Haematologica
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Published online 25 August 2008
Haematologica, Vol 93, Issue 11, 1702-1711 doi:10.3324/haematol.13311
Copyright © 2008 by Ferrata Storti Foundation
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Progress in Hematology

B-cell involvement in chronic graft-versus-host disease

Rick Kapur1, Saskia Ebeling2, Anton Hagenbeek3

1 School for Utrecht Medical Masters (SUMMA), University Medical Center Utrecht, Utrecht
2 Department of Immunology, University Medical Center Utrecht, Utrecht and
3 Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands

Correspondence: Anton Hagenbeek, Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands. E-mail:a.hagenbeek{at}umcutrecht.nl

Chronic graft-versus-host disease is a serious complication in long-term survivors of allogeneic hematopoietic stem cell transplantation, with several organ systems affected. Chronic graft-versus-host disease is an important cause of morbidity and mortality in allogeneic hematopoietic stem cell transplantation. This article reviews the pathogenesis of chronic graft-versus-host disease. In particularly, the role of B cells in chronic graft-versus-host disease is evaluated, as is evident from several studies which have investigated the presence of antibodies as well as studies which have analyzed B cells as a target for immunotherapy. Thirty autoantibodies and 5 alloantibodies have been identified in chronic graft-versus-host disease patients in 24 studies, and 8 autoantibodies and 5 alloantibodies seemed to be strongly associated with chronic graft-versus-host disease. In addition, various studies have observed significant improvements in chronic graft-versus-host disease using the anti-CD20+ antibody rituximab. However, it appears to be highly likely that both B cells as well as T cells are of major importance in chronic graft-versus-host disease. Further research is required to clarify the pathogenesis of chronic graft-versus-host disease.

Key words: B cells, chronic graft-versus-host disease, autoantibodies, rituximab.






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