Is a well-behaved immune system key to successful transplant outcomes?

Dr. Kate Markey, assistant professor (Hematology and Oncology) has discovered a link between the intestinal microbiome and chronic graft-versus-host disease (cGVHD), a common complication of allogeneic stem cell transplants.

This type of bone marrow transplant is used to treat aggressive blood cancers such as leukemia and involves replacing the immune system of the patient with one from a donor. 

“Transplant offers the gift of a cure and improved quality of life but can come with serious complications,” she said.

Nearly 30% of allogeneic transplant recipients suffer from chronic GVHD.

Markey has been researching GVHD for 20 years, since she started working on her PhD examining the role of cytokines, immune system-signaling molecules, and deciphering how the immune system knows what to react to and what to ignore. 

Now she’s training her lens on the microbiome and the role it might play in how a person recovers from a transplant, thanks to a new four-year $946,000 grant from the American Cancer Society. 

It appears that damage to the microbiome is associated with poor outcomes for cancer patients, including more GVHD, infections and even earlier death.

“We are trying to answer the question: what levers do we have within the microbiome that we can use to try to improve things for patients?” Markey said.