title: Extracorporeal photopheresis in refractory chronic graft-versus-host disease: the influence on peripheral blood T cell subpopulations. A study by the Hellenic Association of Hematology.
abstract: Extracorporeal photopheresis (ECP) has been established as an effective treatment modality for patients with chronic extensive graft-versus host disease (GVHD). In the present study, we evaluated the influence of ECP on the numbers of CD4+, CD8+, CD20+, CD56+ cells, and on T-regulatory (Tregs), as well as on the numbers of naïve, central memory (CM), and effector memory (EM) T-cells in patients treated for refractory chronic GVHD. Flow cytometric analysis of peripheral blood lymphocytes was performed for the calculation of the different T-cell subsets. Patients with GVHD had a higher percentage of EM-CD4+ cells in comparison with healthy donors (p=0.046). The percentages of naïve-CD8+, naïve-CD4+, CM-CD8+, CM-CD4+, EM-CD8+, and Tregs were not different between patients with GVHD and healthy donors. Similarly there was no statistical difference in the percentages of naïve, CM, and EM CD4+ and CD8+ cells before and after 3 months of treatment with ECP. However, in the subset of Tregs a statistically significant increase was observed after 3 months of treatment with ECP (p=0.015). Responders to ECP had statistically significantly higher absolute numbers of CD4+, and CD8+ cells, in comparison with non-responders. These data further support the concept that ECP does not cause immune-suppression, but should be better considered as an immune-modulating treatment.
authors: 2nd Department of Internal Medicine, "ATTIKON" General University Hospital, Medical School, University of Athens, Greece. panagtsirigotis@gmail.com
authors: Panagiotis
authors: P
authors: Tsirigotis
authors: Violetta
authors: V
authors: Kapsimalli
authors: Ioannis
authors: I
authors: Baltadakis
authors: Panayotis
authors: P
authors: Kaloyannidis
authors: Dimitrios
authors: D
authors: Karakasis
authors: Apostolia
authors: A
authors: Papalexandri
authors: Ekaterini
authors: E
authors: Psarra
authors: Efi
authors: E
authors: Nosi
authors: Evi
authors: E
authors: Konsta
authors: Myrofora
authors: M
authors: Vikentiou
authors: Sotirios
authors: S
authors: Papageorgiou
authors: Ioanna
authors: I
authors: Sakellari
authors: Vassiliki
authors: V
authors: Pappa
authors: Nikolaos
authors: N
authors: Harhalakis
authors: Achilles
authors: A
authors: Anagnostopoulos
authors: John
authors: J
authors: Dervenoulas
mesh_terms: D018414:CD8-Positive T-Lymphocytes; D015331:Cohort Studies; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood* / Q000628:therapy*; D006405:Hematology; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D017893:Photopheresis / Q000379:methods*; D012955:Societies, Medical; D050378:T-Lymphocytes, Regulatory; D013997:Time Factors