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Chen Y, Xu LP, Zhang XH, Chen H, Liu KY, Qing J, Yang YL, Huang XJ. Haploidentical hematopoietic stem cell transplantation with busulfan, cyclophosphamide, and fludarabine conditioning for X-linked adrenal cerebral leukodystrophy. Pediatr Transplant 2024; 28:e14735. [PMID: 38602169 DOI: 10.1111/petr.14735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/20/2023] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE We investigated the safety and efficacy of haploidentical stem cell transplantation (SCT) in pediatric patients with X-linked adrenoleukodystrophy (ALD). METHODS A retrospective analysis of transplantation data from 29 cases of ALD, treated between December 2014 and April 2022, was conducted. Neurologic function scores (NFS) were assessed. The conditioning regimen was busulfan 9.6 mg/kg, cyclophosphamide 200 mg/kg, and fludarabine 90 mg/m2 (BFC). Graft-versus-host disease prophylaxis consisted of anti-human thymocyte globulin, cyclosporine A, mycophenolate mofetil, and short course of methotrexate. RESULTS Among the 29 cases, 14 cases (NFS = 0) were asymptomatic, and 15 (NFS ≥ 1) were symptomatic. The median age at SCT was 8 years (range: 4-16 years); the median follow-up time was 1058 days (range: 398-3092 days); 28 cases were father donors and 1 case was a grandfather donor. Hematopoietic reconstitution was successful in all patients, and all of them achieved complete donor chimerism at the time of engraftment. The leading cause of death was still primary disease progression (n = 4). Survival free of major functional disabilities was 100% in asymptomatic patients versus 66.67% in the symptomatic group (p = .018). CONCLUSION BFC regimen used in haploidentical SCT was administered safely without major transplant-related complications even in symptomatic patients, and neurological symptoms were stabilized after SCT.
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Affiliation(s)
- Yao Chen
- Peking University People's Hospital, Beijing, China
- Peking University Institute of Hematology, Beijing, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Lan-Ping Xu
- Peking University People's Hospital, Beijing, China
- Peking University Institute of Hematology, Beijing, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital, Beijing, China
- Peking University Institute of Hematology, Beijing, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Huan Chen
- Peking University People's Hospital, Beijing, China
- Peking University Institute of Hematology, Beijing, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Kai-Yan Liu
- Peking University People's Hospital, Beijing, China
- Peking University Institute of Hematology, Beijing, China
| | - Jiong Qing
- Peking University People's Hospital, Beijing, China
| | | | - Xiao-Jun Huang
- Peking University People's Hospital, Beijing, China
- Peking University Institute of Hematology, Beijing, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
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2
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Richardson T, Scheid C, Herling M, Frenzel LP, Herling C, Aguilar MRC, Theurich S, Hallek M, Holtick U. Post-transplant-cyclophosphamide and short-term Everolimus as graft-versus-host-prophylaxis in patients with relapsed/refractory lymphoma and myeloma-Final results of the phase II OCTET-EVER trial. Eur J Haematol 2024. [PMID: 38616351 DOI: 10.1111/ejh.14210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/16/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Conditioning regimens and the choice of immunosuppression have substantial impact on immune reconstitution after allogeneic hematopoietic stem cell transplantation (aHSCT). The pivotal mechanism to maintain remission is the induction of the graft-versus-tumor effect. Relapse as well as graft versus host disease remain common. Classic immunosuppressive strategies implementing calcineurin inhibitors (CNI) have significant toxicities, hamper the immune recovery, and reduce the anti-cancer immune response. METHODS We designed a phase II clinical trial for patients with relapsed and refractory lymphoid malignancies undergoing aHSCT using a CNI-free approach consisting of post-transplant cyclophosphamide (PTCy) and short-term Everolimus after reduced-intensity conditioning and matched peripheral blood stem cell transplantation. The results of the 19 planned patients are presented. Primary endpoint is the cumulative incidence and severity of acute GvHD. RESULTS Overall incidence of acute GvHD was 53% with no grade III or IV. Cumulative incidence of NRM at 1, 2, and 4 years was 11%, 11%, and 16%, respectively, with a median follow-up of 43 months. Cumulative incidence of relapse was 32%, 32%, and 42% at 1, 2, and 4 years after transplant, respectively. Four out of six early relapses were multiple myeloma patients. Overall survival was 79%, 74%, and 62% at 1, 2, and 4 years. GvHD-relapse-free-survival was 47% after 3 years. CONCLUSIONS Using PTCy and short-term Everolimus is safe with low rates of aGvHD and no severe aGvHD or cGvHD translating into a low rate of non-relapse mortality. Our results in this difficult to treat patient population are encouraging and warrant further studies.
