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A mantle cell lymphoma survivor discusses being a transplant patient.
Curing cancer is complicated. It’s always been a rather mysterious and seemingly haphazard business, but with current advances it’s getting more effective and also harder to understand.
I’m both a science nerd and a long time fighter of mantle cell lymphoma. For 12 years, I’ve been talking to my world class doctors about the mechanisms of my disease, both in my body and in the treatments they give me. Recently, I found out that I’ve been completely misunderstanding how my several stem cell transplants fight my cancer.
I’d been under the impression that it was graft-versus-host disease (GVHD) that fought off the bad cells my body produces. By having someone else’s bone marrow system, the rest of my body was fighting this "foreign invader." In turn, my donor’s bone marrow was killing off my original cells and holding off the cancer.
All transplant patients know that getting GVHD can be a pretty scary deal. I always thought, though, that you wanted just a little bit of the reaction to keep the cancer at bay. Lately, my amazing transplant oncologist explained to me about the graft-versus-lymphoma (GVL) effect, sometimes called graft-versus-tumor effect. It turns out that there are two different things going on. GVHD does, indeed, kill off cancer cells. Of course, it’s also causing all sorts of other bad things along the way. After almost 40 years of research, scientists and doctors are convinced there is another mechanism, GVL, at work.
This research shows that even if you don’t get GVHD, the donor cells living in your body have a way to kill off cancer cells that may get produced long after your transplant. I slogged through many scientific papers and it seems like researchers finally understand how, and why, this works. The recent appearance of Car T Therapy is one way they are trying to use this "new" learning.
There’s not a lot available on the internet about the GVL effect, and what is there is pretty technical. The best source of information, like all things lymphoma, is your oncologist or transplant doctor. Ask them to explain their views on this important and complicated subject.
I’ve heard patients worrying that if they didn’t get GVHD, they might not be cured. It’s a weird world we cancer fighters live in, when we are concerned that not getting sick is a bad thing! Rest easy, my fellow warriors and transplant survivors. It’s looking like our new little friend, GVL, is on duty and quietly helping a lot of us stay healthy, without those pesky nuisances like skin rashes, diarrhea, nausea and dry eyes.
Besides the other wonderful blogs on Cure Today’s site, I hope you'll also visit my Taking Vienna site. That’s where I talk in a much more personal way about my battle, my family and friends, and other random and odd musings.