Abstract:
:Steroid-resistant or steroid-refractory acute graft-versus-host disease (SR-aGVHD) poses one of the most vexing challenges faced by providers who care for patients after allogeneic hematopoietic cell transplantation. For the past 4 decades, research in the field has been driven by the premise that persistent graft-versus-host disease (GVHD) results from inadequate immunosuppression. Accordingly, most efforts to solve this problem have relied on retrospective or prospective studies testing agents that have direct or indirect immunosuppressive effects. Retrospective studies far outnumber prospective studies, and no controlled prospective trial has shown superior results for any agent over others. Truth be told, I do not know how to treat SR-aGVHD. Preclinical work during the past decade has provided fresh insights into the pathogenesis of acute GVHD, and translation of these insights toward development of more effective treatments for patients with SR-aGVHD has at last begun. Given the limited state of current knowledge, this "How I Treat" review highlights the overriding imperative to avoid harm in caring for patients with SR-aGVHD. Prospective trials that are widely available are urgently needed to advance the field.
journal_name
Bloodjournal_title
Bloodauthors
Martin PJdoi
10.1182/blood.2019000960subject
Has Abstractpub_date
2020-05-07 00:00:00pages
1630-1638issue
19eissn
0006-4971issn
1528-0020pii
452748journal_volume
135pub_type
杂志文章相关文献
BLOOD文献大全abstract::A semiquantitative polymerase chain reaction assay was used to monitor the blood levels of Epstein-Barr virus (EBV)-DNA in 9 patients receiving allogeneic bone marrow transplants (BMT). Four of 5 recipients of HLA-mismatched T-cell-depleted grafts showed a 4- to 5-log increase of EBV-DNA within 1 to 3 months after BMT...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract::Erythropoietin (EPO) and its receptor (EPOR) are critical for definitive erythropoiesis, as mice lacking either gene product die during embryogenesis with severe anemia. Here we demonstrate that mice expressing just one functional allele of the EpoR have lower hematocrits and die more frequently than do wild-type litt...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood.v99.7.2603
更新日期:2002-04-01 00:00:00
abstract::The kidney is the main physiologic source of erythropoietin (EPO) in the adult and responds to decreases in tissue oxygenation with increased EPO production. Although studies in mice with liver-specific or global gene inactivation have shown that hypoxia-inducible factor 2 (Hif-2) plays a major role in the regulation ...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2010-02-270322
更新日期:2010-10-21 00:00:00
abstract::Chronic myeloid leukemia (CML) is a malignant disorder of the hematopoietic stem cell. It has been shown that normal stem cells coexist with malignant stem cells in the bone marrow of patients with chronic-phase CML. To characterize the primitive hematopoietic progenitor cells within CML marrow, CD34+DR- and CD34+DR+ ...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::As our technological capacities improve, genomic testing is increasingly integrating into patient care. The field of clinical hematology is no exception. Genomic testing carries great promise, but several ethical issues must be considered whenever such testing is performed. This review addresses these ethical consider...
