N-acetylcysteine (NAC) is a known antioxidant and induces modulation of glutathione cellular content effects. It has been suggested that in the context of stem cell transplantation (SCT), NAC was suggested as a possible agent in order to prevent and treat graft-vs.-host disease, veno-occlusive disease and idiopathic pneumonia syndrome. We investigated the possible effect of NAC on graft-vs.-leukemia effect (GVL) and lymphokine activated cells (LAK) activity in murine models. After 10 days of either oral or intraperitoneal NAC treatment, the cytotoxic activity of the LAK cells against Yac cells (H-2a, NK sensitive tumor cell line)did not significantly differ from LAK activity generated from spleen cells obtained from untreated controls. However, NAC mildly suppressed GVL (appearance of BCL1 leukemia in 8/36 animals treated with NAC as compared to 0/20 in the transplantation control group, p=0.023, figure 1). In spite of this mild suppression of GVL, no negative effect on engraftment, judged by achievement of donor chimerism, was seen.

We conclude that NAC usage in SCT maybe relatively safe in regard to the GVL effect, yet further clinical studies are warranted.

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Topics:
acetylcysteine, lymphokines, graft vs leukemia effect, leukemia, tissue transplants, antioxidants, cyclin d1, glutathione, hematopoietic stem cell transplantation, idiopathic pneumonia syndrome

Disclosure: No relevant conflicts of interest to declare.

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2006, The American Society of Hematology
2006
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