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Affiliation(s)
- Tim Richardson
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Christof Scheid
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Marco Herling
- Department of Hematology, Cellular Therapy, and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Lukas P Frenzel
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Carmen Herling
- Department of Hematology, Cellular Therapy, and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Marta Rebecca Cruz Aguilar
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Sebastian Theurich
- Department of Medicine III, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany
| | - Michael Hallek
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Udo Holtick
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
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3
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Gohil D, Gandhi KA, Gupta SK, Gera P, Yadav S, Patwardhan R, Checker R, Sharma D, Khattry N, Sandur S, Gota V. Immunomodulation by juglone alleviates acute graft-versus-host disease without compromising the graft-versus-leukaemia activity in mice. Br J Pharmacol 2024. [PMID: 38584000 DOI: 10.1111/bph.16350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 11/15/2023] [Accepted: 12/10/2023] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND AND PURPOSE Acute graft-versus-host disease (GVHD) remains a major barrier to successful transplantation outcomes. Recent studies have shown that pharmacotherapy for GVHD should target both the innate and adaptive inflammatory immune responses. Juglone, a redox-active phytochemical found in walnuts, has shown potent anti-inflammatory effects in models of colitis and inflammatory bowel disease. However, its effects on T-cell-mediated immune responses remain largely unknown. Considering the overlapping mediators of inflammation in GVHD and the aforementioned conditions, we investigated the use of juglone as a prophylactic agent for GVHD. EXPERIMENTAL APPROACH Immunomodulatory activity and mechanism of action of juglone were studied using murine splenic leukocytes in vitro. The GVHD prophylactic efficacy of orally administered juglone was evaluated using a murine model of allogeneic haematopoietic stem cell transplantation based on an MHC mismatch. KEY RESULTS Juglone exhibited immunomodulatory activity by (i) inhibiting the activation of dendritic cells and CD4+ T-cells, (ii) inhibiting cytokine secretion and lymphocyte proliferation, and (iii) inducing exhaustion of CD4+ T-cells, as shown by increased expression of CTLA-4 (CD152) and Fas (CD95). Oral administration of juglone significantly reduced mortality and morbidity associated with GVHD while maintaining graft-versus-leukaemia activity. This was accompanied by a decrease in the number of naïve CD4+ cells, and an increase in the number of CD4+ and CD8+ central memory T-cells. CONCLUSION AND IMPLICATIONS Juglone is a potent immunomodulator for GVHD prophylaxis. Our study is the first to provide a dosage framework for the oral administration of juglone that can be used for clinical development.
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Affiliation(s)
- Dievya Gohil
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
| | - Khushboo A Gandhi
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
| | - Saurabh Kumar Gupta
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
| | - Poonam Gera
- ICGC Lab, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Biorepository, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
| | - Subhash Yadav
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
- Department of Pathology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
| | - Raghavendra Patwardhan
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
- Radiation Biology & Health Science Division, Bio-science group, Bhabha Atomic Research Centre, Mumbai, India
| | - Rahul Checker
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
- Radiation Biology & Health Science Division, Bio-science group, Bhabha Atomic Research Centre, Mumbai, India
| | - Deepak Sharma
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
- Radiation Biology & Health Science Division, Bio-science group, Bhabha Atomic Research Centre, Mumbai, India
| | - Navin Khattry
- Department of Medical Oncology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
| | - Santosh Sandur
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
- Radiation Biology & Health Science Division, Bio-science group, Bhabha Atomic Research Centre, Mumbai, India
| | - Vikram Gota
- Department of Clinical Pharmacology, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Training School Complex, Homi Bhabha National Institute, Mumbai, India
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4
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Imataki O, Yoshida S, Ishida T, Fujita H, Uemura M. Graft-versus-host disease after autologous stem cell transplantation in a recipient who underwent allogeneic stem cell transplantation 20 years earlier. EJHaem 2024; 5:383-386. [PMID: 38633119 PMCID: PMC11020104 DOI: 10.1002/jha2.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
A literature review does not provide information about the safety of autologous hematopoietic stem cell transplantation (HSCT) in a recipient who has previously received allogeneic HSCT. We treated a 69-year-old woman with diffuse large B cell lymphoma. The patient received autologous stem cell transplantation (ASCT) in the second complete remission of malignant lymphoma. The patient had undergone allogeneic hematopoietic SCT (allo-HSCT) for chronic myeloid leukemia 20 years ago. Chronic myeloid leukemia had been in complete remission for the previous 20 years. Thus, the patient received autologous and allogenic HSCT 20 years apart. ASCT involves the patient receiving "self" hematopoietic cells from an allogeneic donor. In other words, this is immunologically the second allo-HSCT. The allo-HSCT 20 years ago was undergone by a related healthy brother, a human leukocyte antigen (HLA) 8/8 full matched donor. The conditioning regimen was reduced-intensity consisting of fludarabine and busulfan. The patient did not experience acute or chronic graft-versus-host disease (GVHD) after allo-HSCT. The second transplantation, ASCT was performed to the MEAM conditioning regimen. Engraftment was uneventful, and complete donor chimerism had been achieved even after ASCT. She suffered from an acute gastric mucosal lesion 52 days after ASCT. Pathological finding of gastric mucosa was nonspecific acute gastritis with significant neutrophil infiltration. Sex chromosome analysis of gastric mucosa demonstrated that mucosal cells had XX signals, whereas infiltrating neutrophils had XY signals. We speculated the patient onset of an acute gastric GVHD in this recipient after the second transplantation. This case remarked infiltration of neutrophils triggered GVHD reaction by resetting allogeneic immune reaction after the second transplantation. We describe a rare occurrence of GVHD reaction in a recipient of ASCT following allo-HSCT.
