Sclerodermatous chronic graft-versus-host disease

Chosidow, Olivier; Bagot, M.; Vernant, Jean‐Paul; Roujeau, Jean‐Claude; Cordonnier, Catherine; Kuentz, Mathieu; Wechsler, Janine; André, Chantal; Touraine, R; Revuz, J

doi:10.1016/0190-9622(92)70005-z

Cited by 126 publications

(113 citation statements)

References 16 publications

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…However, the results suggest that maleoffspring T cells present in PB and/or skin of women with SSc exhibit a functional profile prevalently oriented toward Th2 rather than Th1 cytokine production in response to stimulation with maternal MHC antigens. This finding supports the concept that fetal cells found in the PB and/or skin of women with SSc are functionally similar to those responsible for cGVHD in experimental animal models (9,10).…”

Section: Discussionsupporting

confidence: 84%

Th2‐oriented profile of male offspring T cells present in women with systemic sclerosis and reactive with maternal major histocompatibility complex antigens

Scaletti

Vultaggio

Bonifacio

et al. 2002

Arthritis & Rheumatism

122

View full text Add to dashboard Cite

Objective. To characterize the cytokine production profile of male-offspring T cells reactive against maternal major histocompatibility complex (MHC) antigens present in the peripheral blood and/or skin from women with systemic sclerosis (SSc).Methods. T cell clones were generated from peripheral blood and/or skin biopsy specimens from 3 women with SSc of recent onset and from peripheral blood from 3 healthy women, all of whom had 1 male child. All clones were screened for their proliferative response in vitro to maternal MHC antigens by measuring 3 H-thymidine uptake and for their expression of Y chromosome by using fluorescence in situ hybridization. The concentrations of interferon-␥ and interleukin-4 (IL-4) released by T cell clones in response to maternal MHC antigens were evaluated in culture supernatants, using appropriate enzyme-linked immunosorbent assays.Results. Thirty-nine of 202 T cell clones generated from women with SSc and 11 of 312 from healthy women proliferated in vitro in response to maternal MHC antigens. Seven MHC-reactive T cell clones obtained from women with SSc and 1 obtained from healthy women exhibited the Y chromosome, thus indicating that the clones were derived from T cells of male offspring. All clones generated from male-offspring T cells of SSc women (but not from those of healthy women) produced significantly higher levels of IL-4 in response to stimulation with maternal MHC antigens than did all other clones generated from the same women. The other clones proliferated in response to maternal or allogeneic MHC antigens but did not exhibit the Y chromosome.Conclusion. Male-offspring T cells that are present in the blood and skin of women with SSc and react with maternal MHC antigens exhibit a Th2-oriented profile, supporting the possibility that a chronic graft-versus-host reaction attributable to longterm microchimerism plays a pathogenic role in SSc.

show abstract

Section: Discussionsupporting

confidence: 84%

Th2‐oriented profile of male offspring T cells present in women with systemic sclerosis and reactive with maternal major histocompatibility complex antigens

Scaletti

Vultaggio

Bonifacio

et al. 2002

Arthritis & Rheumatism

122

View full text Add to dashboard Cite

show abstract

“…2 The precise incidence of ScGVHD is not known but may occur in ϳ 13% of patients who develop cGVHD. 3,4 Although ScGVHD is not an acute life-threatening manifestation, widespread involvement may lead to significant functional disability and morbidity. 1 Skin ulceration and poor wound healing associated with skin fibrosis increases the risk of infection.…”

Section: Introductionmentioning

confidence: 99%

“…CD3 T-cell dose in the graft, eosinophilia, positive antinuclear antibodies (ANAs), and antecedent nonsclerotic cGVHD skin involvement have been proposed as markers of ScGVHD 4 ; however, previous series included only small samples of patients and retrospective study designs, and registry and cancer center data fail to distinguish between sclerotic and nonsclerotic cutaneous manifestations of cGVHD. [2][3][4][8][9][10][11] The National Institutes of Health (NIH) Consensus Project recently proposed clear definitions of the sclerotic features of cGVHD, 12 but it will take many years to prospectively collect a significant number of patients with this rare cGVHD subset. The NIH cGVHD Natural History cohort comprises a unique referral population of cGVHD patients with significant (63% NIH global score of "severe") refractory disease (median previous therapies ϭ 4) who undergo a comprehensive prospective multisystem evaluation.…”

