کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2100773 1083066 2008 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Advances in the clinical management of GVHD
موضوعات مرتبط
علوم زیستی و بیوفناوری بیوشیمی، ژنتیک و زیست شناسی مولکولی تحقیقات سرطان
پیش نمایش صفحه اول مقاله
Advances in the clinical management of GVHD
چکیده انگلیسی
The principal cause of mortality and morbidity following hematopoietic cell transplantation (HCT) is graft-versus-host disease (GVHD). Studies in murine models have revealed that inflammatory mediators such as tumor necrosis factor-α (TNF-α) promote destruction of host tissue following HCT. Elevated plasma levels of soluble TNF receptor 1 have been associated with patients with GVHD and blocking TNF-α in experimental models has shown a reduced incidence of GVHD. Based on this finding, patients with new onset GVHD were treated with steroids plus the TNF-α inhibitor, etanercept, on a previously reported pilot trial (n = 20) and a phase 2 trial (n = 41) and their outcomes were compared with those of contemporaneous patients with GVHD (n = 99) whose initial therapy was steroids alone. Patients treated with etanercept were more likely to achieve CR than were patients treated with steroids alone. Plasma TNFR1 levels, a biomarker for GVHD activity, were elevated at GVHD onset and decreased significantly only in patients with CR. A four protein fingerprint of IL-2Rα, TNFR1, IL-8, and HGF in the plasma has been identified to predict whether a patient will be at high-risk for GVHD based on biomarker analysis. In univariate and multivariate analysis, this four-protein fingerprint has shown a strong association with the grade of acute GVHD, and it can stratify patients into low- and high-risk groups and can be used as a laboratory-based screening method, to diagnose and perhaps treat patients preemptively.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Best Practice & Research Clinical Haematology - Volume 21, Issue 4, December 2008, Pages 677-682
نویسندگان
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