Noxafil (posaconazole), an anti- fungal agent may be better than other anti-fungals in helping cancer patients that have GVHD.

GVHD, graft-versus host disease, is a potential complication that can happen after a stem cell transplant. What is really happening is that the new stem cells given from a donor are now giving the patient a chance to build a new immune system--hopefully one that will give a cure. The foreign immune system can begin to attack the cancer patients body that received the transplant. Just like your immune system might reject a heart transplant, the new immune system is seeing the organs of the body as foreign and attack.

To combat this from happening the patients are usually given agents that suppress the immune system. This however, can then cause infections that can quickly develop into a life threatening situation. Researchers are continuing to look for ways to combat the infections that arise.

Noxafil was compared to Diflucan in a study of 600 patients with GVHD who were also receiving therapy to suppress their immune system. The anti-fungal agent that won out was Noxafil for the prevention of fungal infections.

Graft-versus-host disease (GvHD) is a complication that can occur after a stem cell transplant. GvHD occurs when infection-fighting cells from the donor recognize the patient's body as being different or foreign. These infection-fighting cells then attack tissues in the patient's body just as if they were attacking an infection. GvHD is often treated with steroids, though this does not always work. GvHD is a serious condition with a high death rate so researchers are constantly evaluating new ways to treat it or reduce the symptoms.

European researchers conducted a study to see if a certain type of stem cell, infused into patients with GvHD that are not responding to treatment, would be effective. Patients were treated with mesenchymal stem cells, that are specific types of stems cells that are collected from the bone marrow of a donor. These stem cells are thought to help suppress the donor's immune cells and reduce the risk of GvHD.

The researcher found that 68 percent of the patients responded, children having slightly better results. They concluded that treatment with mesenchymal stem cells appears to effectively treat recurrent GvHD that would otherwise have been fatal in a majority of patients.

Children that undergo bone marrow transplants can develop life threatening infections while the immune system is trying to regenerating itself. St. Jude Children's Research Hospital thinks they have found a better way to harvest stem cells that are more vigorous in reproducing and rebuilding the immune system. These stem cells would reduce the time it takes for the immune system to rebuild--reducing the risk of infection.

When harvesting the donated bone marrow a specific antibody is used to find the vigorous stem cells that mature and reproduce faster. They found that using a new antibody along with the one already used might prove to have better results in capturing the best stem cells needed. This could help the donated bone marrow to take hold faster and lessen the risk of the time children are exposed to serious infections.

Although the studies so far have been done on mice, the researchers believe that this is promising information that with further studies can translate into better treatment for children that need to undergo a bone marrow transplant.

University of Michigan Comprehensive Cancer Center researchers can accurately predict, one week after a bone marrow transplant, which patients will develop graft vs. host disease, GVHD, a serious and deadly complication where the body rejects the new bone marrow, by measuring the level of a protein called tumor necrosis factor, TNF, a trigger for inflammation. TNF is elevated in patients who will develop GVHD. The advantage to knowing which patients are at risk, before any physical symptoms of GVHD, gives the medical team an advance opportunity to treat patients showing elevated TNF levels with anti-TNF drugs. Clinical trials with anti-TNF drugs are being conducted now.