Late recurrence of autologous GvHD in a myeloma patient: a myth or diagnostic challenge?

Failures in thymus medulla regeneration during immune recovery cause tolerance loss and prime recipients for auto-GVHD

“…We used autologous BMT, meaning signs of autoimmunity shown here are not caused by allogeneic responses. Importantly however, cases of GVHD termed “auto-GVHD” have been reported in an autologous BMT setting ( El-Jurdi et al, 2017 ; Kline et al, 2008 ). Similar to our experiments using syngeneic host and donor mice, such symptoms cannot be explained by allogeneic T cell responses.…”

“…Importantly, allogenic BMT can result in graft-versus-host disease (GVHD), a damaging condition that is caused by donor T cell reactivity against host tissues ( Arber et al, 2013 ; Barton-Burke et al, 2008 ; Cooke et al, 2017 ). Interestingly, several studies have also reported a condition, sometimes termed "auto-GVHD" or "autoaggression syndrome" ( Sprent et al, 1992 ; Kline et al, 2008 ; El-Jurdi et al, 2017 ), which can occur following transplantation of autologous BMT. Importantly, the autoimmune symptoms that occur following autologous BMT cannot be explained by alloreactivity.…”

Graft-versus-host disease in a child with neuroblastoma after autologous stem cell transplantation

“…Graft-versus-host disease is a common complication of allo-SCT which is induced by donor T cell recognition of recipient alloantigens [6]. GVHD after autologous HSCT or transplantation from a genetically identical twin may cause clinical and histopathologic findings consistent with GVHD [1]. Some investigator propose that all forms of AGVHD (i.e., cutaneous, GI, and liver) be included under the umbrella term “engraftment syndrome” [5].…”

“…Some investigator propose that all forms of AGVHD (i.e., cutaneous, GI, and liver) be included under the umbrella term “engraftment syndrome” [5]. Beyond the nomenclature AGVHD is an under-diagnosed complication of autologous HSCT resembling GVHD occurring after allogeneic HSCT [1]. There are several hypotheses to explain the pathogenesis of AGVHD.…”

“…Allogeneic and autologous hematopoietic stem cell transplantation (HSCT) is potentially curative for several malignancies. Acute graft-versus-host disease (GVHD) is an immunologically mediated process, involving donor T cell responses to host alloantigens and the dysregulation of inflammatory cytokine cascade after allogeneic hematopoietic stem cell transplantation (allo-SCT) [1–3]. Graft-versus-host disease (GVHD) in patients who received autologous hematopoietic stem cell transplantation (HSCT) is less common compared to patients who received allogeneic stem cell transplantation.…”