The role of B cells in the pathogenesis of graft-versus-host disease.
Allogeneic hematopoietic stem cell transplantation is an established treatment modality for malignant and nonmalignant hematologic diseases. Acute and chronic graft-versus-host diseases (GVHDs) are a major cause of morbidity and mortality after allogeneic stem cell transplantation. T cells have been identified as key players in the graft-versus-host reaction and, therefore, most established drugs used against GVHD target T cells. Despite our knowledge on the pathogenesis of the GVH reaction, success of established therapies for prevention and treatment of GHVD is unsatisfactory. Recently, animal and human studies demonstrated that B cells are involved in the immunopathophysiology of acute and chronic GVHD. Early phase clinical trials of B-cell depletion with rituximab have shown beneficial effects on both acute and chronic GVHD. This review summarizes the current experimental and clinical evidence for the involvement of B cells in the pathogenesis of acute and chronic GVHD and discusses the clinical implications for the management of patients undergoing allogeneic stem cell transplantation.
Shimabukuro-Vornhagen
Alexander
A
Laboratory for Tumor and Transplantation Immunology, Stem Cell Transplantation Program and Max Eder Junior Research Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
Hallek
Michael J
MJ
Storb
Rainer F
RF
von Bergwelt-Baildon
Michael S
MS
D000818:Animals; D001402:B-Lymphocytes / Q000276:immunology*; D006086:Graft vs Host Disease / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans