Acute graft-versus-host disease: new treatment strategies.

Abstract:

PURPOSE OF REVIEW:Graft-versus-host disease (GVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT), despite improvements in our understanding of its pathophysiology as well as the generation of new monoclonal antibodies, immunomodulatory chemotherapy, cellular therapeutics and supportive care. Herein, we review therapies that have proven effective as well as newer agents that have recently improved GVHD response rates and survival following HCT. RECENT FINDINGS:Novel approaches to prevent or treat GVHD are often based on evidence from experimental models. Our understanding of the pathophysiology of GVHD may lead to the development of innovative strategies that target both soluble and cellular effectors. Among such agents are sirolimus, anti-tumor necrosis factor antibodies, anti-LFA-3-IgG fusion protein, extracorporeal photopheresis, mesenchymal stem cells and regulatory T cells. SUMMARY:Obstacles to the improvement of HCT include the tight linkage between GVHD toxicity and the beneficial graft-versus-leukemia (GVL) effect, as well as the impairment of immune reconstitution by immunomodulatory drugs leading to life-threatening infections. The design of newer phase I/II clinical trials are underway. Future therapies are likely to include modulation of cell types that play key roles in the GVH process, including regulatory T cells, dendritic cells, natural killer T cells and B cells.

journal_name

Curr Opin Hematol

authors

Paczesny S,Choi SW,Ferrara JL

doi

10.1097/MOH.0b013e3283319a6f

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

427-36

issue

6

eissn

1065-6251

issn

1531-7048

journal_volume

16

pub_type

杂志文章,评审
  • Platelets, leukocytes, and coagulation.

    abstract::Considerable data now support the hypothesis that platelets actively regulate the propagation of coagulation by (1) expressing specific, high-affinity receptors for coagulation proteases, zymogens, and cofactors; (2) protecting the bound coagulation enzymes from inactivation/inhibition; (3) restricting coagulant activ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200109000-00001

    authors: Bouchard BA,Tracy PB

    更新日期:2001-09-01 00:00:00

  • Transfusion triggers for blood components.

    abstract::Whereas there are general guidelines for acceptable transfusion therapy, optimal transfusion therapy has not been determined for most clinical settings. Recent research has focused on controlled studies of red cell transfusion in specific clinical settings. Better determinations of oxygen delivery and consumption are ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章

    doi:10.1097/00062752-200111000-00012

    authors: Clark P,Mintz PD

    更新日期:2001-11-01 00:00:00

  • Congenital dysfibrinogenemia.

    abstract::Fibrinogen abnormalities can be classified as congenital or acquired. Each class manifests quantitative or qualitative alterations; the latter are known as dysfibrinogenemias. In dysfibrinogenemias, structural defects cause alterations in the conversion of fibrinogen to fibrin. Approximately 300 abnormal fibrinogens h...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199704050-00010

    authors: Martinez J

    更新日期:1997-09-01 00:00:00

  • Regulation and function of hematopoietic stem cells.

    abstract::Hematopoietic stem cells, defined as cells with extensive self-renewal and pluripotent differentiation potential, represent a minor population of adult bone marrow (< 1 in 10(4) to 10(5) nucleated marrow cells). Recent advances in cell surface phenotype analysis and separation technology have permitted enrichment of h...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:

    authors: Moore MA,Shapiro F

    更新日期:1994-05-01 00:00:00

  • Regulation of endothelial and hematopoietic development by the ETS transcription factor Etv2.

    abstract:PURPOSE OF REVIEW:Vasculogenesis and hematopoiesis are essential for development. Recently, the ETS domain transcription factor Etv2 has been identified as an essential regulator of vasculogenesis and hematopoiesis. Here, we review the recent studies that have established the critical role of Etv2 in the specification ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3283523e07

    authors: Lammerts van Bueren K,Black BL

    更新日期:2012-05-01 00:00:00

  • Regulation of alternative pre-mRNA splicing during erythroid differentiation.

