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Thymopoiesis following HSCT; a retrospective review comparing interventions for aGVHD in a pediatric cohort

Lookup NU author(s): Dr Aisling Flinn, Dr Mary Slatter, Professor Roderick Skinner, Dr Andrew Gennery

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Abstract

© 2018 Elsevier Inc. Acute graft-versus-host disease (aGVHD) complicates allogeneic hematopoietic stem cell transplantation (HSCT), and is treated with topical and/or systemic corticosteroids. Systemic corticosteroids and aGVHD damage thymic tissue. We compared thymopoietic effect of topical steroid therapy, corticosteroids and extracorporeal photopheresis (ECP) in 102 pediatric allogeneic HSCT patients.We categorized patients into 4 groups: - no aGVHD, aGVHD treated with topical or systemic steroid, or ECP. Naïve CD4+ CD45RA+ CD27+ T-lymphocyte values at 3, 6, 9, 12months post-HSCT were recorded: for ECP patients, values were recorded at 3, 6, 9, 12months during ECP. Differences were compared using the Kruskal-Wallis test.41 patients had no aGVHD, 23 had aGVHD treated topically or systemically (25), 13 received ECP. Rate of thymopoiesis was significantly different between all groups at all time-points post-transplant (p = 0.002, p. <. 0.001, p. <. 0.001, p = 0.001 respectively).Even mild aGVHD impairs thymopoiesis. Worst recovery was in ECP patients. Earlier institution of ECP may speed thymic recovery.


Publication metadata

Author(s): Flinn AM, Roberts CF, Slatter MA, Skinner R, Robson H, Lawrence J, Guest J, Gennery AR

Publication type: Article

Publication status: Published

Journal: Clinical Immunology

Year: 2018

Volume: 193

Pages: 33-37

Print publication date: 01/08/2018

Online publication date: 01/02/2018

Acceptance date: 17/01/2018

ISSN (print): 1521-6616

ISSN (electronic): 1521-7035

Publisher: Academic Press Inc.

URL: https://doi.org/10.1016/j.clim.2018.01.006

DOI: 10.1016/j.clim.2018.01.006


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