BACKGROUND: One proposed mechanism of extracorporeal photopheresis (ECP) in reducing chronic graft-versus-host disease (cGVHD) is alteration in numbers of circulating dendritic cells (DCs). This hypothesis was tested by correlating numbers of DC precursors and T cells in the blood before and during ECP therapy with response of cGVHD. STUDY DESIGN AND METHODS: Twenty-five patients with cGVHD were treated with ECP. Data were collected with emphasis on blood cellular markers, clinical response to ECP, and overall survival. RESULTS: Fourteen patients (56%) responded and had better 2-year survival than nonresponders (88% vs. 18%, p=0.003). Responders had higher baseline circulating myeloid DC (mDC) and plasmacytoid DC precursors and CD4+ and CD8+ T cells compared with nonresponders. Receiver operating characteristic curve analyses showed that the best baseline cutoff values to predict response to ECP were mDC counts of 3.7 cells/µL (79% sensitivity, 82% specificity) and CD4+ T-cell counts of 104 cells/µL (71% sensitivity, 82% specificity). CD4+ T cells declined in responders over time, but not in nonresponders, and no significant changes were seen in CD8 T-cell or DC numbers over a 12-month period in responder or nonresponder groups. CONCLUSIONS: Higher baseline numbers of circulating DCs and T cells may predict clinical response to ECP in patients with cGVHD.
BACKGROUND: One proposed mechanism of extracorporeal photopheresis (ECP) in reducing chronic graft-versus-host disease (cGVHD) is alteration in numbers of circulating dendritic cells (DCs). This hypothesis was tested by correlating numbers of DC precursors and T cells in the blood before and during ECP therapy with response of cGVHD. STUDY DESIGN AND METHODS: Twenty-five patients with cGVHD were treated with ECP. Data were collected with emphasis on blood cellular markers, clinical response to ECP, and overall survival. RESULTS: Fourteen patients (56%) responded and had better 2-year survival than nonresponders (88% vs. 18%, p=0.003). Responders had higher baseline circulating myeloid DC (mDC) and plasmacytoid DC precursors and CD4+ and CD8+ T cells compared with nonresponders. Receiver operating characteristic curve analyses showed that the best baseline cutoff values to predict response to ECP were mDC counts of 3.7 cells/µL (79% sensitivity, 82% specificity) and CD4+ T-cell counts of 104 cells/µL (71% sensitivity, 82% specificity). CD4+ T cells declined in responders over time, but not in nonresponders, and no significant changes were seen in CD8 T-cell or DC numbers over a 12-month period in responder or nonresponder groups. CONCLUSIONS: Higher baseline numbers of circulating DCs and T cells may predict clinical response to ECP in patients with cGVHD.
Authors: H T Greinix; G Socié; A Bacigalupo; E Holler; M G Edinger; J F Apperley; T Schwarz; S E Ullrich; M L Albert; R M Knobler; D Peritt; J L M Ferrara Journal: Bone Marrow Transplant Date: 2006-08 Impact factor: 5.483
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Authors: N Apisarnthanarax; M Donato; M Körbling; D Couriel; J Gajewski; S Giralt; I Khouri; C Hosing; R Champlin; M Duvic; P Anderlini Journal: Bone Marrow Transplant Date: 2003-03 Impact factor: 5.483
Authors: R Edelson; C Berger; F Gasparro; B Jegasothy; P Heald; B Wintroub; E Vonderheid; R Knobler; K Wolff; G Plewig Journal: N Engl J Med Date: 1987-02-05 Impact factor: 91.245
Authors: Petros Athanassopoulos; Leonard M B Vaessen; Alex P W M Maat; Aggie H M M Balk; Willem Weimar; Ad J J C Bogers Journal: Eur J Cardiothorac Surg Date: 2004-04 Impact factor: 4.191
Authors: Edmund K Waller; Brent R Logan; Mingwei Fei; Stephanie J Lee; Dennis Confer; Alan Howard; Shanmuganathan Chandrakasan; Claudio Anasetti; Shanelle M Fernando; Cynthia R Giver Journal: Blood Adv Date: 2019-08-13