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Affiliation(s)
- Osamu Imataki
- Department of Internal MedicineDivision of HematologyFaculty of MedicineKagawa UniversityKagawaJapan
| | - Shunsuke Yoshida
- Department of Internal MedicineDivision of HematologyFaculty of MedicineKagawa UniversityKagawaJapan
| | - Tomoya Ishida
- Department of Internal MedicineDivision of HematologyFaculty of MedicineKagawa UniversityKagawaJapan
| | - Haruyuki Fujita
- Department of Internal MedicineDivision of HematologyFaculty of MedicineKagawa UniversityKagawaJapan
| | - Makiko Uemura
- Department of Internal MedicineDivision of HematologyFaculty of MedicineKagawa UniversityKagawaJapan
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5
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Bajonaid A, Guntaka PK, Harper M, Cutler C, Duncan C, Villa A, Sroussi HY, Woo SB, Treister NS. Characterization of orofacial features in sclerodermatous chronic graft-versus-host disease. Oral Dis 2024. [PMID: 38514965 DOI: 10.1111/odi.14932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/20/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Chronic graft-versus-host disease (cGVHD) is a leading cause of morbidity and mortality following allogeneic hematopoietic cell transplantation (alloHCT). The sclerodermatous form of cGVHD can be particularly debilitating; however, orofacial sclerodermatous involvement remains poorly described. OBJECTIVE To characterize orofacial features of sclerodermatous cGVHD in a single center cohort of patients who underwent alloHCT. STUDY DESIGN Retrospective data were collected from electronic medical records and analyzed descriptively. RESULTS There were 39 patients who received alloHCT between 1993 and 2017 and developed orofacial sclerodermatous cGVHD. Concomitant cutaneous sclerodermatous cGVHD was common (n = 20, 51%). Orofacial sclerodermatous cGVHD features included fibrous bands of the buccal mucosa (n = 23, 59%), limited mouth opening (n = 19, 54%), perioral fibrosis (n = 8, 21%), and focal gingival recession (n = 4, 10%). Oral mucosal fibrosis was observed at the site of active or resolved chronic lichenoid inflammation in 30 patients, with all but two also presenting with a history of ulcerations. Management included jaw stretching exercises (n = 10; 6 stable/improved), surgery (n = 3; 2 improved), and intralesional corticosteroid injections (n = 2; 2 improved). CONCLUSIONS Orofacial involvement with sclerodermatous cGVHD can present with multiple manifestations including fibrous banding, limited mouth opening, perioral fibrosis, and focal gingival recession. Surgical and non-surgical management strategies may improve clinical function and reduce morbidity.
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Affiliation(s)
- Amal Bajonaid
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | - Matthew Harper
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Dentistry, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Corey Cutler
- Division of Stem Cell Transplantation and Cellular Therapy, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Christine Duncan
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, California, USA
- Herbert Wertheim College of Medicine and Miami Cancer Institute, Miami, Florida, USA
| | - Hervé Y Sroussi
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sook-Bin Woo
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nathaniel S Treister
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts, USA
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6
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Akiyama S, Murayama C, Aizawa S, Mizushima A, Maeda Y, Taniguchi N, Nagai K, Harada T. Extremely late-onset chronic graft-versus-host disease presenting with bronchiolitis obliterans and pleuroparenchymal fibroelastosis. Respirol Case Rep 2023; 11:e01201. [PMID: 37534048 PMCID: PMC10390817 DOI: 10.1002/rcr2.1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Abstract
A 35-year-old woman experienced left back pain after a 2-h flight. She reported coughing and left back pain 1 day later when she presented to our hospital. Chest computed tomography showed pneumothorax of the left lung, bronchiectasis, thickening of the bronchial wall, nodules, and cavity lesions in both lungs. A pulmonary function test revealed obstructive ventilation disorder with normal lung diffusing capacity. She had a history of haematopoietic stem cell transplantation (HSCT) at 2 years and 3 months of age during the second disease remission of acute myeloid leukaemia. She was diagnosed with chronic graft-versus-host disease (cGVHD) presenting with bronchiolitis obliterans (BO) and pleuroparenchymal fibroelastosis (PPFE). To our knowledge, this is the first reported case of BO and PPFE diagnosed more than 30 years after HSCT.
