Altered B-cell homeostasis and excess BAFF in human chronic graft-versus-host disease.

Journal Article (Journal Article)

Chronic graft-versus-host disease (cGVHD) causes significant morbidity and mortality in patients otherwise cured of malignancy after hematopoietic stem cell transplantation (HSCT). The presence of alloantibodies and high plasma B cell-activating factor (BAFF) levels in patients with cGVHD suggest that B cells play a role in disease pathogenesis. We performed detailed phenotypic and functional analyses of peripheral B cells in 82 patients after HSCT. Patients with cGVHD had significantly higher BAFF/B-cell ratios compared with patients without cGVHD or healthy donors. In cGVHD, increasing BAFF concentrations correlated with increased numbers of circulating pre-germinal center (GC) B cells and post-GC "plasmablast-like" cells, suggesting in vivo BAFF dependence of these 2 CD27(+) B-cell subsets. Circulating CD27(+) B cells in cGVHD comprised in vivo activated B cells capable of IgG production without requiring additional antigen stimulation. Serial studies revealed that patients who subsequently developed cGVHD had delayed reconstitution of naive B cells despite persistent BAFF elevation as well as proportional increase in CD27(+) B cells in the first year after HSCT. These studies delineate specific abnormalities of B-cell homeostasis in patients with cGVHD and suggest that BAFF targeting agents may be useful in this disease.

Full Text

Duke Authors

Cited Authors

  • Sarantopoulos, S; Stevenson, KE; Kim, HT; Cutler, CS; Bhuiya, NS; Schowalter, M; Ho, VT; Alyea, EP; Koreth, J; Blazar, BR; Soiffer, RJ; Antin, JH; Ritz, J

Published Date

  • April 16, 2009

Published In

Volume / Issue

  • 113 / 16

Start / End Page

  • 3865 - 3874

PubMed ID

  • 19168788

Pubmed Central ID

  • PMC2670799

Electronic International Standard Serial Number (EISSN)

  • 1528-0020

Digital Object Identifier (DOI)

  • 10.1182/blood-2008-09-177840


  • eng

Conference Location

  • United States