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[Treatment of transfusion-associated graft-versus-host disease]
1First Department of Internal Medicine, Ehime University School of Medicine.
Transfusion-associated graft-versus-host disease (TA-GVHD) in immunocompetent patients is mediated by activated lymphocytes derived from the donor directed against host allogeneic HLA antigens. When considering this pathogenesis, the target of TA -GVHD treatment should be focused on the cytotoxic T cells (CTL) directed against host HLA. The combination therapy of anti-CD3 monoclonal antibody, OKT3, cyclosporin A, and corticosteroid may be effective to inhibit the cytotoxic activity of CTL. In addition to these immunosuppressive agents, monoclonal antibodies against functional cell surface molecules, such as LFA-1, ICAM-1, Fas, and Fas ligand, must be effective for treatment of TA-GVHD. Since the effective standard therapy of TA -GVHD has not been established, the prevention by gamma irradiation of cellular blood components is most important.
Transfusion-associated graft-versus-host disease (TA-GVHD) in immunocompetent patients is mediated by activated lymphocytes derived from the donor directed against host allogeneic HLA antigens. When considering this pathogenesis, the target of TA -GVHD treatment should be focused on the cytotoxic T cells (CTL) directed against host HLA. The combination therapy of anti-CD3 monoclonal antibody, OKT3, cyclosporin A, and corticosteroid may be effective to inhibit the cytotoxic activity of CTL. In addition to these immunosuppressive agents, monoclonal antibodies against functional cell surface molecules, such as LFA-1, ICAM-1, Fas, and Fas ligand, must be effective for treatment of TA-GVHD. Since the effective standard therapy of TA -GVHD has not been established, the prevention by gamma irradiation of cellular blood components is most important.