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

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

ABSTRACT

Chronic graft-versus-host disease (cGVHD) is a serious complication in long-term survivors of allogeneic hematopoietic stem cell transplantation (HSCT), with several organ systems affected. cGVHD is an important cause of morbidity and mortality in allogeneic HSCT. This article reviews the pathogenesis of cGVHD. In particularly, the role of B cells in cGVHD 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 cGVHD patients in 24 studies, and 8 autoantibodies and 5 alloantibodies seemed to be strongly associated with cGVHD. In addition, various studies have observed significant improvements in cGVHD 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 cGVHD. Further research is required to clarify the pathogenesis of cGVHD.

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