    abstract::Although the mature enucleated erythrocyte is no longer active in nuclear processes such as pre-mRNA splicing, the function of many of its major structural proteins is dependent on alternative splicing choices made during the earlier stages of erythropoiesis. These splicing decisions fundamentally regulate many aspect...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200103000-00003

    authors: Hou VC,Conboy JG

    更新日期:2001-03-01 00:00:00

  • Update on thrombopoietin in preclinical and clinical trials.

    abstract::Thrombopoietin, also termed the c-Mpl ligand, is a lineage-dominant hematopoietic factor that primarily regulates megakaryopoiesis and thrombopoiesis. Treatment of normal animals with recombinant human megakaryocyte growth and development factor, a truncated molecule of the c-Mpl ligand, which is modified with polyeth...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199805000-00009

    authors: Miyazaki H

    更新日期:1998-05-01 00:00:00

  • Hairy cell leukemia: an update.

    abstract::Hairy cell leukemia is an indolent, chronic B-cell lymphoproliferative disorder comprising approximately 2 to 3% of all adult leukemias in the United States. Hairy cells are clonal expansions of mature, activated B-cells. They co-express CD11c, CD19, CD20, CD22, CD25, and CD103. Hairy cells possess clonal immunoglobul...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200307000-00002

    authors: Goodman GR,Bethel KJ,Saven A

    更新日期:2003-07-01 00:00:00

  • Beyond Philadelphia: 'Ph-like' B cell precursor acute lymphoblastic leukemias - diagnostic challenges and therapeutic promises.

    abstract:PURPOSE OF REVIEW:The presence of the Philadelphia chromosome causing the fusion between BCR to ABL1 in B cell precursor acute lymphoblastic leukemias (ALLs) was associated with a particularly bad prognosis, which has been markedly improved with the addition of imatinib to chemotherapy. Recent genomic studies have lead...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000050

    authors: Izraeli S

    更新日期:2014-07-01 00:00:00

  • New insights into erythropoiesis.

    abstract::Commitment of hematopoietic cells to the erythroid lineage involves the actions of several transcription factors, including TAL1, LMO2, and GATA-2. The differentiation of committed erythroid progenitor cells involves other transcription factors, including NF-E2 and EKLF. Upon binding erythropoietin, the principal regu...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200203000-00002

    authors: Koury MJ,Sawyer ST,Brandt SJ

    更新日期:2002-03-01 00:00:00

  • Progress and strategies for patients with relapsed and refractory acute myeloid leukemia.

    abstract:PURPOSE OF REVIEW:The treatment of patients with refractory or relapsed acute myeloid leukemia remains challenging. Management of these patients must take into account patient and leukemia-related factors in order to organize a comprehensive approach to treatment. Many new therapies are under study. RECENT FINDINGS:Ne...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32801684ef

    authors: Litzow MR

    更新日期:2007-03-01 00:00:00

  • Mitochondrial defects lie at the basis of neutropenia in Barth syndrome.

    abstract:PURPOSE OF REVIEW:Barth syndrome (BTHS) is a mitochondrial disorder characterized by neutropenia, among other defects. As yet, the correlation between the mitochondrial defect in BTHS and the neutropenia observed in these patients is unclear. In this review, we hope to shed some light upon the correlation between the m...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32831c83f3

    authors: van Raam BJ,Kuijpers TW

    更新日期:2009-01-01 00:00:00

  • Recent advances in inherited platelet disorders.

    abstract:PURPOSE OF REVIEW:The increasing use of high throughput sequencing and genomic analysis has facilitated the discovery of new causes of inherited platelet disorders. Studies of these disorders and their respective mouse models have been central to understanding their biology, and also in revealing new aspects of platele...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000525

    authors: Pluthero FG,Kahr WHA

    更新日期:2019-09-01 00:00:00

  • Immunotherapy for thrombotic thrombocytopenic purpura.

