The role of B cells in the pathogenesis of graft-versus-host disease

Blood. 2009 Dec 3;114(24):4919-27. doi: 10.1182/blood-2008-10-161638. Epub 2009 Sep 11.

Abstract

Allogeneic hematopoietic stem cell transplantation is an established treatment modality for malignant and nonmalignant hematologic diseases. Acute and chronic graft-versus-host diseases (GVHDs) are a major cause of morbidity and mortality after allogeneic stem cell transplantation. T cells have been identified as key players in the graft-versus-host reaction and, therefore, most established drugs used against GVHD target T cells. Despite our knowledge on the pathogenesis of the GVH reaction, success of established therapies for prevention and treatment of GHVD is unsatisfactory. Recently, animal and human studies demonstrated that B cells are involved in the immunopathophysiology of acute and chronic GVHD. Early phase clinical trials of B-cell depletion with rituximab have shown beneficial effects on both acute and chronic GVHD. This review summarizes the current experimental and clinical evidence for the involvement of B cells in the pathogenesis of acute and chronic GVHD and discusses the clinical implications for the management of patients undergoing allogeneic stem cell transplantation.

Publication types

  • Review

MeSH terms

  • Animals
  • B-Lymphocytes / immunology*
  • Graft vs Host Disease / immunology*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans