Monitoring the kinetics of B-cell recovery following rituximab may guide the management of steroid-refractory chronic GvHD

Author: Z DeFilipp, M Purcell, W A C Harris, D J Chandra, C Gleason, J Wrammert, S Sarantopoulos and E K Waller
Date Published: December-2015
Source: Nature.com

Recent studies have demonstrated that activated donor B cells are central to the immunopathology of chronic GvHD (cGvHD).1 Following allogeneic hematopoietic stem cell transplantation, donor B-cell reconstitution occurs in the setting of factors, which promote the aberrant persistence of allo- and autoreactive B cells.2 Persistently elevated levels of B-cell activating factor (BAFF) during hematopoietic reconstitution lead to failure of physiological negative selection and promote the survival autoreactive B cells.3 These B cells clones produce auto- and alloantibodies that can lead to sclerosis and other clinical manifestations of cGvHD.4, 5