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Affiliation(s)
- Sae Akiyama
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Chisa Murayama
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Saori Aizawa
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Arei Mizushima
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Yukiko Maeda
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Natsuko Taniguchi
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Katsura Nagai
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
| | - Toshiyuki Harada
- Center for Respiratory DiseasesJapan Community Healthcare Organization Hokkaido HospitalSapporoJapan
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7
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Tomomasa D, Isoda T, Mitsuiki N, Yamashita M, Morishita A, Tomoda T, Okano T, Endo A, Kamiya T, Yanagimachi M, Imai K, Kanegane H, Takagi M, Morio T. Successful ruxolitinib administration for a patient with steroid-refractory idiopathic pneumonia syndrome following hematopoietic stem cell transplantation: A case report and literature review. Clin Case Rep 2021; 9:e05242. [PMID: 34987813 PMCID: PMC8693824 DOI: 10.1002/ccr3.5242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/02/2021] [Accepted: 12/14/2021] [Indexed: 12/03/2022] Open
Abstract
Idiopathic pneumonia syndrome (IPS) is an acute lung complication observed after the early posthematopoietic stem cell transplantation (HSCT) period. Ruxolitinib was effective for a patient with myelodysplastic syndrome who developed severe IPS after second HSCT. No severe adverse effects were observed. Ruxolitinib may be an alternative choice for HSCT-related IPS.
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Affiliation(s)
- Dan Tomomasa
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Takeshi Isoda
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Noriko Mitsuiki
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Motoi Yamashita
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Aoi Morishita
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Takahiro Tomoda
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Tsubasa Okano
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Akifumi Endo
- Clinical Research CenterTokyo Medical and Dental UniversityTokyoJapan
| | - Takahiro Kamiya
- Clinical Research CenterTokyo Medical and Dental UniversityTokyoJapan
| | - Masakatsu Yanagimachi
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
- Department of Hematology and OncologyKanagawa Children's Medical CenterYokohamaJapan
| | - Kohsuke Imai
- Department of Community Pediatrics, Perinatal and Maternal MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Hirokazu Kanegane
- Department of Child Health and DevelopmentTokyo Medical and Dental UniversityTokyoJapan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental BiologyTokyo Medical and Dental UniversityTokyoJapan
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Gan Y, Zhang T, Chen X, Cao W, Lin L, Du L, Wang Y, Zhou F, He X, He Y, Gan J, Sheng H, Sorokin L, Shi Y, Wang Y. Steroids Enable Mesenchymal Stromal Cells to Promote CD8 + T Cell Proliferation Via VEGF-C. Adv Sci (Weinh) 2021; 8:2003712. [PMID: 34194927 PMCID: PMC8224440 DOI: 10.1002/advs.202003712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/27/2021] [Indexed: 05/07/2023]
Abstract
Mesenchymal stromal cells (MSCs) function as a formidable regulator of inflammation and tissue homeostasis and expanded MSCs are shown to be effective in treating various inflammatory diseases. Their therapeutic effects require the existence of certain inflammatory cytokines. However, in the absence of sufficient proinflammatory stimuli or in the presence of anti-inflammatory medications, MSCs are animated to promote immune responses and unable to alleviate inflammatory disorders. In this study, it is demonstrated that steroid co-administration interferes the efficacy of MSCs in treating acute graft-versus-host disease (aGvHD). Molecular analysis reveals that vascular endothelial growth factor C (VEGF-C) is highly induced in MSCs by steroids and TNFα and VEGF-C in turn promotes CD8+ T cell response. This immune promoting effect is abolished by blockade or specific genetic ablation of VEGFR3 in CD8+ T cells. Additionally, administration of VEGF-C alone exacerbates aGvHD progression through eliciting more vigorous CD8+ T cell activation and proliferation. Further studies demonstrate that VEGF-C augments the PI3K/AKT signaling process and the expression of downstream genes, such as Cyclin D1. Thus, the data demonstrate that steroids can reverse the immunosuppressive effect of MSCs via promoting VEGF-C-augmented CD8+ T cell response and provide novel information for designing efficacious MSC-based therapies.
