Identification of amplified clonal T cell populations in the blood of patients with chronic graft-versus-host disease: positive correlation with response to photopheresis

French, Lars E.; Alcindor, Thierry; Shapiro, Michael B.; McGinnis, Karen S.; Margolis, David J.; Porter, David; Leonard, Debra G.B.; Rook, Alain H.; Foss, Francine M.

doi:10.1038/sj.bmt.1703705

Cited by 40 publications

(31 citation statements)

References 36 publications

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“…Molecular hematology/oncology tests such as B-and Tcell clonality assays and detection of gene translocations are amenable to CE [234][235][236][237][238][239][240][241][242][243][244][245][246][247][248][249][250][251][252][253]. Monoclonal populations of B-cells can be detected by identifying the Ig heavy chain (IgH) gene rearrangements (Fig.…”

Section: Hematology Oncologymentioning

confidence: 99%

Capillary electrophoresis and the clinical laboratory

et al. 2006

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Over the past 15 years, CE as an analytical tool has shown great promise in replacing many conventional clinical laboratory methods, such as electrophoresis and HPLC. CE's appeal was that it was fast, used very small amounts of sample and reagents, was extremely versatile, and was able to separate large and small analytes, whether neutral or charged. Because of this versatility, numerous methods have been developed for analytes that are of clinical interest. Other than molecular diagnostic and forensic laboratories CE has not been able to make a major impact in the United States. In contrast, in Europe and Japan an increasing number of clinical laboratories are using CE. Now that automated multicapillary instruments are commercially available along with cost-effective test kits, CE may yet be accepted as an instrument that will be routinely used in the clinical laboratories. This review will focus on areas where CE has the potential to have the greatest impact on the clinical laboratory. These include analyses of proteins found in serum and urine, hemoglobin (A1c and variants), carbohydrate-deficient transferrin, forensic and therapeutic drug screening, and molecular diagnostics.

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Section: Hematology Oncologymentioning

confidence: 99%

Capillary electrophoresis and the clinical laboratory

et al. 2006

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“…Experience with 8-methoxypsoralen (8-MOP) and ultraviolet A (UVA) light had established the use of photochemical modification of leukocytes for treatment of cutaneous T-cell lymphoma 25 and for treatment of stem cell transplant-related chronic GVHD. 26 Both of these treatments were postulated to act via specific interactions with T cells. Starting in 1989, a series of research publications examined the utility of existing psoralens (8-MOP and AMT) and novel psoralens (amotosalen HCl) for the inactivation of infectious pathogens and leukocytes in platelet and plasma blood components.…”

Section: Risk Factors For Ta-gvhd and Current Technologymentioning

confidence: 99%

Novel processes for inactivation of leukocytes to prevent transfusion-associated graft-versus-host disease

Corash

Lin

2003

Bone Marrow Transplant

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Summary:Transfusion-associated graft-versus-host disease (TA-GVHD) is a serious complication of blood component transfusion therapy. Currently, cellular blood components for patients recognized at risk for TA-GVHD are irradiated prior to transfusion in order to prevent this complication. Considerable progress has been made in elucidating the pathophysiology of this highly morbid complication, but questions as to which patients are at risk and what is the most robust technology to prevent TA-GVHD remain. As new technologies for inactivating or modulating leukocyte function are introduced, the question of how to evaluate these technologies becomes relevant. Over the past two decades, a number of research groups have explored technology to inactivate infectious pathogens and leukocytes contaminating cellular blood components. Few clinicians have an in-depth understanding of the methods or the criteria for selection of how to approach new technologies for leukocyte inactivation with potential to replace current methods. This mini review focuses on the salient aspects of current and evolving technology for prevention of TA-GVHD.

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“…Subjects who responded to ECP were more likely to have a clonal T-cell population, although these populations were found equally in people with and without chronic GVHD. 72 Approximately 5% of mononuclear cells undergo apoptosis after ECP, and these degrading cells may cause autoimmunization and an increased production of IL-10 and IL-1 receptor antagonist (IL-1Ra). 73 Clinical responses are typically delayed until 2 to 3 months of therapy.…”

Section: Interventions To Induce Tolerancementioning

confidence: 99%

New approaches for preventing and treating chronic graft-versus-host disease

Lee

2005

Blood

127

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Despite improvements in the practice of allogeneic hematopoietic stem cell transplantation (HCT) over the last 25 years, chronic graft-versus-host disease (GVHD) remains a substantial problem with little change in the incidence, morbidity, and mortality of this complication. In fact, with increased use of peripheral blood, transplantation of older patients, and less immediate transplantation-related mortality, the prevalence of chronic GVHD may increase. One of the difficulties in combating chronic GVHD is a lack of understanding about the pathophysiology of the syndrome. IntroductionChronic graft-versus-host disease (GVHD) is the most serious and common long-term complication of allogeneic hematopoietic stem cell transplantation (HCT), occurring in 20% to 70% of people surviving more than 100 days. 1,2 Approximately half of affected people have 3 or more involved organs, and treatment typically requires immunosuppressive medications for a median of 1 to 3 years. Because of higher treatment-related (nonrelapse) mortality, chronic GVHD remains the major cause of late death despite its association with a lower relapse rate. 3,4 In addition, secondary malignancies are more common in people with chronic GVHD, particularly of commonly involved tissues such as mouth and skin, suggesting that chronic inflammation, prolonged exposure to immunosuppressive medications, or immune dysregulation facilitates the development of new cancers. 5 Finally, the functional consequences of chronic GVHD organ involvement are major determinants of the health and quality of life of survivors. 6,7 Despite the well-recognized adverse effects of chronic GVHD on the long-term success of allogeneic transplantation, its pathophysiology is poorly understood, and management strategies beyond systemic corticosteroids have not been established.While there are some lessons that can be translated from basic and clinical studies of acute GVHD, several lines of evidence suggest that chronic GVHD is not simply a continuation of acute GVHD, and that separate approaches will be required for its prevention and management. First, except for T-cell depletion and use of umbilical cord blood, the major innovations that have improved acute GVHD rates do not seem to have affected chronic GVHD incidence. Second, while there is significant overlap between the organs involved in acute and chronic GVHD, the distribution of affected organs in chronic GVHD is much broader. Fully evolved chronic GVHD is largely an inflammatory and fibrotic process, while acute GVHD is more likely to reflect apoptosis and necrosis. Although traditionally the boundary between acute and chronic GVHD has been set at 100 days after transplantation, more recent definitions hinge on different clinical manifestations rather than time of onset. Third, while acute GVHD is highly associated with subsequent chronic GVHD, approximately 25% to 35% of chronic GVHD is de novo without any preceding acute manifestations, while 20% to 30% of people who had acute GVHD do not go on to develop chronic GVH...

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Identification of amplified clonal T cell populations in the blood of patients with chronic graft-versus-host disease: positive correlation with response to photopheresis

Cited by 40 publications

References 36 publications

Capillary electrophoresis and the clinical laboratory

Capillary electrophoresis and the clinical laboratory

Novel processes for inactivation of leukocytes to prevent transfusion-associated graft-versus-host disease

New approaches for preventing and treating chronic graft-versus-host disease

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