University researchers have discovered a method of earlier detection for a disease that affects patients who receive bone marrow transplants that will allow for more specialized treatment and for patients to know they have the disease before it becomes life threatening.

Graft-versus-host disease afflicts about half of patients who receive allogening bone marrow, which can be outwardly manifested in a skin rash. However, a rash is also a very common reaction to the antibiotics used to treat bone marrow transplant patients. A skin biopsy was the only way to determine if the rash was due to GVHD or the antibiotics, but thanks to a University study published last month, doctors can now use a blood test to detect the disease.

In addition to the skin rash, GVHD, which is a response to the introduction of foreign bone marrow into the body, manifests itself in liver damage and GI tract damage. Bone marrow transplants are used to treat sickle cell anemia, leukemia, lymphoma and other blood diseases.

University researchers recently discovered that a protein, elafin, may be used to identify whether patients with rashes have GVHD. Elafin — which can be detected through a blood test — will not only enable medical professionals to diagnose GVHD, but it will also predict the intensity of the disease, according to Professor of Pediatrics and Internal Medicine James Ferrara, the study’s senior author.

Ferrara, who is also director of the Adult and Pediatric Blood and Marrow Transplant Program, said the protein develops as inflammations on the skin in response to attacks on foreign bone marrow by the immune system.

Ferrara said he collaborated with former University Prof. Sam Hanash, the foremost expert on the study of proteins, to find a way to identify elevated protein levels in GVHD patients.

“We wanted a simple test that we could use, and initially our hope is that if we could start treatment early, we can control GVHD in a larger number of patients, but we needed a good test,” Ferrara said.

This is the first lab test of its kind developed to identify signs of GVHD, Ferrara said.

“It was like looking for a needle in a haystack the size of Michigan,” he said. “We got lucky.”

According to Ferrara, GVHD has an overall mortality rate of 40 percent. Detection within a week allows medical professionals to control its progression, lowering the mortality rate to 15 percent, while lack of detection will raise the mortality rate up to 90 percent, he said.

Currently, all allogeneic transplant recipients are given medicine before the operation as a preventative measure, Ferrara said. Patients exhibiting rashes post-operation are given high-dose steroids as a step to avoid the possibility of GVHD, but they weaken a patient’s immune system. Ferrara said this treatment method has not changed in the past 40 years.

Ferrara said he hopes that detection of elafin levels will allow for more personalized treatment, where patients with higher levels will be offered more intensive therapy and patients with lower levels will be given fewer steroids.

Ferrara said he and fellow researchers are now working together with the University Medical Center to introduce this technique into medical practice. He said he hopes that the test will be available to all patients, not just ones at the University, by the end of this year.

Ferrara said they already received calls from people in Texas and North Carolina, asking whether the researchers would accept blood samples to test for the disease. But Ferrara said the researchers aren’t ready to apply the technique to practical use just yet.

He added that he hopes to make the elafin test more widely available by accepting these samples in the future.