Magazine article Science News

Thalidomide: Is There a Silver Lining?

Magazine article Science News

Thalidomide: Is There a Silver Lining?

Article excerpt

Thalidomide: Is there a silver lining?

Once exiled from medicine for thesevere birth defects it can cause, the drug thalidomide may have found a respectable role in preventing the severe reaction associated with transplanting tissues.

According to Georgia B. Vogelsang ofthe Johns Hopkins University School of Medicine in Baltimore, thalidomide is being used successfully there to treat graft-versus-host disease (GVHD) in a small group of bone marrow recipients. She reported preliminary results this week in San Diego at the American Cancer Society's annual Science Writers' Seminar.

In the late 1950s, women given thalidomideas a sleep-inducing and anti-morning sickness drug while pregnant ran the risk of giving birth to infants who lacked arms or legs. It is "one of the most notorious drugs ever introduced,' says Vogelsang.

Nevertheless, Vogelsang believes thalidomidemay redeem itself in the transplantation field. Although bone marrow transplants often are used to treat leukemia, aplastic anemia and certain genetic disorders, there can be serious setbacks. Because bone marrow contains a large number of cells capable of an immune response, clinicians are careful to match a recipient with donor bone marrow through compatibility testing. However, in 40 to 60 percent of these grafts, the donor bone marrow (graft) recognizes the recipient (host) as foreign and "attacks.' The potentially fatal GVHD that results may be acute or chronic, with symptoms that include mouth ulcers, skin problems and liver failure. To fight GVHD, the immunosupressant cyclosporine currently is the drug of choice; but its high toxicity and slow-acting effects reduce its usefulness.

In the search for alternatives, studieshave shown that cyclosporine and thalidomide influence the same type of immune cell. This, coupled with earlier observations in the 1960s that thalidomide may have caused improvement of leprosy, pointed the way to thalidomide, says Vogelsang. …

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