Anti-HIV Drugs Can Reduce Complications Of Graft-Versus-Host-Disease, According To New Study

Anti-HIV Drugs Can Reduce Complications Of Graft-Versus-Host-Disease, According To New Study

Researchers from the Perelman School of Medicine at the University of Pennsylvania revealed that a drug which is used for HIV treatment can reduce dangerous complications of graft-versus-host-disease in blood cancer patients that underwent an allogenic bone marrow transplantation. This anti-HIV drug redirects the traffic of  immune cells to certain organs, thus suppressing the immune system, reduces the risk of developing graft-versus-host- disease. Maraviroc, the anti-HIV drug which redirects the immune cells, can reduce the occurrence of graft-versus-host-disease complications, without suppression of the immune system.

“There hasn’t been a change to the standard of care for graft-versus-host-disease since the late 1980s, so we’re very excited about these results, which exceeded our expectations. Until now, we thought that only extreme suppression of the immune system can get rid of graft-versus-host-disease, but in this approach we are not killing immune cells or suppressing their activity, we are just preventing them from moving into certain sensitive organs that they could harm.” says Ran Reshef, MD, an assistant professor in the division of Hematology-Oncology and a member of the Hematologic Malignancies Research Program at Penn’s Abramson Cancer Center.

The researchers demonstrated that Maraviroc is a very good and safe drug that can be used in patients that underwent a allogenic bone marrow transplantation. After administration 73 percent of patients did not presented graft-versus-host-disease complications and 6 percent developed sever graft-versus-host-disease, six months after transplant, compared with a control group in which 22 percent developed sever graft-versus-host-disease.

“Just like in real estate, immune responses are all about location, location, location. Cells of the immune system don’t move around the body in a random way. There is a very distinct and well orchestrated process whereby cells express particular receptors on their surface that allow them to respond to small proteins called chemokines. The chemokines direct the immune cells to specific organs, where they are needed, or in the case of graft-versus-host-disease, to where they cause damage.”, Reshef said.

T lympocytes

Thirty-eight patients with acute myeloid leukemia, myelodysplastic syndrome, lymphoma, myelofibrosis were included in this clinical trial. They received the standard therapy for graft-versus-host-disease that includes methotrexate and tracomlimus. Two days before the bone marrow transplantation they began a 33-day course of maraviroc. None of the patients that were treated with maraviroc developed graft-versus-host-disease, in the first 100 days after the bone marrow transplant, compared with the control group where 12.5 percent developed  graft-versus-host-disease in the gut and 8.3 percent developed graft-versus-host-disease in the liver, in the first 100 days after transplant.

These findings indicate that maraviroc is very useful in preventing graft-versus-host-disease, by limiting the mobilization of T lymphocytes in certain organs in the body. This anti-HIV drug works by blocking the CCR5 receptor of the lymphocytes, thus preventing the mobilization of this cells to certain organs.

After 180 days of maraviroc treatment, the incidence of gut and liver complications of graft-versus-host-disease was 8.8 percent for the gut and 2.9 percent for the liver.  In the control group, the incidence of this complications remained higher, 28.4 percent for gut and 14.8 percent for liver complications of graft-versus-host-disease.

The researchers also observed that maraviroc treatment did not influence the relapse rate of the underlying disease or increase the disease treatment toxicity.