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Affiliation(s)
- Yurun Gan
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Tao Zhang
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Xiaodong Chen
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Wei Cao
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Liangyu Lin
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Liming Du
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Yu Wang
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
| | - Fei Zhou
- Cyrus Tang Hematology CenterCollaborative Innovation Center of HematologyState Key Laboratory of Radiation Medicine and ProtectionCam‐Su Genomic Resources CenterSoochow UniversitySuzhouChina
| | - Xuefeng He
- The Third Affiliated Hospital of Soochow UniversityThe First Affiliated Hospital of Soochow UniversityState Key Laboratory of Radiation Medicine and ProtectionInstitutes for Translational MedicineSoochow University Medical CollegeSuzhouJiangsu215123China
| | - Yulong He
- Cyrus Tang Hematology CenterCollaborative Innovation Center of HematologyState Key Laboratory of Radiation Medicine and ProtectionCam‐Su Genomic Resources CenterSoochow UniversitySuzhouChina
| | - Jianhe Gan
- The Third Affiliated Hospital of Soochow UniversityThe First Affiliated Hospital of Soochow UniversityState Key Laboratory of Radiation Medicine and ProtectionInstitutes for Translational MedicineSoochow University Medical CollegeSuzhouJiangsu215123China
| | - Huiming Sheng
- Tongren HospitalShanghai Jiao Tong University School of MedicineShanghai200336China
| | - Lydia Sorokin
- Institute of Physiological Chemistry and PathobiochemistryUniversity of MuensterMuenster48149Germany
| | - Yufang Shi
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
- The Third Affiliated Hospital of Soochow UniversityThe First Affiliated Hospital of Soochow UniversityState Key Laboratory of Radiation Medicine and ProtectionInstitutes for Translational MedicineSoochow University Medical CollegeSuzhouJiangsu215123China
| | - Ying Wang
- CAS Key Laboratory of Tissue Microenvironment and TumorShanghai Institute of Nutrition and HealthUniversity of Chinese Academy of SciencesChinese Academy of SciencesShanghai200031China
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9
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Nguyen JT, Allen CT, Dodge JT, Van Doorslaer K, McBride AA, Pavletic SZ, Mays JW. HPV32-related Heck's disease in a chronic graft-versus-host disease patient with long-term successful KTP laser treatment: A rare case report. Clin Case Rep 2021; 9:e04253. [PMID: 34026202 PMCID: PMC8123741 DOI: 10.1002/ccr3.4253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/09/2022] Open
Abstract
We recently identified and treated a rare case of oral focal epithelial hyperplasia (FEH) in an adult patient with chronic graft-vs-host disease. This is the first report linking KTP laser therapy to successful long-term treatment HPV32 FEH.
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Affiliation(s)
- Joe Truong Nguyen
- Oral Immunobiology UnitNational Institute of Dental and Craniofacial ResearchNational Institutes of HealthBethesdaMDUSA
| | - Clint T. Allen
- Section on Translational Tumor ImmunologyNational Institute on Deafness and Other Communication DisordersNational Institutes of HealthBethesdaMDUSA
| | - Joshua T. Dodge
- Oral Immunobiology UnitNational Institute of Dental and Craniofacial ResearchNational Institutes of HealthBethesdaMDUSA
| | - Koenraad Van Doorslaer
- DNA Tumor Virus SectionLaboratory of Viral DiseasesNational Institute of Allergy and Infectious DiseasesBethesdaMDUSA
- VirologySchool of Animal and Comparative Biomedical SciencesThe University of Arizona. TucsonAZUSA
| | - Alison A. McBride
- DNA Tumor Virus SectionLaboratory of Viral DiseasesNational Institute of Allergy and Infectious DiseasesBethesdaMDUSA
| | - Steven Z. Pavletic
- Graft‐versus‐Host Disease and Late Effects SectionCenter for Cancer ResearchNational Cancer InstituteNational Institutes of HealthBethesdaMDUSA
| | - Jacqueline W. Mays
- Oral Immunobiology UnitNational Institute of Dental and Craniofacial ResearchNational Institutes of HealthBethesdaMDUSA
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10
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Gelbrich N, Stope MB, Bekeschus S, Weigel M, Burchardt M, Zimmermann U. BK virus-induced nephritis and cystitis after matched unrelated donor stem cell transplantation: A case report. Clin Case Rep 2020; 8:2839-2842. [PMID: 33363833 PMCID: PMC7752429 DOI: 10.1002/ccr3.3246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/22/2020] [Indexed: 01/01/2023] Open
Abstract
Currently, there is no standard therapy for a BK virus infection of the urogenital tract in immunocompromised, stem cell transplanted patients, so that early diagnosis and introduction of supportive measures have the highest response rates to date.
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Affiliation(s)
- Nadine Gelbrich
- Department of UrologyUniversity Medicine GreifswaldGreifswaldGermany
| | - Matthias B. Stope
- Department of Gynaecology and Gynaecological OncologyUniversity Medicine BonnBonnGermany
| | - Sander Bekeschus
- ZIK PlasmatisLeibniz Institute for Plasma Science and Technology (INP Greifswald)GreifswaldGermany
| | - Martin Weigel
- Department of Hematology and OncologyUniversity Medicine GreifswaldGreifswaldGermany
| | - Martin Burchardt
- Department of UrologyUniversity Medicine GreifswaldGreifswaldGermany
| | - Uwe Zimmermann
- Department of UrologyUniversity Medicine GreifswaldGreifswaldGermany
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11
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Sullivan LC, Shaw EM, Stankovic S, Snell GI, Brooks AG, Westall GP. The complex existence of γδ T cells following transplantation: the good, the bad and the simply confusing. Clin Transl Immunology 2019; 8:e1078. [PMID: 31548887 PMCID: PMC6748302 DOI: 10.1002/cti2.1078] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/05/2019] [Accepted: 08/05/2019] [Indexed: 12/14/2022] Open
Abstract
Gamma delta (γδ) T cells are a highly heterogeneous population of lymphocytes that exhibit innate and adaptive immune properties. Despite comprising the majority of residing lymphocytes in many organs, the role of γδ T cells in transplantation outcomes is under‐researched. γδ T cells can recognise a diverse array of ligands and exert disparate effector functions. As such, they may potentially contribute to both allograft acceptance and rejection, as well as impacting on infection and post‐transplant malignancy. Here, we review the current literature on the role and function of γδ T cells following solid organ and hematopoietic stem cell transplantation.
