ABSTRACT
Chronic graft-versus-host disease (cGVHD), a potentially debilitating complication of hematopoietic cell transplantation, confers increased risk for mortality. Whereas treatment decisions rely on an accurate assessment of disease activity/severity, validated methods of assessing cutaneous cGVHD activity/severity appear to be limited. In this study, we aimed to identify and evaluate current data on the assessment of disease activity/severity in cutaneous cGVHD. Using modified PRISMA methods, we performed a critical literature review for relevant articles. Our literature search identified 1741 articles, of which 1635 were excluded as duplicates or failure to meet inclusion criteria. Of the included studies (n = 106), 39 (37%) addressed clinical and/or histopathologic parameters, 53 (50%) addressed serologic parameters, 8 (7.5%) addressed imaging parameters, and 6 (5.5%) addressed computer-based technologies. The only formally validated metric of disease activity/severity assessment in cutaneous cGVHD is the National Institutes of Health consensus scoring system, which is founded on clinical assessment alone. The lack of an objective marker for cGVHD necessitates further studies. An evaluation of the potential contributions of serologic, imaging, and/or computer-based technologies is warranted.
Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Skin Diseases , Graft vs Host Disease/diagnosis , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Severity of Illness Index , Skin , Skin Diseases/diagnosisSubject(s)
Drug Resistance, Neoplasm , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , Proto-Oncogene Proteins/genetics , Receptor Protein-Tyrosine Kinases/genetics , Up-Regulation , beta Catenin/genetics , Antineoplastic Agents/pharmacology , Cell Line, Tumor , Cells, Cultured , Coculture Techniques , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/drug effects , Up-Regulation/drug effects , Axl Receptor Tyrosine KinaseABSTRACT
We report the development of a Shiga toxin-producing Escherichia coli O157 gastrointestinal infection associated with hemolytic uremic syndrome in an allogenic stem cell transplant recipient with a history of gastrointestinal graft-vs-host disease receiving long-term immunosuppression.
ABSTRACT
Chemotherapy cures only a minority of adult patients with acute lymphoblastic leukemia (ALL). In addition, relapsed ALL has a poor outcome with 5-year survival as low as 7 %. Hence, there is a need to develop effective therapies to treat relapsed disease and to combine these agents with chemotherapy to improve outcomes in newly diagnosed patients. ALL cells express several antigens amenable to target therapies including CD19, CD20, CD22, and CD52. Over the last decade, there has been a surge in the development of immune therapies which target these receptors and that have induced robust responses. In this manuscript, we review these novel immune agents in the treatment of B-ALL. As these new therapies mature, the challenge going forward will be to find safe and effective combinations of these agents with chemotherapy and to determine their place in the current treatment schema.
