Bone Marrow Transplants and the life saving effect of omega 3

About 6 years ago my youngest brother, a doctor (emergency medicine), husband, and father of 4 was diagnosed with acute myeloid leukemia. This is cancer of the blood – or rather the  blood making stem cells in the bone marrow. He had a really nasty aggressive type, and a bone marrow transplant was recommended. This required killing off all his bone marrow with chemotherapy and then giving him healthy bone marrow stem cells, from a donor with a tissue type matched as closely as possible.

There are 4 of us siblings, so we healthy three had our tissue types done to see if they matched. Unfortunately none of us did, in fact they were all so different – it looked like we were unrelated.

This meant an unrelated donor had to be found. Within a few days one was found in Melbourne Australia. The tissue type was a very good match. However this procedure called MUD or Matched Unrelated Donor, is not without risk. When one has an organ transplant, there is always the risk of rejection, and immuno-suppressant drugs are taken for the rest of ones life to decrease this rejection risk. When you have a stem cell transplant, you are changing your blood, and the blood contains immune cells. There is a risk that if not matched closely enough, the newly transplanted material attacks the transplant recipient’s body. This is called Graft-versus-host disease (GVHD) Rates of GVHD vary from between 30 – 40% among related donors and recipients to 60 – 80% between unrelated donors and recipients. Strong immuno-suppressant drugs are required to stop this attack. You cannot simply remove the organ like you can a kidney if it is rejected, your very blood rejects you and and all your organs, and severe GVHD leads to death.

Not a happy thought. As you can imagine – I had my head buried in Pubmed looking for any supplement / diet etc. that might help my brother survive.

I found this study “Oral eicosapentaenoic acid for complications of bone marrow transplantation”

The ‘systemic inflammatory response syndrome’ (SIRS) may represent the underlying cause of complications after bone marrow transplantation (BMT). This study was conducted to determine whether blocking the etiologic factors of SIRS could improve the complications of BMT. Sixteen consecutive patients with unrelated donors were allocated alternately to two groups.

Seven patients received 1.8 g/day of eicosapentaenoic acid (EPA) orally from 3 weeks before to about 180 days after transplantation, while nine patients did not. These two groups were compared with respect to complications, survival, and various cytokines and factors causing vascular endothelial damage. All seven patients receiving EPA survived and only two had grade III graft-versus-host disease (GVHD).

Among the nine patients not receiving EPA, three had grade III or IV GVHD. In addition, thrombotic microangiopathy developed in four patients and cytomegalovirus disease occurred in four. Five patients died in this group.

The levels of leukotriene B₄, thromboxane A₂, and prostaglandin I₂ were significantly lower in patients receiving EPA than in those not receiving it (all P < 0.01). Cytokines such as tumor necrosis factor-, interferon-, and interleukin-10 were also significantly decreased by EPA (P < 0.05), as were factors causing vascular endothelial damage such as thrombomodulin and plasminogen activator inhibitor-1 (P < 0.05). The survival rate was significantly higher in the group given EPA (P < 0.01). EPA significantly reduced the complications of BMT, indicating that these complications may be manifestations of the systemic inflammatory response syndrome.

Bone Marrow Transplantation (2001) 28, 769–774.

WOW, of 7 in a group that takes EPA Omega 3, there is less inflammation and GVHD and no deaths, and in the group not taking it 5 of 9 die!

This study too from the same group:

Oral eicosapentaenoic acid for acute colonic graft-versus-host disease after bone marrow transplantation.

Abstract

We investigated whether pretreatment with eicosapentaenoic acid, an inhibitor of leukotriene (LT) B4, could ameliorate acute colonic graft-versus-host disease (GVHD) after bone marrow transplantation (BMT). Seventeen patients undergoing unrelated BMT were divided into two groups, with eight patients receiving eicosapentaenoic acid and nine not receiving it. The grade of GVHD after transplantation was compared with that estimated from the pretransplantation LTB4 level. The levels of LTB4 and several cytokines were also monitored. The actual grade of GVHD was lower than that estimated from LTB4 levels in three of the eight patients from the treated group, and there was a significant difference between the treated and untreated groups (p < 0.05, chi 2 test). The levels of LTB4, tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) were all significantly lower in the treated group (p < 0.05, Student’s t-test). These findings suggest that eicosapentaenoic acid may ameliorate acute colonic GVHD when administered from before BMT

I showed this to my brother and gave him a bottle of Dr Sears OmegaRx liquid fish oil. (High strength, high purity and no oxidation, batch tested, I didn’t want to take any risks here with cheap fish oil) By the way omega 3 is also shown to make chemotherapy more effective. “Nutritional intervention with omega-3 fatty acids enhances tumor response to anti-neoplastic agents”. So he started taking it, through the nauseating chemo, the days in the transplant unit, before and after his transplant.

Following his Bone Marrow Transplant, he only suffered a very low level of GVHD, and after a few months was able to go back to work part time, and eventually he was also able to discontinue his immuno-suppressant medication.

It is now around 6 years post BMT, although he gets tired and has some mild symptoms, he is able to work part time in the hospital emergency department, and he is fine. I wrote to share this study as without the benefit of it, and taking the fish oil, I’m not sure my brother would have come through this as well as he did. (It seems even the doctors in the transplant unit didn’t know about it).

Vitamin D may also be an important – it is highly likely that a leukemia patient has low vitamin D levels – a crucial pro-hormone for immune function:

Vitamin D deficiency, autoimmunity, and graft-versus-host-disease risk: Implication for preventive therapy

I hope that others might benefit from this knowledge.

Dr Sears Omega Rx can be bought in New Zealand (New Zealand and Australian customers) here.