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Affiliation(s)
- Lucy C Sullivan
- Department of Microbiology and Immunology The University of Melbourne at The Peter Doherty Institute for Infection and Immunity Melbourne VIC Australia.,Lung Transplant Service The Alfred Hospital Melbourne VIC Australia
| | - Evangeline M Shaw
- Department of Microbiology and Immunology The University of Melbourne at The Peter Doherty Institute for Infection and Immunity Melbourne VIC Australia
| | - Sanda Stankovic
- Department of Microbiology and Immunology The University of Melbourne at The Peter Doherty Institute for Infection and Immunity Melbourne VIC Australia
| | - Gregory I Snell
- Lung Transplant Service The Alfred Hospital Melbourne VIC Australia
| | - Andrew G Brooks
- Department of Microbiology and Immunology The University of Melbourne at The Peter Doherty Institute for Infection and Immunity Melbourne VIC Australia
| | - Glen P Westall
- Lung Transplant Service The Alfred Hospital Melbourne VIC Australia
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12
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Meng L, Ji S, Wang Q, Bu B. Polymyositis as a manifestation of chronic graft-versus-host disease after allo-HSCT. Clin Case Rep 2018; 6:1723-1726. [PMID: 30214750 PMCID: PMC6132093 DOI: 10.1002/ccr3.1709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 06/03/2018] [Accepted: 06/21/2018] [Indexed: 01/08/2023] Open
Abstract
Patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) may develop T cell-mediated immunologic injury to muscles, recapitulating the characteristics of polymyositis clinically and pahtologically. Polymyositis is a rarely reported complication of graft-versus-host disease (GVHD), which often responds well to corticosteroids and immunosuppressive treatment.
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Affiliation(s)
- Lijuan Meng
- Department of NeurologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Suqiong Ji
- Department of NeurologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Qiong Wang
- Department of NeurologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Bitao Bu
- Department of NeurologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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13
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Ofosu A, Zabolotsky A, Rufail M, Spataro J, Civan J. Graft-versus-host disease, a rare complication after orthotopic liver transplantation. Clin Case Rep 2018; 6:238-239. [PMID: 29375877 PMCID: PMC5771921 DOI: 10.1002/ccr3.1314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 09/05/2017] [Accepted: 11/10/2017] [Indexed: 11/06/2022] Open
Abstract
Acute graft-versus-host disease (GVHD) after orthotopic liver transplantation (OLT) is a rare but fatal complication that poses a major diagnostic and therapeutic challenge. Our case highlights the need for further studies to develop therapeutic modalities to improve outcomes in patients who develop GHVD following OLT.
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Affiliation(s)
- Andrew Ofosu
- Division of Gastroenterology & Hepatology Department of Medicine Jefferson Digestive Health Institute Philadelphia Pennsylvania
| | - Andrew Zabolotsky
- Division of Gastroenterology & Hepatology Department of Medicine Jefferson Digestive Health Institute Philadelphia Pennsylvania
| | - Miguel Rufail
- Department of Pathology, Anatomy, and Cell Biology Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania
| | - Joseph Spataro
- Department of Medicine Thomas Jefferson University Hospital Philadelphia Pennsylvania
| | - Jesse Civan
- Division of Gastroenterology & Hepatology Department of Medicine Jefferson Digestive Health Institute Philadelphia Pennsylvania
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14
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Yang X, Liu C, Fujino M, Yang J, Li XK, Zou H. A modified graft-versus-host-induced model for systemic sclerosis, with pulmonary fibrosis in Rag2-deficient mice. FEBS Open Bio 2017; 7:1316-1327. [PMID: 28904861 PMCID: PMC5586340 DOI: 10.1002/2211-5463.12268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 11/10/2022] Open
Abstract
Systemic sclerosis (SSc) is a connective tissue disease that results in fibrosis in multiple organs. Various animal models for this disease have been developed, both genetic and induced. One of the induced models, sclerodermatous graft‐versus‐host disease (scl‐GvHD), exhibits the main characteristics of SSc, but involves lethal γ‐irradiation of recipients. We sought to develop a modified scl‐GvHD model. Spleen cells from B10.D2 donor mice were transplanted into immunodeficient Rag‐2 recipients on the BALB/c genetic background. Tissue fibrosis was analyzed at 3 and 9 weeks after transplantation. In addition to serum levels of anti‐Scl‐70 autoantibody and cytokines, tissue inflammation, fibrosis, expression of collagen‐I and α‐smooth muscle actin (α‐SMA), infiltration of leukocytes, mRNA expression of transforming growth factor (TGF)‐β, collagen‐I, α‐SMA, tumor necrosis factor (TNF)‐α, and interleukin (IL)‐6, the classical signal pathway of TGF‐β, Smad‐3, and p‐Smad‐3 expression in tissue were analyzed. Skin thickening and increased collagen synthesis, as well as the manifestation of tissue fibrosis, could be detected in skin, kidney, and lung of modified scl‐GvHD mouse model. Increased serum levels of anti‐Scl‐70 autoantibody, IL‐10, and TGF‐β could be detected. Increased CD4+ T cells and F4/80+ macrophage infiltration were found in skin, kidney, and lung. Gene expression of collagen‐I, TGF‐β, α‐SMA, TNF‐α, and IL‐6 was increased in tissue of the scl‐GvHD model. Moreover, TGF‐β expression and Smad‐3 phosphorylation were detected in skin, kidney, and lung of scl‐GvHD mice. Our data show that spleen cells from B10.D2 donor mice transplanted into immunodeficient Rag‐2 recipients could induce typical fibrosis not only of the skin and kidney but also of lung, which was missing from previous scl‐GvHD models. Thus, the modified scl‐GvHD model might be a promising model to explore the immunologic mechanisms of SSc and may be useful for investigation of new therapies for systemic sclerosis.
