Extracorporeal photopheresis in solid organ transplant-associated acute graft-versus-host disease

Transfusion
Brett L HoustonChristine M Cserti-Gazdewich

Abstract

Extracorporeal photopheresis (ECP) culls pathogenic T lymphocytes, be these the clones of cutaneous T-cell lymphoma, or mediators of chronic graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT-GVHD). Whether or not ECP may have an effect in the rarer instances of solid organ transplantation-associated GVHD (SOT-GVHD) is unclear. Mortality rates in SOT-GVHD rival those of transfusion-associated GVHD, with fatalities preceded by pancytopenia and peripheral blood chimerism (PBC) levels exceeding 20%. ECP has been described in two SOT-GVHD cases to date, with one surviving. Clinicolaboratory features (including HLA relationships) in a case of multivisceral transplantation were reviewed from the time of surgery to the onset and progression of SOT-GVHD. ECP, which was introduced as a less immunosuppressive and more selective intervention, was assessed for its effect on serial PBC (as measured by short-tandem-repeat analysis) and clinical outcome. Multivisceral SOT-GVHD manifested with erythroderma, neutropenic sepsis, and PBC increasing from 6% on Posttransplant Day (PTD) 38 to 78% by PTD 60 (at a doubling time of 6 days despite corticosteroids). ECP was administered on PTDs 62 and 67 and was associated...Continue Reading

References

Sep 22, 1994·The New England Journal of Medicine·S TakemotoJ M Cecka
Aug 1, 1993·Journal of the American Academy of Dermatology·P RedondoJ Prieto
Sep 23, 1997·The American Journal of Surgical Pathology·S KohlerB R Smoller
Jan 25, 2003·Transplantation·Douglas M SmithGoran Klintmalm
Aug 17, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·George V MazariegosJorge Reyes
Nov 24, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R Domiati-SaadD M Smith
Dec 31, 2005·Journal of the American Society of Nephrology : JASN·Emilio D PoggioPeter S Heeger
Dec 29, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Srinath ChinnakotlaGoran B Klintmalm
Feb 13, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Sven KohlerPeter Neuhaus
Sep 4, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Nina WorelGottfried J Locker
Mar 3, 2009·Inflammatory Bowel Diseases·Hideo Yoshida, D Neil Granger
Oct 20, 2009·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Mahnaz Fatahzadeh
Nov 20, 2009·The New England Journal of Medicine·Clara Abraham, Judy H Cho
Nov 30, 2011·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Panayotis Kaloyannidis, Despina Mallouri
Oct 17, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Richard S MangusRodrigo M Vianna
Oct 30, 2012·Transfusion Medicine Reviews·Evan M BlochMichael P Busch
Jan 1, 2013·Annals of Transplantation : Quarterly of the Polish Transplantation Society·Amit SharmaKamar Godder
Jul 3, 2013·Transplant Infectious Disease : an Official Journal of the Transplantation Society·J PrimeggiaJ G Timpone
Sep 21, 2013·Blood·Judith C W Marsh, Austin G Kulasekararaj
Oct 2, 2013·Therapeutic Advances in Hematology·James W HartAmin M Alousi
Dec 10, 2013·Hematology·Judith C W Marsh, Austin G Kulasekararaj
Apr 29, 2014·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Peter Jaksch, Robert Knobler
May 16, 2014·Journal of Clinical Apheresis·Marisa B Marques, Jill Adamski
Jul 11, 2014·World Journal of Gastroenterology : WJG·Sait Murat DoğanCezmi Karaca
Aug 5, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H M Gebel, R A Bray
Sep 16, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A P RossiD C Brennan
Nov 16, 2014·Blood·Mary E D Flowers, Paul J Martin
Mar 26, 2015·Journal of the American Society of Nephrology : JASN·Ana Konvalinka, Kathryn Tinckam
May 2, 2015·Blood·Ilana KopolovicJeannie Callum

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.