[HTML][HTML] Chronic graft-versus-host disease after granulocyte colony-stimulating factor-mobilized allogeneic stem cell transplantation: the role of donor T-cell dose and …

KPA MacDonald, V Rowe, C Filippich… - Biology of Blood and …, 2004 - Elsevier
KPA MacDonald, V Rowe, C Filippich, D Johnson, ES Morris, AD Clouston, JLM Ferrara…
Biology of Blood and Marrow Transplantation, 2004Elsevier
The use of granulocyte colony-stimulating factor (G-CSF)–mobilized peripheral blood as a
source of stem cells has resulted in a high incidence of severe chronic graft-versus-host
disease (cGVHD), which compromises the outcome of clinical allogeneic stem cell
transplantation. We have studied the effect of G-CSF on both immune complex and fibrotic
cGVHD directed to major (DBA/2→ B6D2F1) or minor (B10. D2→ BALB/c) histocompatibility
antigens. In both models, donor pretreatment with G-CSF reduced cGVHD mortality in …
The use of granulocyte colony-stimulating factor (G-CSF)–mobilized peripheral blood as a source of stem cells has resulted in a high incidence of severe chronic graft-versus-host disease (cGVHD), which compromises the outcome of clinical allogeneic stem cell transplantation. We have studied the effect of G-CSF on both immune complex and fibrotic cGVHD directed to major (DBA/2 → B6D2F1) or minor (B10.D2 → BALB/c) histocompatibility antigens. In both models, donor pretreatment with G-CSF reduced cGVHD mortality in association with type 2 differentiation. However, after escalation of the donor T-cell dose, scleroderma occurred in 90% of the recipients of grafts from G-CSF-treated donors. In contrast, only 11% of the recipients of control grafts developed scleroderma, and the severity of hepatic cGVHD was also reduced. Mixing studies confirmed that in the presence of high donor T-cell doses, the severity of scleroderma was determined by the non-T-cell fraction of grafts from G-CSF-treated donors. These data confirm that the induction of cGVHD after donor treatment with G-CSF is dependent on the transfer of large numbers of donor T cells in conjunction with a putatively expanded myeloid lineage, providing a further rationale for the limitation of cell dose in allogeneic stem cell transplantation.
Elsevier