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Extracoporeal photopheresis treatment of acute graft-versus-host disease following allogeneic haematopoietic stem cell transplantation [version 1; referees: 2 approved]

Lookup NU author(s): Dr Aisling Flinn, Professor Andrew GenneryORCiD

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Abstract

© 2016 Flinn AM and Gennery AR. Acute graft-versus-host disease (aGvHD) continues to be a major obstacle to allogeneic haematopoietic stem cell transplantation. Thymic damage secondary to aGvHD along with corticosteroids and other non-selective T lymphocyte-suppressive agents used in the treatment of aGvHD concurrently impair thymopoiesis and negatively impact on immunoreconstitution of the adaptive immune compartment and ultimately adversely affect clinical outcome. Extracorporeal photopheresis (ECP) is an alternative therapeutic strategy that appears to act in an immunomodulatory fashion, potentially involving regulatory T lymphocytes and dendritic cells. By promoting immune tolerance and simultaneously avoiding systemic immunosuppression, ECP could reduce aGvHD and enable a reduction in other immunosuppression, allowing thymic recovery, restoration of normal T lymphopoiesis, and complete immunoreconstitution with improved clinical outcome. Although the safety and efficacy of ECP has been demonstrated, further randomised controlled studies are needed as well as elucidation of the underlying mechanisms responsible and the effect of ECP on thymic recovery.

Publication metadata

Author(s): Flinn AM, Gennery AR

Publication type: Review

Publication status: Published

Journal: F1000Research

Year: 2016

Volume: 5

Online publication date: 27/06/2016

Acceptance date: 02/04/2016

ISSN (print): 2046-1402

ISSN (electronic): 1759-796X

Publisher: Faculty of 1000 Ltd

URL: http://doi.org/10.12688/F1000RESEARCH.8118.1

DOI: 10.12688/F1000RESEARCH.8118.1

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