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NEW YORK, Mar 08 (Reuters Health) - The thymus, a small gland just behind the breast bone that shrinks during childhood, plays a key role in restoring normal immune function after stem cell transplantation, researchers report.
Stem cell transplants, like bone marrow transplants, are commonly used to treat leukemia, but they often result in a weakened immune system because of the underproduction of new infection-fighting T cells. These new T cells are usually produced in the thymus gland, according to Dr. Kenneth Weinberg from the Children's Hospital Los Angeles, California, and associates.
The investigators wanted to know what affected T cell production after stem cell transplantation and, particularly, whether new T cells came from the donor or were produced in the shrunken thymus gland of the recipient.
According to the report in the March 1st issue of Blood, the researchers measured the levels of TREC, which reflect new T cell production by the thymus gland.
Within 2 months after transplant, TREC levels rose in children and adults, the authors report, especially among those patients who did not have graft-versus-host disease (GVHD), a complication in which the transplanted immune cells attack the cells of the recipient.
In contrast, patients with any history of GVHD developed far lower levels of TREC, the report indicates, suggesting that GVHD significantly impairs the functioning of the thymus gland.
Restoration of thymus gland function, as reflected by increasing TREC levels, had no relationship with the age of the patient or whether they received drugs to suppress GVHD or other immune responses resulting from the transplant.
From these results, Weinberg and colleagues conclude that the thymus gland can function normally in children and adults to replenish the T cells lost during the stem cell transplantation procedure, but that GVHD can seriously damage that function.
The researchers suggest that thymus gland function after transplant might be improved by preventing GVHD and by developing drugs that increase normal thymus gland activity.
SOURCE: Blood 2001;97:1458-1466.
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