18-FLT PET/MR Imaging to Predict Graft Failure and GVHD in Bone Marrow Transplant Patients
Status:
Active, not recruiting
Trial end date:
2022-06-01
Target enrollment:
Participant gender:
Summary
Allogeneic HSCT is potentially curative for numerous high risk hematologic malignancies and
offers several advantages over traditional chemotherapy. First, higher doses of cytotoxic
chemotherapy and/or irradiation can be given since patients are subsequently rescued from the
severe myelosuppression induced by the pre-transplant conditioning regimen by the infusion of
healthy hematopoietic stem cells.
Second and perhaps more importantly, mature T cells contained in the graft are able to mount
immune responses against residual cancer cells surviving the conditioning regimen due to
major and/or minor MHC disparities between the donor and recipient. Unfortunately, the
allo-immune responses driving the GVL effect are typically not specific for malignant cells.
As a consequence, donor immune cells attack normal host tissues resulting in a process known
as acute graft-versus-host disease (GVHD). Acute GVHD is primarily T cell driven, usually
occurs within the first few months after transplant, and results in skin rash, diarrhea,
cholestatic liver damage, and, on occasion, acute lung injury.