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Affiliation(s)
- Xue Yang
- Division of Rheumatology Huashan Hospital Fudan University Shanghai China.,Division of Transplantation Immunology National Research Institute for Child Health and Development Tokyo Japan.,Institute of Rheumatology, Immunology and Allergy Fudan University Shanghai China
| | - Chi Liu
- Division of Transplantation Immunology National Research Institute for Child Health and Development Tokyo Japan
| | - Masayuki Fujino
- Division of Transplantation Immunology National Research Institute for Child Health and Development Tokyo Japan.,AIDS Research Center National Institute of Infectious Diseases Tokyo Japan
| | - Ji Yang
- Department of Dermatology Zhongshan Hospital Fudan University Shanghai China
| | - Xiao-Kang Li
- Division of Transplantation Immunology National Research Institute for Child Health and Development Tokyo Japan.,Institute of Rheumatology, Immunology and Allergy Fudan University Shanghai China
| | - Hejian Zou
- Division of Rheumatology Huashan Hospital Fudan University Shanghai China.,Institute of Rheumatology, Immunology and Allergy Fudan University Shanghai China
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15
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Enriquez-Marulanda A, Sierra-Ruiz M, Jaramillo FJ, Escobar LA, Granados AM, Rodríguez-Rojas LX, Lees AJ, Orozco JL. Hemichoreo-hemibalism as a Manifestation of Central Nervous System Chronic Graft-versus-Host Disease. Mov Disord Clin Pract 2017; 4:495-498. [PMID: 30713967 DOI: 10.1002/mdc3.12497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/06/2017] [Accepted: 04/09/2017] [Indexed: 11/07/2022] Open
Affiliation(s)
| | | | | | - Luis Alberto Escobar
- Fundación Valle del Lili Cali Colombia.,Clinical Research Center Cali Colombia.,Universidad Icesi Cali Colombia
| | - Ana María Granados
- Fundación Valle del Lili Cali Colombia.,Clinical Research Center Cali Colombia.,Universidad Icesi Cali Colombia
| | | | - Andrew J Lees
- Department of Molecular Neuroscience Queen Square Brain Bank for Neurological Disorders University College London London United Kingdom
| | - Jorge Luis Orozco
- Fundación Valle del Lili Cali Colombia.,Clinical Research Center Cali Colombia.,Universidad Icesi Cali Colombia
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16
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Isernhagen A, Malzahn D, Viktorova E, Elsner L, Monecke S, von Bonin F, Kilisch M, Wermuth JM, Walther N, Balavarca Y, Stahl-Hennig C, Engelke M, Walter L, Bickeböller H, Kube D, Wulf G, Dressel R. The MICA-129 dimorphism affects NKG2D signaling and outcome of hematopoietic stem cell transplantation. EMBO Mol Med 2016; 7:1480-502. [PMID: 26483398 PMCID: PMC4644379 DOI: 10.15252/emmm.201505246] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The MHC class I chain-related molecule A (MICA) is a highly polymorphic ligand for the activating natural killer (NK)-cell receptor NKG2D. A single nucleotide polymorphism causes a valine to methionine exchange at position 129. Presence of a MICA-129Met allele in patients (n = 452) undergoing hematopoietic stem cell transplantation (HSCT) increased the chance of overall survival (hazard ratio [HR] = 0.77, P = 0.0445) and reduced the risk to die due to acute graft-versus-host disease (aGVHD) (odds ratio [OR] = 0.57, P = 0.0400) although homozygous carriers had an increased risk to experience this complication (OR = 1.92, P = 0.0371). Overall survival of MICA-129Val/Val genotype carriers was improved when treated with anti-thymocyte globulin (HR = 0.54, P = 0.0166). Functionally, the MICA-129Met isoform was characterized by stronger NKG2D signaling, triggering more NK-cell cytotoxicity and interferon-γ release, and faster co-stimulation of CD8+ T cells. The MICA-129Met variant also induced a faster and stronger down-regulation of NKG2D on NK and CD8+ T cells than the MICA-129Val isoform. The reduced cell surface expression of NKG2D in response to engagement by MICA-129Met variants appeared to reduce the severity of aGVHD.
