Victorian Clinical Genetics Services and Murdoch Childrens Research Institute develop a new test to monitor the success of bone marrow transplants.

A new blood test developed by researchers at the Victorian Clinical Genetics Service (VCGS) and Murdoch Childrens Research Institute (MCRI) allows clinicians to more confidently measure the health of bone marrow transplants and react more quickly to any changes in the transplant.

The Organ Health BMT test, developed by a team headed by A/Prof Howard Slater from VCGS and MCRI, uses copy number variation differences between recipient and donor(s) to measure the proportion of cells in blood or bone marrow that are produced by the transplant donor. The test is capable of producing results where multiple donors have been used for transplants or where donors may be closely related to recipients, a challenge faced by prior approaches.

The test uses a newer measurement platform, digital droplet PCR, which permits faster turnaround for test results and improved accuracy. Inherent in the test design are multiple markers specific to both the recipient and donor(s), which increases confidence in the result by providing a measure of precision and replication within the test. This unique approach has just been published in the journal Experimental Hematology.

Combining these benefits, clinicans can more confidently measure the health of bone marrow transplants and closely monitor the effect of changes in treatment. The test is more sensitive, meaning that it can pick up changes in health of the transplant earlier, permitting earlier intervention if appropriate. The test has been in use at Melbourne’s Royal Children’s Hospital (RCH) since the beginning of 2016 and has been well received by treating specialists.

RCH Clinician and MCRI Researcher, Dr Rachel Conyers said:

“From a clinical perspective this new technique gives us an extremely quick and sensitive way of monitoring the success of the transplant. It gives the clinician the opportunity to act early if post-transplant alterations to the graft are necessary. This can, and will, impact upon patient survival.”

The Organ Health BMT test was used to monitor the bone marrow transplant of two-year-old Brydee from Bendigo, who was diagnosed with Juvenile Myelomonocytic Leukaemia at 6 months of age. Her test identified early stage changes in the health of her transplant and her treatment was altered to compensate. Further monitoring showed the transplant had completely recovered. Visit MCRI for more of Brydee’s story.

The Organ Health team are also investigating applications of this test for monitoring the health of solid organ transplants, such as kidney, heart and lung transplants. In these transplants, the test is capable of measuring the amount of donor DNA released into recipient blood and urine, a possible marker of rejection. This research is ongoing.

VCGS is looking for opportunities to collaborate with other pathology services and industry to broaden access to its new test.