    abstract:PURPOSE OF REVIEW:This review focuses on recent advances in the use of immune-based therapy to treat patients with refractory and relapsing acquired thrombotic thrombocytopenic purpura. RECENT FINDINGS:Advances in understanding of the pathophysiology of idiopathic thrombotic thrombocytopenic purpura have provided the ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/01.moh.0000170534.33517.99

    authors: Cataland SR,Wu HM

    更新日期:2005-09-01 00:00:00

  • Recent advances in the management of therapy-related myelodysplastic syndromes and acute myeloid leukemia.

    abstract:PURPOSE OF REVIEW:Therapy-related myelodysplastic syndromes and acute myelogenous leukemia (t-MDS/AML) comprise an increasingly common, poor-risk disease cohort without standard treatment options. This review describes available treatments and recent advances that may influence the clinical management of t-MDS/AML. RE...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32835d82e6

    authors: Klimek VM

    更新日期:2013-03-01 00:00:00

  • Methods and progress in assessing the quality of life effects of supportive care with erythropoietin therapy.

    abstract::Anemia is a common disorder in patients with cancer and can be caused by the disease itself or by cancer-related therapy. The cardinal symptom of anemia, fatigue, is the most commonly reported symptom in patients with cancer and has profound effects on patient well-being and quality of life. Until recently, blood tran...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200205000-00010

    authors: Yount S,Lai JS,Cella D

    更新日期:2002-05-01 00:00:00

  • Chronic idiopathic neutropenias and severe congenital neutropenia.

    abstract:PURPOSE OF REVIEW:Chronic idiopathic and severe congenital neutropenias are rare disorders for which recent discoveries have highlighted mechanisms and consequences. RECENT FINDINGS:An inflammatory bone marrow milieu has been shown to be a major contributor to the pathophysiology of chronic idiopathic neutropenia. Act...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3282f172d3

    authors: Palmblad J,Papadaki HA

    更新日期:2008-01-01 00:00:00

  • Peptide generation in the major histocompatibility complex class I antigen processing and presentation pathway.

    abstract::The bulk of antigens that are presented by major histocompatibility complex (MHC) class I molecules are processed in the cytosol. Therefore, the cellular protein degradation machinery is thought to play a major role in antigen processing. For example, there is clear evidence that the ubiquitin-proteasome pathway, the ...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200101000-00003

    authors: Androlewicz MJ

    更新日期:2001-01-01 00:00:00

  • Butyrate in the treatment of sickle cell disease and beta-thalassemia.

    abstract::The search for, and discovery of, a physiologic model in which the developmentally regulated switch from fetal to adult globin gene expression could be prevented has resulted in the development of a new class of therapeutic agents, consisting of simple fatty acids, such as butyric acid, for the treatment of the beta-h...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199502020-00002

    authors: Faller DV,Perrine SP

    更新日期:1995-03-01 00:00:00

  • Transplant strategies for patients with myelodysplastic syndromes.

    abstract:PURPOSE OF REVIEW:Hematopoietic cell transplantation offers potentially curative therapy for patients with myelodysplastic syndrome. The median patient age at diagnosis, however, is about 70 years, which has limited the application of conventional hematopoietic cell transplantation. In addition, the optimum timing of t...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/01.moh.0000208466.63861.9f

    authors: Deeg HJ

    更新日期:2006-03-01 00:00:00

  • Immune and idiopathic neutropenia.

    abstract::Neutropenia is often attributed to immunologically mediated injury to mature neutrophils or their precursors. Clinically it is useful to classify immune mediated neutropenias as isoimmune, autoimmune (including some drug-associated neutropenias), and idiopathic (cases possibly with an immune mechanism). Isoimmune neut...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199801000-00006

    authors: Dale DC

    更新日期:1998-01-01 00:00:00

  • Chronic myelogenous leukemia.

    abstract::Chronic myelogenous leukemia is a clonal hematopoietic malignancy characterized by a balanced translocation between chromosomes 9 and 22 that results in the generation of an abnormal bcr/abl fusion protein with increased tyrosine kinase activity. This abnormal fusion protein has transforming activity for hematopoietic...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199502040-00009

    authors: Enright H,McGlave PB

    更新日期:1995-07-01 00:00:00

  • The use of hematopoietic growth factors in treating HIV infection.