journal_title:Blood
pub_type: 杂志文章,评审
doi:10.1182/blood-2017-01-734558
更新日期:2017-07-27 00:00:00
abstract::Autoimmune lymphoproliferative syndrome (ALPS) is a disorder of abnormal lymphocyte survival caused by defective Fas-mediated apoptosis, leading to lymphadenopathy, hepatosplenomegaly, and an increased number of double-negative T cells (DNTs). Treatment options for patients with ALPS are limited. Rapamycin has been sh...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2006-01-010124
更新日期:2006-09-15 00:00:00
abstract::Erythroid cell iron and transferrin uptake and release was studied in the anemia of the Belgrade laboratory rat (gene symbol, b), an autosomal recessive trait characterized by hypochromia and hyperferrinemia. When reticulocyte-rich red cells were incubated in vitro with doubly (59Fe, 125I) labeled transferrin, b/b cel...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract::Ischemia/reperfusion (I/R) injury in the kidney is a major cause of acute kidney injury (AKI) in humans and is associated with significantly high mortality. To identify genes that modulate kidney injury and repair, we conducted genome-wide expression analysis in the rat kidneys after I/R and found that the mRNA levels...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2011-02-338061
更新日期:2011-08-18 00:00:00
abstract::Various virus infections cause dysfunctional hemostasis and in some instances lead to the development of viral hemorrhagic fever syndrome. How do diverse viruses induce the expression of tissue factor on vascular cells? We hypothesize that a direct stimulation of pattern recognition receptors (PRR) by viral nucleic ac...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2008-02-137901
更新日期:2009-01-15 00:00:00
abstract::Tumor-associated macrophages (TAM) are important components of the multiple myeloma (MM) microenvironment that support malignant plasma cell survival and resistance to therapy. It has been proposed that macrophages (MØ) retain the capacity to change in response to stimuli that can restore their antitumor functions. He...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2016-01-695395
更新日期:2016-11-03 00:00:00
abstract::We have been transducing mouse hematopoietic cells with the human MDR1 (MDR) gene in retroviral vectors to determine the optimal conditions for retroviral gene transfer as a model system for potential human gene therapy. In these studies, we have demonstrated transduction and expression of the human MDR gene using eco...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1994-07-15 00:00:00
abstract::Human herpesvirus 6 (HHV-6) is detected in the plasma of approximately 40% of patients undergoing hematopoietic cell transplantation (HCT) and sporadically causes encephalitis in this population. The effect of HHV-6 reactivation on central nervous system function has not been fully characterized. This prospective stud...
journal_title:Blood
pub_type: 临床试验,杂志文章
doi:10.1182/blood-2010-10-316083
更新日期:2011-05-12 00:00:00
abstract::To investigate underlying mechanisms of thrombocytopenia in myelodysplastic syndrome (MDS), radiolabeled platelet studies were performed in 30 MDS patients with platelet counts less than 100 x 10(9)/L. Furthermore, plasma thrombopoietin and glycocalicin index (a parameter of platelet or megakaryocyte destruction) were...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2004-06-2108
更新日期:2005-05-01 00:00:00
abstract::Although a large body of data on mobilization have yielded valuable clues, the mechanism(s) dictating egress of stem/progenitor cells during baseline hematopoiesis and after their mobilization are poorly understood. We have previously provided functional in vivo evidence that cytoadhesion molecules, specifically the b...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract::We show further differences between two clinically related entities, T-cell acute lymphoblastic leukemia (T-ALL) and lymphoblastic lymphoma (T-LL), by using several monoclonal antibodies (MoAbs) reacting with either constant or variable regions of T-cell receptors (TcR) alpha beta and gamma delta or with various CD mo...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1990-02-15 00:00:00
abstract::The timely clearance of apoptotic neutrophils from inflammation sites is an important function of macrophages; however, the role of macrophages in maintaining neutrophil homeostasis under steady-state conditions is less well understood. By conditionally deleting the antiapoptotic gene cellular FLICE-like inhibitory pr...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2010-01-265959
更新日期:2011-01-13 00:00:00
abstract::P-selectin (CD62P) is a member of the selectin family of adhesion molecules involved in the regulation of leukocyte traffic. P-selectin glycoprotein ligand-1 (PSGL-1) is a mucin-like molecule that is thought to be a primary ligand for P-selectin. The interaction of P-selectin with PSGL-1 results in leukocyte rolling a...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::Stem cell localization, conservation, and differentiation is believed to occur in niches in the marrow stromal microenvironment. Our recent observation that long-term in vitro human hematopoiesis requires a stromal heparan sulfate proteoglycan (HSPG) led us to hypothesize that such HSPG may orchestrate the formation o...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1998-12-15 00:00:00
abstract::Glucocorticoids are keystone drugs in the treatment of childhood acute lymphoblastic leukemia (ALL). To get more insight in signal transduction pathways involved in glucocorticoid-induced apoptosis, Affymetrix U133A GeneChips were used to identify transcriptionally regulated genes on 3 and 8 hours of prednisolone expo...
