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Track: Contributed Abstracts
Saturday, February 16, 2013, 6:45 PM-7:45 PM
Hall 1 (Salt Palace Convention Center)
CGVHD develops in more than 50% of survivors of allogeneic stem cell transplantation and is responsible for mortality in one third of patients. Long term immunosuppressive therapy with steroids is the standard treatment. ECP has shown activity in acute and cGVHD and is successful in about 50% of the patients after 3 – 6 months of therapy. We studied the cytokine profiles in 6 patients with cGVHD undergoing ECP. A comprehensive assessment of organ system involvement using NIH Consensus response assessment tools was done at study entry and at six months. Patients underwent ECP treatments twice on two consecutive days every two weeks for 3 to 6 months. All patients underwent baseline, two-months, four months and six-month assessments. 10 ml of leukopheresed blood was obtained from the ECP machine prior to the initiation of ECP at baseline, and at 2, 4 and 6 months post treatment to assess peripheral blood B and T cells and the cytokine analysis. CD4+ T cells were purified from PBMCs and stimulated with anti-CD3 and anti-CD28 for five days. Tissue culture supernatants were collected and analyzed for the production of 42 cytokines using Luminex® technology. Three patients responded to treatment with ECP and three did not and later received other therapies. We have previously reported that responding patients had higher CD4+CD25+FoxP3+ cells. Of the cytokines analyzed, soluble CD25 and TNFb were secreted at significantly higher levels in responding patients prior to ECP initiating therapy ( figure). In responders, sCD25 and TNFb levels remained high throughout the monitoring period. The other 40 cytokines did not show significant trend between responders and non responders. Thus, sCD25 and TNFb can be potentially used as biomarkers to predict response of cGvHD to ECP. Studies with larger number of patients on ECP will be required to confirm these findings.