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Lookup NU author(s): Dr Aisling Flinn, Professor Andrew GenneryORCiD
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© 2016 Flinn AM and Gennery AR. Acute graft-versus-host disease (aGvHD) continues to be a major obstacle to allogeneic haematopoietic stem cell transplantation. Thymic damage secondary to aGvHD along with corticosteroids and other non-selective T lymphocyte-suppressive agents used in the treatment of aGvHD concurrently impair thymopoiesis and negatively impact on immunoreconstitution of the adaptive immune compartment and ultimately adversely affect clinical outcome. Extracorporeal photopheresis (ECP) is an alternative therapeutic strategy that appears to act in an immunomodulatory fashion, potentially involving regulatory T lymphocytes and dendritic cells. By promoting immune tolerance and simultaneously avoiding systemic immunosuppression, ECP could reduce aGvHD and enable a reduction in other immunosuppression, allowing thymic recovery, restoration of normal T lymphopoiesis, and complete immunoreconstitution with improved clinical outcome. Although the safety and efficacy of ECP has been demonstrated, further randomised controlled studies are needed as well as elucidation of the underlying mechanisms responsible and the effect of ECP on thymic recovery.
Author(s): Flinn AM, Gennery AR
Publication type: Review
Publication status: Published
Journal: F1000Research
Year: 2016
Volume: 5
Online publication date: 27/06/2016
Acceptance date: 02/04/2016
ISSN (print): 2046-1402
ISSN (electronic): 1759-796X
Publisher: Faculty of 1000 Ltd
URL: http://doi.org/10.12688/F1000RESEARCH.8118.1
DOI: 10.12688/F1000RESEARCH.8118.1