Extracorporeal photopheresis in refractory chronic graft-versus-host disease: the influence on peripheral blood T cell subpopulations. A study by the Hellenic Association of Hematology

Transfus Apher Sci. 2012 Apr;46(2):181-8. doi: 10.1016/j.transci.2011.10.028. Epub 2011 Nov 23.

Abstract

Extracorporeal photopheresis (ECP) has been established as an effective treatment modality for patients with chronic extensive graft-versus host disease (GVHD). In the present study, we evaluated the influence of ECP on the numbers of CD4+, CD8+, CD20+, CD56+ cells, and on T-regulatory (Tregs), as well as on the numbers of naïve, central memory (CM), and effector memory (EM) T-cells in patients treated for refractory chronic GVHD. Flow cytometric analysis of peripheral blood lymphocytes was performed for the calculation of the different T-cell subsets. Patients with GVHD had a higher percentage of EM-CD4+ cells in comparison with healthy donors (p=0.046). The percentages of naïve-CD8+, naïve-CD4+, CM-CD8+, CM-CD4+, EM-CD8+, and Tregs were not different between patients with GVHD and healthy donors. Similarly there was no statistical difference in the percentages of naïve, CM, and EM CD4+ and CD8+ cells before and after 3 months of treatment with ECP. However, in the subset of Tregs a statistically significant increase was observed after 3 months of treatment with ECP (p=0.015). Responders to ECP had statistically significantly higher absolute numbers of CD4+, and CD8+ cells, in comparison with non-responders. These data further support the concept that ECP does not cause immune-suppression, but should be better considered as an immune-modulating treatment.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • CD8-Positive T-Lymphocytes*
  • Cohort Studies
  • Female
  • Graft vs Host Disease / blood*
  • Graft vs Host Disease / therapy*
  • Hematology
  • Humans
  • Lymphocyte Count
  • Male
  • Photopheresis / methods*
  • Societies, Medical
  • T-Lymphocytes, Regulatory*
  • Time Factors