    abstract::Human immunodeficiency virus infection causes multilineage hematopoietic defects. Defects in the production and function of CD4+ helper cells have been the focus of the majority of HIV research, but anemia, neutropenia, and thrombocytopenia are significant clinical problems as well. Bone marrow suppression is the dose...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199502030-00012

    authors: Miles S

    更新日期:1995-05-01 00:00:00

  • Multifaceted role of vascular endothelial growth factor signaling in adult tissue physiology: an emerging concept with clinical implications.

    abstract:PURPOSE OF REVIEW:In addition to the crucial role of vascular endothelial growth factor (VEGF)A in vessel development, it has become apparent that the VEGF signaling pathway (VSP) plays an important role during adulthood in the maintenance of tissue homeostasis in normal physiological processes, as well as in pathologi...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e32833865e6

    authors: Sung HK,Michael IP,Nagy A

    更新日期:2010-05-01 00:00:00

  • Evidence based therapeutic apheresis in autoimmune and other hemolytic anemias.

    abstract:PURPOSE OF REVIEW:This article reviews recent publications that bear on the evidential basis for therapeutic apheresis in diseases in which hemolytic anemia is a prominent feature. RECENT FINDINGS:Therapeutic plasma exchange continues to be reported sporadically in severe autoimmune hemolytic anemia, with inconsistent...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0b013e3282c8ca66

    authors: McLeod BC

    更新日期:2007-11-01 00:00:00

  • Recent advances in multiple myeloma.

    abstract::Multiple myeloma is the second most common hematologic malignancy, with approximately 15,000 new cases each year in the United States. Our understanding of the pathophysiology underlying myeloma continues to expand, but the cause of this plasma cell dyscrasia remains unclear. Though controversy remains regarding a pos...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200007000-00007

    authors: Sjak-Shie NN,Vescio RA,Berenson JR

    更新日期:2000-07-01 00:00:00

  • Leukoreduction and blood-borne vCJD transmission risk.

    abstract:PURPOSE OF REVIEW:Risk assessments for transmission of variant Creutzfeldt-Jakob disease predicted that leukocyte reduction would be inefficient at preventing transmission of the disease by blood transfusion. Nevertheless, approximately 14 years ago, a significant proportion of European countries decided to implement l...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/MOH.0000000000000101

    authors: Douet JY,Bujdoso R,Andréoletti O

    更新日期:2015-01-01 00:00:00

  • Bone marrow transplantation for globoid cell leukodystrophy, adrenoleukodystrophy, metachromatic leukodystrophy, and Hurler syndrome.

    abstract::Bone marrow transplantation protocols for inherited metabolic storage diseases are unique for each disorder treated. Differences depend also upon how old the patient was when onset occurred and rate of progression of disease. Treatment is directed to prevent or ameliorate the inexorable neurological deterioration that...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199911000-00004

    authors: Krivit W,Aubourg P,Shapiro E,Peters C

    更新日期:1999-11-01 00:00:00

  • TEL/AML1-positive pediatric leukemia: prognostic significance and therapeutic approaches.

    abstract::This article presents the most recent insights into the biology, prognostic significance, and therapeutic approaches to TEL/AML1-positive leukemia. The TEL/AML1 fusion gene, also known as ETV6 /CBFA2, is the most commonly occurring gene rearrangement in pediatric acute lymphoblastic leukemia (ALL). Considerable contro...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-200207000-00013

    authors: Loh ML,Rubnitz JE

    更新日期:2002-07-01 00:00:00

  • Optimal dosing and triggers for prophylactic use of platelet transfusions.

    abstract::Despite the reliance on platelet transfusion support in patients receiving myeloablative therapy, controversies surround platelet transfusion practices. These include the appropriate platelet dose and the threshold at which prophylactic platelet transfusions will be most effective. These issues bear directly on patien...

    journal_title:Current opinion in hematology

    pub_type: 杂志文章,评审

    doi:10.1097/00062752-199911000-00015

    authors: Rinder HM,Arbini AA,Snyder EL

    更新日期:1999-11-01 00:00:00