Balancing Graft versus Leukemia and Graft versus Host responses
EHA Library. Falkenburg F. 06/14/17; 185030
Topic: 4Bf Acute and chronic graft versus host disease
Fred Falkenburg
Contributions
Contributions
Learning Objectives
Nicolaus Kröger - Chair Introduction
Graft-versus Host Disease (GvHD) is a major cause of morbidity and mortality after allogeneic stem cell transplantation and it mainly caused by alloreactive donor T –cells. However, alloreactive donor T cells are also targeting recipient hematopoietic cells including the malignant cells. Several studies have shown a close correlation between the occurrence of GvHD and a reduced risk of relapse suggesting absence of GvHD implies also a less stronger graft –versus leukemia (GvL) effect. In this Educational update new insights into the pathogenesis of GvHD will be presented with special focus of the increasing role of the intestinal microbiota and its modulation by antibiotics, which may have a greater impact in preventing GvHD (CK Stein-Thoeringer and MRM van den Brink) . Furthermore, in the recent years new possibilities in preventing and treatment of GvHD by targeting JAK pathway or chemokine receptors are becoming available or are currently tested in clinical trial (R. Zeiser) and finally elegant ways of immunmodulation by selecting specific T cells as donor lymphocyte infusion may allow a better balance between GvHD and GvL effect (F. Falkenburg) will be presented
Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- Understand pathogenesis of graft-versus Host Disease (GvHD) including new therapeutic optinons in prevention and treatment.
- Understand the emerging role of intestinal microbiota in GvHD and the impact of microbiota modulation by antibiotics.
- Understand how Graft-versus Leukemia (GvL) effect can be balanced to the risk of Graft-versus Host Disease.
Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Understand the different nature of allo-immune T cell responses following HLA matched and HLA mismatched stem cell transplantation.
- Estimate the likelihood of developing selective GVL responses after allogeneic stem cell transplantation.
- Understand how post-transplant circumstances and interventions influence the balance between GVL and GVHD.
Graft-versus Host Disease (GvHD) is a major cause of morbidity and mortality after allogeneic stem cell transplantation and it mainly caused by alloreactive donor T –cells. However, alloreactive donor T cells are also targeting recipient hematopoietic cells including the malignant cells. Several studies have shown a close correlation between the occurrence of GvHD and a reduced risk of relapse suggesting absence of GvHD implies also a less stronger graft –versus leukemia (GvL) effect. In this Educational update new insights into the pathogenesis of GvHD will be presented with special focus of the increasing role of the intestinal microbiota and its modulation by antibiotics, which may have a greater impact in preventing GvHD (CK Stein-Thoeringer and MRM van den Brink) . Furthermore, in the recent years new possibilities in preventing and treatment of GvHD by targeting JAK pathway or chemokine receptors are becoming available or are currently tested in clinical trial (R. Zeiser) and finally elegant ways of immunmodulation by selecting specific T cells as donor lymphocyte infusion may allow a better balance between GvHD and GvL effect (F. Falkenburg) will be presented
Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- Understand pathogenesis of graft-versus Host Disease (GvHD) including new therapeutic optinons in prevention and treatment.
- Understand the emerging role of intestinal microbiota in GvHD and the impact of microbiota modulation by antibiotics.
- Understand how Graft-versus Leukemia (GvL) effect can be balanced to the risk of Graft-versus Host Disease.
Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Understand the different nature of allo-immune T cell responses following HLA matched and HLA mismatched stem cell transplantation.
- Estimate the likelihood of developing selective GVL responses after allogeneic stem cell transplantation.
- Understand how post-transplant circumstances and interventions influence the balance between GVL and GVHD.
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