UF selected as core center for bone marrow transplant research

The National Institutes of Health selected the University of Florida as one of 16 core centers in the nation to conduct research into new therapies for blood and bone marrow transplant recipients.

The blood and marrow transplant program at the University of Florida Shands Cancer Center was selected from among 49 applications as one of only two centers in the Southeast to be part of the Blood and Marrow Transplant Clinical Trials Network, a core group of institutions that will develop and conduct randomized trials of new therapies that hopefully will lead to improvements in transplant outcomes.

The new initiative is jointly sponsored by the NIH-affiliated National Heart, Lung and Blood Institute, and the National Cancer Institute. The NIH award will provide as much as $2 million over five years to support UF’s participation in network trials.

Dr. John Wingard, a professor in the College of Medicine’s division of hematology and oncology, and director of the UF Blood and Marrow Transplant Program, has been selected to chair the steering committee that oversees the nationwide network. In addition, a research study Wingard proposed to investigate a new fungus-fighting medication in blood and marrow transplant recipients has been chosen one of the first to be tested under the initiative. Wingard also is the associate director for clinical and translational research at the UF Shands Cancer Center.

Researchers will investigate a new drug named voriconazole to prevent invasive fungal infections, which are the major infectious cause of death in these patients. The effectiveness of the new drug will be compared to that of fluconazole, the standard medication now used to treat these infections.

A Food and Drug Administration advisory panel has recommended voriconazole be approved, and Wingard expects it will be licensed and ready for testing in patients within the next several months. Because of the size of the network — which performs about 1,500 bone marrow transplants a year in aggregate — the study likely can be completed within 30 months, he said.

As many as 15,000 people each year receive blood and marrow transplants for cancer, immune deficiency disorders such as aplastic anemia and other diseases. Of the half who receive allogeneic transplants — those performed using stem cells collected from another person — about 20 percent die of fungal infections despite treatment with fluconazole.

In research conducted by Wingard and others, voriconazole has been found to be safe and highly effective in fighting fungal infections in individuals with suppressed immunity. Research findings from one of those studies involving the drug’s use in patients with depressed white blood cell counts and persistent fever were published in the Jan. 24 issue of the New England Journal of Medicine.

“This new drug is a very exciting drug that seems to be safe and quite effective,” Wingard said. “Giving the drug as prophylaxis in patients at high risk for infection could be even more effective and could potentially improve survival in bone marrow transplant patients by 15 to 20 percent.”