No abstract

Immunological effects of IL-21 on T-, B-, and NK-cells have been reported, but the role for IL-21 in graft-versus-host disease (GVHD) remains obscure. Here we demonstrate that morbidity and mortality of GVHD was significantly reduced after bone marrow transplantation with splenocytes from IL-21R−/− mice compared to those from wild type mice. To further confirm our observation, we generated a decoy receptor for IL-21. GVHD was again less severe in mice receiving bone marrow cells transduced with the IL-21 decoy receptor than control mice These results suggest that IL-21 critically regulates GVHD and that blockade of the IL-21 signal may represent a novel strategy for the prophylaxis for GVHD.

No abstract

Mesenchymal stem cells (MSCs) have been identified in animals, especially in bone marrow. As stem cells, they have the ability to differentiate into multiple cell types. This potential raises exciting therapeutic possibilities. A recent report described the successful use of MSCs for the treatment of graft-versus-host disease; however, the scientific community has yet to define the molecular mechanisms of immunomodulation by MSCs. This review summarizes what is known and discusses the conflicting data with regard to the mechanisms of immunomodulation by MSCs.

In the rituximab era, several large studies have suggested that full-dose rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) might be the best treatment for patients with diffuse large B-cell lymphoma (DLBCL) aged 60 years and older. However, it remains unclear whether this is also the case for those aged 70 years and older. Previously untreated patients with DLBCL aged 70 years and older (elderly) were treated with R-70%CHOP, and patients younger than 70 years (younger) were treated with full-dose R-CHOP every 3 weeks, for a total of 6-8 cycles. Complete remission (CR) rates in elderly versus younger patients were 75 vs. 78% (p = 0.7), respectively. The 3-year overall survival, event-free survival and progression-free survival of elderly versus younger patients were 58 vs. 78% (p < 0.05), 45 vs. 70% (p < 0.05) and 64 vs. 72% (p = 0.43), respectively. Severe adverse events were more frequent in the elderly, even with the dose reduction in that age group. Three-year PFS with R-70%CHOP for patients aged 70 years and older was not significantly worse than that with full-dose R-CHOP for younger patients, suggesting that R-70% CHOP might be a reasonable choice for patients with DLBCL aged 70 years and older, especially for those with comorbidities.