scholarly journals Unrelated Stem Cell Transplantation after a Reduced Intensity Conditioning Regimen Containing High-Dose Thymoglobulin Leads to Controllable Graft-versus-Host Disease

2007 ◽  
Vol 13 (4) ◽  
pp. 494-497 ◽  
Author(s):  
J.F. Lacerda ◽  
C. Martins ◽  
F. Lourenço ◽  
J.A. Carmo ◽  
C. Juncal ◽  
...  
Blood ◽  
2005 ◽  
Vol 106 (13) ◽  
pp. 4407-4411 ◽  
Author(s):  
Mohamad Mohty ◽  
Didier Blaise ◽  
Catherine Faucher ◽  
Norbert Vey ◽  
Reda Bouabdallah ◽  
...  

This study investigated the role of inflammatory cytokines in acute graft-versus-host disease (aGVHD) incidence and severity in 113 patients who underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT). Among all tested cytokines in the first 3 months after allo-SCT, only interleukin-12 p70 (IL-12p70) levels in the first month were significantly associated with grades II to IV aGVHD development (P < .001). IL-12p70 levels were directly correlated with aGVHD severity grade (P < .001). Before aGVHD onset, blood monocytes, the main precursor pool of IL12p70-secreting dendritic cells, recovered more rapidly in patients with grades II to IV aGVHD (P = .005). Similarly, at the effector level, there was a more robust reconstitution of naive CD3+CD4+CD45RA+CD27+ T cells in patients developing grades II to IV aGVHD (P = .006). In multivariate analysis, IL-12p70 level measured in the first month was the strongest predictive factor for aGVHD development (P < .001). These findings, reconstituting a TH1 loop, support a model in which aGVHD reflects a type 1 alloreaction after RIC allo-SCT.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5127-5127
Author(s):  
Gerda C. Leitner ◽  
Hildegard T. Greinix ◽  
Peter Kalhs ◽  
Hoecker Paul ◽  
Panzer Simon

Abstract Background: Mismatches between donor and recipient for human platelet antigens (HPA) may affect the success of transplantation due to: a) serving as minor histocompatibility antigens and therefore render recipients at risk for GvHD, b) inhibition of thrombopoiesis due to platelet antibodies. Patients and Methods: We evaluated in 54 patients receiving hematopoietic stem cell transplantation (HSC T) from HLA matched siblings after a myeloablative conditioning regimen the occurrence of GvHD, transplant related mortality (TRM), and the need of platelet support by prospective analyzes of donor-recipient pairs for HPA -1, -2, -3, and -5 allotypes. Patients were screened for platelet antibodies prior to transplantation and in weekly intervals until day 100 after transplantation. Forty five patients receiving HSCT from related or unrelated donors after a reduced-intensity conditioning regimen (RIC) were enrolled retrospectively after a median observation time of 372 days. Results: Neither the incidence of GvHD and TRM, nor the onset of thrombopoiesis, nor the CCI after platelet transfusions, nor the frequency of platelet transfusions were affected by HPA mismatches. TRM among patients receiving a RIC was higher when grafts were from unrelated donors with 2 or more mismatches. Six of 7 patients who died due to TRM had 2 mismatches in the HPA system, although TRM was not significantly associated with mismatched HPA (p = 0.06). However, within donor-recipient pairs with more than one HPA mismatch TRM occurred when grafts were from unrelated donors (p = 0.03). Conclusion: Thus, the HPA match does not affect the success of transplantation.


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