Biomarker profile predicts clinical efficacy of extracorporeal photopheresis in steroid‐resistant acute and chronic graft‐vs‐host disease after allogenic hematopoietic stem cell transplant
| Autor: | Francisco Martínez-Ruiz, Maria Cruz Viguria, Andreu Martínez, Juan Carlos Hernández-Boluda, Olga López, Inmaculada Heras, Rosa Goterris, Ariadna Pérez, Paula Amat, Lucía López-Corral, Carlos Solano, Cristina Arbona |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty CD3 Graft vs Host Disease Disease 030204 cardiovascular system & hematology T-Lymphocytes Regulatory Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine immune system diseases Internal medicine Extracorporeal Photopheresis medicine Humans Transplantation Homologous Prospective Studies IL-2 receptor Aged Response rate (survey) biology business.industry Hematopoietic Stem Cell Transplantation Hematopoietic stem cell Hematology General Medicine Middle Aged Treatment Outcome surgical procedures operative medicine.anatomical_structure Photopheresis biology.protein Cytokines Biomarker (medicine) Female Steroids business Biomarkers CD8 030215 immunology |
| Zdroj: | Journal of Clinical Apheresis. 36:697-710 |
| ISSN: | 1098-1101 0733-2459 |
| DOI: | 10.1002/jca.21918 |
| Popis: | We conducted a multicenter interventional study to assess the efficacy of Therakos ECP to treat steroid-resistant graft-vs-host disease (SRes-GVHD) after allogeneic HSCT and to identify biomarkers of GVHD response. A total of 62 patients were treated for acute SRes-GVHD (n = 37) or chronic SRes-GVHD (n = 25). Median time to best response was 35 days (range, 28-85) and 90 days (range, 27-240) in acute and chronic SRes-GVHD, respectively. Overall, 27 patients (72.9%) with SRes-aGVHD responded to treatment (40.5% CR and 32.4% PR). The response rate was significantly higher in grade I-II than in grade III-IV aGVHD (100% vs 50.0%, respectively, P-value = .001). In chronic SRes-GVHD, 22 patients (88%) achieved a clinical response (24.0% CR and 64% PR). Response was higher in moderate than in severe SRes-cGVHD (100% vs 75%, P = .096). In both acute and chronic SRes-GVHD patients, the percentage of peripheral blood CD3+ CD4+ was higher and CD3+ CD8+ lower in responding than nonresponding patients. Acute SRes-GVHD responding patients presented a higher number of Treg cells (CD4+ CD25+ CD127low/- ) at day 0 (P = .028) than nonresponding patients, differences that were maintained over the observation period. Phenotypic analysis of T-cell maturation showed a trend toward reduction in TCD8 naive cells, along with an increased percentage of TCD8 Mem Efect T cells after starting ECP in responding patients. None of the studied serum cytokines displayed statistically significant changes in either acute or chronic SRes-GVHD. ECP is an effective treatment for patients with SRes-GVHD. Biomarkers could help guide decision-making on ECP treatment initiation and duration. |
| Databáze: | OpenAIRE |
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