Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

ABO incompatible allogeneic bone marrow transplants can be performed successfully to treat patients with leukemia or aplastic anemia. These transplants carry no great risk of rejection or graft-versus-host disease, however, some method must be used to avoid acute hemolysis at the time of infusion of ABO incompatible marrow. We have used successfully large volume plasma exchange to remove anti-A or anti-B antibodies prior to marrow infusion. More recently we have used immunoadsorbent columns containing synthetic A or B antigen specifically to remove anti-A or anti-B antibodies in lieu of plasma exchange. These columns are better tolerated than plasma exchange where allergic reactions are common.
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PMID:Plasma exchange and immunoadsorption for removal of antibodies prior to ABO incompatible bone marrow transplant. 703 Feb 80

Functional studies of helper and cytotoxic T cells in families with recombinant HLA haplotypes have played a crucial role in the early studies of the HLA chromosomal region. It has been shown that for the generation of CTLs directed against HLA-A or -B antigen differences an additional difference in the HLA-D region between responder and stimulator cells was a prerequisite. We have re-examined in a sensitive limiting dilution assay the possibility of generating CTL against HLA class I antigens in responder-stimulator pairs with a negative MLC reaction of two recombinant families (differing in one or two HLA class I antigens but identical in class II antigens) and two pairs of unrelated individuals. In all cases we could detect low but definitely measurable CTL activity (8-15 CTL precursors in 10(6) PBMCs) directed against the mismatched class I HLA antigen(s). We conclude that mismatches in class I HLA antigens in MLC nonreactive responder-stimulator pairs can induce generation of allospecific CTLs. This has implications in allogeneic bone marrow transplantation with HLA-matched unrelated donors; i.e., in the case of an HLA-A,B,DR matched donor a low donor CTLpf against the recipient may be an indication of a serologically not-detected class I HLA "subtype" incompatibility which might cause graft-versus-host disease.
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PMID:Estimates of cytotoxic T-lymphocyte precursor frequencies against HLA class I antigens in responder-stimulator pairs with a negative mixed lymphocyte culture reaction. 884 34

We conducted a phase I-II clinical trial to test the hypothesis that removal of CD4 cells from an HLA-mismatched unrelated marrow graft would substantially reduce the risk of grades III-IV graft-versus-host disease (GVHD) and that retention of a specified number of CD8 cells in the graft would be sufficient to prevent rejection. Patients were eligible for this study when an HLA-A, -B, or -DRB1-matched unrelated donor could not be identified. HLA matching of the donor and recipient was based on typing of HLA-A and -B antigens by serologic methods and by typing of HLA-DRB1 alleles by molecular methods, and donors were selected when disparity was limited to a single HLA-DRB1 allele or a single HLA-A or -B antigen. Twenty-seven patients with hematologic malignancy or aplastic anemia were prepared to receive a transplant with conventional regimens of cyclophosphamide and fractionated total body irradiation, and a standard regimen of methotrexate and cyclosporine was given for GVHD prophylaxis. CD4 cells were removed from the donor marrow, and the numbers of CD8 cells were adjusted systematically in graded steps for successive patients, depending on the occurrence of grades III-IV GVHD or graft failure in previously enrolled patients. Removal of CD4 cells did not cause graft rejection or appreciably decrease the risk of grades III-IV GVHD. Depletion of CD8 cells was associated with an increased risk of rejection with either HLA-DRB1 disparity or with HLA-A or -B disparity. With either type of disparity, the risk of grades III-IV GVHD is likely to be higher than 15% at any dose of CD8 cells associated with less than 5% risk of graft failure. The absence of graft failure associated with CD4 depletion supports the hypothesis that donor CD4 cells are not essential for preventing marrow graft rejection in humans. The correlation between graft failure and the number of CD8 cells in the donor marrow supports the hypothesis that donor CD8 cells help to prevent marrow graft rejection.
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PMID:A phase I-II clinical trial to evaluate removal of CD4 cells and partial depletion of CD8 cells from donor marrow for HLA-mismatched unrelated recipients. 1049 88