journal_title:Blood
pub_type: 临床试验,杂志文章
doi:10.1182/blood-2006-11-056366
更新日期:2007-05-01 00:00:00
abstract::High concentrations of bovine factor VIII cause clumping of platelets into a few very large aggregates. This response is termed superaggregation. It is distinct from factor-VIII-induced agglutination but is also independent of both extracellular calcium ions and platelet energy metabolism. Neither agglutinating lectin...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1982-12-01 00:00:00
abstract::Posttransplantation lymphoproliferative disease (PTLD) associated with Epstein-Barr virus (EBV) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. PTLD is efficiently prevented by adoptive transfer of EBV-specific T cells from the donor. To make EBV-specific T cells available ...
journal_title:Blood
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1182/blood-2009-08-236356
更新日期:2010-04-08 00:00:00
abstract::Factor IXAlabama is a variant factor IX molecule responsible for a clinically moderate form of hemophilia B. Twenty-five kilobases (kb) of the variant gene, including seven exons coding for the structural protein, were cloned and characterized. The restriction map and the arrangement of coding regions are identical to...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Transferrin receptor 2 (TfR2) is a type 2 transmembrane protein expressed in hepatocytes that binds iron-bound transferrin (Tf). Mutations in TfR2 cause one form of hereditary hemochromatosis, a disease in which excessive absorption of dietary iron can lead to liver cirrhosis, diabetes, arthritis, and heart failure. T...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2004-06-2477
更新日期:2004-12-15 00:00:00
abstract::Activated protein C (APC) is inhibited by two major plasma inhibitors (PCIs). To find evidence for in vivo complexation of APC, immunoblotting studies were performed on plasmas of 85 patients with suspected disseminated intravascular coagulation (DIC). Samples from 62 of these patients contained 5% to 35% of protein C...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract::Hyperresponsiveness to growth factors underlies a wide variety of human diseases,including hemangiomas, the most common tumor of childhood. Hemangiomas have been found to be clonal neoplasms of endothelial cells, with somatic mutations in unknown genes likely to be responsible for their development. ...
journal_title:Blood
pub_type: 评论,杂志文章
doi:10.1182/blood-2012-04-415059
更新日期:2012-05-17 00:00:00
abstract::Hemojuvelin (HJV) positively modulates the iron regulator hepcidin, and its mutations are the major cause of juvenile hemochromatosis (JH), a recessive disease leading to iron overload. Defective HJV reduces hepcidin up-regulation both in humans and in Hjv-deficient mice. To investigate the JH pathogenesis and the fun...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2006-08-041004
更新日期:2007-05-15 00:00:00
abstract::The EEN (extra eleven nineteen) gene, located on chromosome 19p13, was cloned as a fusion with MLL from a patient with acute myeloid leukemia (AML) with translocation t(11;19)(q23;p13). In this study, we characterized the genomic structure of the EEN gene, including its 5' regulatory region and transcription start sit...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2006-02-003517
更新日期:2007-01-15 00:00:00
abstract::The contention that erythropoietin (Epo) affects platelet production was investigated in the rat with recombinant human Epo (rHuEpo). In normal rats, Epo caused a dose-dependent increase in both reticulocyte and platelet numbers, the reticulocyte response preceding that of platelets. Withdrawal of Epo resulted in reti...
journal_title:Blood
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::The events that regulate engraftment and long-term repopulating ability of hematopoietic stem cells (HSCs) after transplantation are not well defined. We report for the first time that major histocompatibility complex (MHC) class I K plays a critical role in HSC engraftment via interaction with recipient natural kille...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2003-11-3910
更新日期:2004-08-01 00:00:00
abstract::Studying human antigen-specific memory B cells has been challenging because of low frequencies in peripheral blood, slow proliferation, and lack of antibody secretion. Therefore, most studies have relied on conversion of memory B cells into antibody-secreting cells by in vitro culture. To facilitate direct ex vivo iso...
journal_title:Blood
pub_type: 杂志文章
doi:10.1182/blood-2011-03-341917
更新日期:2011-07-14 00:00:00