMT Program is the only one in the region that performs non-myeloablative transplants (also called mini-transplants) which rely exclusively on immune reactions to fight cancer, with mild initial chemotherapy or radiation. Mini-transplants can provide a better treatment choice for some patients, such as older adults.The program also performs autologous transplants of the patient’s own cells (or cells from an identical twin) to rebuild the immune system after chemotherapy.


All transplant procedures take place in the BMT unit, where patients have access to a complete team of physicians and


support staff that focuses exclusively on blood and marrow transplants. The team helps support patients emotionally and encourages them to be as physically active as possible. The BMT unit also includes outpatient services.


a progreSSive recovery Trudy spent about four weeks at Froedtert & The Medical College, then lived at


a relative’s downtown Milwaukee condo for several weeks so she could be closely monitored as an outpatient. Her children took turns staying with her.


“After about 100 days, her bone marrow was made up entirely of her brother’s cells,”


Dr. Hari said. “She was completely cured of myelofibrosis at that point.” Trudy had to be careful to avoid infection and wore a mask for nearly 10 months. She


n trudy with her daughter, carrie Schaub


even had to stay away from her grandchildren during that time. Today, a year after her transplant, Trudy is doing well. She’s looking forward to returning to work at the gift shop she runs with her daughter,


Carrie Schaub, in West Bend. The shop is called Serendipity, meaning the accidental discovery of something valuable. Through her journey, Trudy has discovered strength within herself and has an even greater appreciation of her family.


“I’m also so grateful to Dr. Hari and all of his staff,” Trudy said. “I wouldn’t be where I am now without their


dedication. You couldn’t ask for more caring people.” To make an appointment, call 414-805-0505 or 866-680-0505. For more information about the Froedtert


& The Medical College of Wisconsin Blood and Marrow Transplant Program, visit froedtert.com/cancer. n froedtert.com Froedtert Today September 2011 13


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