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Affiliation(s)
- Antje Isernhagen
- Institute of Cellular and Molecular Immunology, University Medical Center Göttingen, Göttingen, Germany
| | - Dörthe Malzahn
- Institute of Genetic Epidemiology, University Medical Center Göttingen, Göttingen, Germany
| | - Elena Viktorova
- Institute of Genetic Epidemiology, University Medical Center Göttingen, Göttingen, Germany
| | - Leslie Elsner
- Institute of Cellular and Molecular Immunology, University Medical Center Göttingen, Göttingen, Germany
| | - Sebastian Monecke
- Institute of Cellular and Molecular Immunology, University Medical Center Göttingen, Göttingen, Germany
| | - Frederike von Bonin
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Markus Kilisch
- Institute of Molecular Biology, University Medical Center Göttingen, Göttingen, Germany
| | - Janne Marieke Wermuth
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Neele Walther
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Yesilda Balavarca
- Institute of Genetic Epidemiology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Michael Engelke
- Institute of Cellular and Molecular Immunology, University Medical Center Göttingen, Göttingen, Germany
| | - Lutz Walter
- Primate Genetics Laboratory, German Primate Center, Göttingen, Germany
| | - Heike Bickeböller
- Institute of Genetic Epidemiology, University Medical Center Göttingen, Göttingen, Germany
| | - Dieter Kube
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Gerald Wulf
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Ralf Dressel
- Institute of Cellular and Molecular Immunology, University Medical Center Göttingen, Göttingen, Germany
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17
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Sang W, Wang Y, Zhang C, Yan D, Niu M, Yang C, Liu X, Sun C, Zhang Z, Loughran TP, Xu K. Fludarabine, idarubicin, and cytarabine regimen together with TKI followed by haploidentical hematopoietic stem cell transplantation, a success for relapsed Ph+ acute lymphoblastic leukemia. Clin Case Rep 2016; 4:390-5. [PMID: 27099735 PMCID: PMC4831391 DOI: 10.1002/ccr3.438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/07/2015] [Accepted: 10/07/2015] [Indexed: 11/11/2022] Open
Abstract
In this report, a case of relapsed Ph+ ALL was remedied by reinduction, and consolidation regimen of TKI and Flu+ Ara-C+ IDA (FLAI) combination, followed by haploidentical SCT. Results suggest that FLAI together with TKI and subsequently with haploidentical SCT could be applied for relapsed Ph+ ALL.
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Affiliation(s)
- Wei Sang
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Ying Wang
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Cong Zhang
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Dongmei Yan
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Mingshan Niu
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Chun Yang
- Department of Radiology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Xia Liu
- Department of Pathology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Cai Sun
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Zhe Zhang
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
| | - Thomas P Loughran
- Department of Medicine University of Virginia Cancer Center Charlottesville Virginia
| | - Kailin Xu
- Department of Hematology Affiliated Hospital of Xuzhou Medical College Xuzhou China
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18
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Sellami MH, Torjemane L, Arias AED, Kaabi H, Ladeb S, Poli F, Othmane TB, Hmida S. Does minor histocompatibility antigen HA-1 disparity affect the occurrence of graft-versus-host disease in tunisian recipients of hematopoietic stem cells? Clinics (Sao Paulo) 2010; 65:1099-103. [PMID: 21243279 PMCID: PMC2999702 DOI: 10.1590/s1807-59322010001100007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 07/26/2010] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Minor histocompatibility antigen HA-1 (MiHAg-HA-1) disparity between a patient and his or her human leukocyte antigen (HLA) genoidentical donor has been widely associated with an increased risk of graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. OBJECTIVE To examine the effect of HA-1 disparity on the incidence of both acute and chronic graft-versus-host disease in Tunisian recipients of hematopoietic stem cells. METHODS A total of 60 patients and their 60 respective sibling hematopoietic stem cell donors were enrolled in this study. All patients prophylactically received cyclosporine A and/or methotrexate for graft-versus-host disease. An HA-1 genotyping assay was performed with the SSP-PCR method, and HLA-A*0201- and/or HLA-A*0206-positive samples were identified using the Luminex HLA typing method. RESULTS The Luminex HLA typing assay showed that 54 patients were positive for either the HLA-A*0201 or HLA-A*0206 alleles. Among these cases, six pairs were mismatched for MiHAg-HA-1. Both acute and chronic graft-versus-host disease occurred in four mismatched patients (Fisher's p-values were 0.044 and 0.170, respectively). A univariate logistic regression model analysis showed that only acute graft-versus-host disease may be affected by recipient MiHAg-HA-1 disparity (p: 0.041, OR: 6.727), while chronic graft-versus-host disease correlates with both age and recipient/donor sex mismatch (p: 0.014, OR: 8.556 and p: 0.033, OR: 8.664, respectively). CONCLUSION Our findings support previously reported data suggesting a significant association between HA-1 disparity and the risk of acute graft-versus-host disease following hematopoietic stem cell transplantation.
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