Section: Introductionmentioning

confidence: 99%

“…Many enrolled patients manifest disease that is refractory to conventional management, including ScGVHD, and as a result, the incidence of skin sclerosis in this cohort (53%) is much greater than described in other reviews (13.2%-14%). 3,4 This population, therefore, provides a unique opportunity to comprehensively evaluate historical, clinical, laboratory, and serologic markers that may be associated with ScGVHD. involving 1 or more organ systems after allogeneic HSCT, were referred to and evaluated by an interdisciplinary team at the NIH Clinical Center from 2004 to 2010 via a cross-sectional protocol in which the authors studied the natural history of cGVHD (http://www.clinicaltrials.gov identifier: NCT00331968).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sclerotic-type chronic GVHD of the skin: clinical risk factors, laboratory markers, and burden of disease

Martires¹,

Baird

Steinberg

et al. 2011

Blood

103

View full text Add to dashboard Cite

Chronic GVHD is one of the most severe complications of allogeneic HSCT. The sclerotic skin manifestations of cGVHD (ScGVHD) result from inflammation and fibrosis of the dermis, subcutaneous tissue, or fascia, leading to significant functional disability. Risk factors and clinical markers associated with ScGVHD remain largely unexamined. By using a singlevisit, cross-sectional design, we evaluated 206 patients with cGVHD at the National Institutes of Health. Most patients manifested severe (ie, 63% National Institutes of Health score "severe"), refractory disease (median treatments ‫؍‬ 4). ScGVHD was detected in 109 (52.9%) patients. ScGVHD was associated with greater platelet count (P < .001) and C3 (P < .001), and decreased forced vital capacity (P ‫؍‬ .013). Total body irradiation (TBI) was associated with development of ScGVHD (P ‫؍‬ .002). TBI administered in reduced-intensity conditioning was most strongly associated with ScGVHD (14/15 patients, P < .0001). Patients with ScGVHD had significant impairments of joint range of motion and grip strength (P < .001). Greater body surface area involvement was associated with poorer survival (P ‫؍‬ .015). We conclude that TBI, particularly in reduced-intensity regimens, may be an important risk factor for ScGVHD.

show abstract

“…1,2 Although sclerotic cGvHD is not an acute life-threatening manifestation, severe sclerotic cGvHD may lead to significant functional disability and morbidity. 3 This form of cGvHD has a negative impact on the quality of life (QoL) for patients. The response to topical interventions is poor and sclerotic cGvHD is often refractory to systemic therapy.…”

Section: Introductionmentioning

confidence: 99%

Pre-transplantation risk factors to develop sclerotic chronic GvHD after allogeneic HSCT: A multicenter retrospective study from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Detrait

Morisset

Latour

et al. 2014

Bone Marrow Transplant

View full text Add to dashboard Cite

Sclerotic chronic GvHD (cGvHD) is one of the most severe complications after allo-hematopoietic stem cell transplantation (HSCT). Risk factors associated with this complication remain not very well defined. With the aim to define a pre-transplantation risk profile, we have conducted a French retrospective analysis in 705 consecutive patients between 2005 and 2010. Analyses to determine pre-transplantation risk factors included as variables: patient and donor age, kind of donor, HLA matching, ABO matching, sex-matching, diagnosis, stem cell source, gender, GvHD prophylaxis and antithymocyte globulin (ATG) in the conditioning regimen. The cumulative incidence of sclerotic cGvHD was 18% (95% CI, 16.6-19.6) 3 years after onset of cGvHD. In univariate analysis, we found a significantly lower number of sclerotic cGvHD form in patients transplanted from cord blood cells (P = 0.0021), in patients with a one mismatched donor (P =0. 041) and in patients who had received ATG in the conditioning regimen (P = 0.002). In multivariate analysis, factors associated with an increased risk of sclerotic cGvHD were young patient age, multiple myeloma and PBSC as the stem cell source. ATG in conditioning regimen and cord blood unit as the stem cell source were associated with a lower risk.

show abstract

Sclerodermatous chronic graft-versus-host disease

Cited by 126 publications

References 16 publications

Th2‐oriented profile of male offspring T cells present in women with systemic sclerosis and reactive with maternal major histocompatibility complex antigens

Th2‐oriented profile of male offspring T cells present in women with systemic sclerosis and reactive with maternal major histocompatibility complex antigens

Sclerotic-type chronic GVHD of the skin: clinical risk factors, laboratory markers, and burden of disease

Pre-transplantation risk factors to develop sclerotic chronic GvHD after allogeneic HSCT: A multicenter retrospective study from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Contact Info

Product

Resources

About