Acute and chronic graft-versus-host disease after ablative and nonmyeloablative conditioning for allogeneic hematopoietic transplantation

Couriel, Daniel R.; Saliba, Rima M.; Giralt, Sergío; Khouri, Issa F.; Andersson, Börje S.; Lima, Marcos de; Hosing, Chitra; Anderlini, Paolo; Donato, M.; Cleary, Karen R.; Gajewski, James; Neumann, Joyce; Ippoliti, Cindy; Rondón, Gabriela; Cohen, A.; Champlin, Richard E.

doi:10.1016/j.bbmt.2003.10.006

Cited by 195 publications

(126 citation statements)

References 18 publications

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“…The first interaction between activated host APCs and donor T cells likely takes place in the lymphoid tissues associated with gastrointestinal tract (Peyer's patches) [23]. For the same reason reduced intensity conditioning causes less aGVHD as there is decreased damage from the conditioning regimen to the host tissue leading to less activation of the immune cascade [24,25]. In nonclinical models GVHD can be reduced via manipulation of APCs as well [26,27].…”

Section: Pathophysiologymentioning

confidence: 99%

State-of-the-art acute and chronic GVHD treatment

Jamil

Mineishi

2015

Int J Hematol

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owing to the advancement in reduced intensity conditioning (RIC) and in patients without HLA-matched donors due to the use of cord blood and haploidentical HSCT [4][5][6]. Although marked improvement has been made in supportive care, immunosuppressive therapy and DNA-based Human Leukocyte Antigen (HLA) typing, graft vs host disease (GVHD) remains a major cause of morbidity and non-relapse mortality among allogeneic HSCT recipients. It was first described by Billingham in 1966 as a syndrome where immunocompetent T cells from the donor recognize and damage the host tissue in an immunocompromised recipient. It presents with heterogeneous symptoms involving multiple organ systems including gastrointestinal tract, skin, mucosa, liver and lungs [7]. In the past clinical features occurring within 100 days after HSCT was called acute GVHD (aGVHD) and those happening after 100 days were labeled chronic GVHD (cGVHD) [8,9]. This definition was rather unsatisfactory thus National Institute of Health (NIH) consensus criteria were developed and have been revised. The criteria have added new categories such as late-onset aGVHD (acute GVHD occurring after 100 days) and overlap syndrome which includes features of both acute and chronic GVHD to the classification, and also have introduced new definitions for organ system involvement [10][11][12]. The categorization of acute vs chronic GVHD is based on the combination of clinical symptoms rather than the time of onset. Depending upon a number of variables associated with patients, donors, and types of transplant, the incidence of aGVHD varies with incidence of grade II-IV GVHD at 40 % in matched related donor (MRD) transplant to 50 % in MUD transplant. The main risk factors for aGVHD include degree of HLA mismatch, age of the patient, previous all immunization of the donor and the kind of GVHD prophylaxis used. About 30-70 % of allogeneic HSCT recipients alive after 100 days will Abstract Graft-versus-host disease (GVHD) remains as the major obstacle for successful hematopoietic stem cell transplant (HSCT). Roughly half of the patients undergoing HSCT develop GVHD which requires treatment, and above 10 % of the patient may die because of it. However, GVHD presents with anti-tumor activity, called graft-versus-tumor (GVT) effect, and it carries significant anti-tumor activity, thus suppressing GVHD completely may increase the relapse of original disease. Thus, it is important to control GVHD to the appropriate level.

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Section: Pathophysiologymentioning

confidence: 99%

State-of-the-art acute and chronic GVHD treatment

Jamil

Mineishi

2015

Int J Hematol

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“…37,39 In our original reports, the incidence of grade II to grade IV aGVHD ranged between 40 and 60% following myeloablative unrelated HLA 2-3 antigen disparate UCBT in pediatric recipients. 2,3 Couriel et al 60 and Mielcarek et al 61 have suggested a reduced incidence of aGVHD in adult recipients following RI-AlloSCT. Our results are consistent with these findings of potentially reduced aGVHD following RI conditioning and UCBT in pediatric recipients.…”

Section: Survivalmentioning

confidence: 99%

Reduced intensity allogeneic umbilical cord blood transplantation in children and adolescent recipients with malignant and non-malignant diseases

Bradley

Satwani

Baldinger

et al. 2007

Bone Marrow Transplant

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“…This patient might also have had age-related renal dysfunction, his renal function being more susceptible to insults including GVHD. Alternatively, differences in the pathogenesis of acute GVHD between conventional myeloablative allo-SCT and RIST 11,12 might have contributed to the development of renal tubulitis in this patient.…”

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confidence: 98%