The role of B cells in the pathogenesis of graft-versus-host disease

A Shimabukuro-Vornhagen, MJ Hallek… - Blood, The Journal …, 2009 - ashpublications.org
A Shimabukuro-Vornhagen, MJ Hallek, RF Storb, MS von Bergwelt-Baildon
Blood, The Journal of the American Society of Hematology, 2009ashpublications.org
Allogeneic hematopoietic stem cell transplantation is an established treatment modality for
malignant and nonmalignant hematologic diseases. Acute and chronic graft-versus-host
diseases (GVHDs) are a major cause of morbidity and mortality after allogeneic stem cell
transplantation. T cells have been identified as key players in the graft-versus-host reaction
and, therefore, most established drugs used against GVHD target T cells. Despite our
knowledge on the pathogenesis of the GVH reaction, success of established therapies for …
Abstract
Allogeneic hematopoietic stem cell transplantation is an established treatment modality for malignant and nonmalignant hematologic diseases. Acute and chronic graft-versus-host diseases (GVHDs) are a major cause of morbidity and mortality after allogeneic stem cell transplantation. T cells have been identified as key players in the graft-versus-host reaction and, therefore, most established drugs used against GVHD target T cells. Despite our knowledge on the pathogenesis of the GVH reaction, success of established therapies for prevention and treatment of GHVD is unsatisfactory. Recently, animal and human studies demonstrated that B cells are involved in the immunopathophysiology of acute and chronic GVHD. Early phase clinical trials of B-cell depletion with rituximab have shown beneficial effects on both acute and chronic GVHD. This review summarizes the current experimental and clinical evidence for the involvement of B cells in the pathogenesis of acute and chronic GVHD and discusses the clinical implications for the management of patients undergoing allogeneic stem cell transplantation.
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