It’s tragically ironic that in medicine, sometimes the cure is almost as harmful as the poison. This is the case for bone marrow transplant, which could have the nearly same chance of saving a patient as it does harming the patient. To minimize the risks and guide the decision process, scientists at the Mount Sinai School of Medicine developed an algorithm that’s smart enough to predict the outcome of this procedure for each patient.
Dubbed the “MAGIC algorithm” (Mount Sinai Acute GVHD International Consortium algorithm), this tool measures the concentrations of the proteins ST2 and REG3A. Abnormal presence of these proteins can signal the oncoming of graft-versus-host disease (GVHD) weeks before symptoms occur. In GVHD, the patient’s body recognizes the transplanted bone marrow as foreign and begins to attack, causing life-threatening complications. Knowing if this scenario will play out should give doctors more time to react and possibly prevent full-blown GVHD cases.
"The MAGIC algorithm gives doctors a roadmap to save many lives in the future. This simple blood test can determine which bone marrow transplant patients are at high risk for a lethal complication before it occurs," said Dr. James L.M. Ferrara, Professor at the Icahn School of Medicine at Mount Sinai, and Co-director of MAGIC. "It will allow early intervention and potentially save many lives."
The algorithm was developed after analyzing nearly 1,300 bone marrow transplant samples from 11 hospital centers. With this extensive sample, the team found that presence of two key proteins predicted the likelihood of a patient developing lethal GVHD.
"This test will make bone marrow transplant safer and more effective for patients because it will guide adjustment of medications to protect against graft-versus-host disease," said Dr. John Levine, Professor at The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai and Co-director of MAGIC. "If successful, the early use of the drugs would become a standard of care for bone marrow transplant patients."
Of note, a bone marrow transplant is a procedure that replaces a patient’s diseased blood stem cells with healthy ones from a matched donor. There are several conditions that warrant a bone marrow transplant. These often involve blood disorders, such as cancer of the blood (leukemia), sickle cell anemia, or thalassemia. In some instances, chemotherapy or radiation treatment can damage the bone marrow, necessitating a transplant.
Additional sources: The Mount Sinai Hospital