Induction of graft-versus-autoimmune (GVA) disease effect against refractory psoriasis by complete donor-type chimerism and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

R. Kojima, M. Kami, S. W. Kim, N. Murashige, Y. Kishi, A. Hori, O. Imataki, T. Hamaki, M. Sakiyama, S. Masuo, Y. Fujisawa, A. Makimoto, Y. Heike, Ryuji Tanosaki, Y. Takaue

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

A 67-year-old man with AML, who had a 21-year history of psoriasis without remission, received a reduced-intensity transplantation from an HLA-identical sibling. The preparative regimen consisted of busulfan and fludarabine. Graft-versus-host-disease (GVHD) prophylaxis was cyclosporine and methotrexate. Psoriasis was completely resolved on day 18. The subsequent clinical course was uneventful until day 42, when psoriasis recurred at the same sites as before RIST. Peripheral blood examined on day 63 showed mixed chimerism with 54% recipient type. Cyclosporine was rapidly tapered off over the next 2 weeks. On day 90, 100% donor-type chimerism was confirmed. Subsequently, psoriasis improved simultaneously with the occurrence of mucositis and rash as a manifestation of GVHD. Scattered erythematous patches of psoriasis disappeared again by day 105. We initiated 0.5 mg/kg prednisolone on day 119, and resumed cyclosporine on day 133. At 7 months after RIST, he still suffers from chronic GVHD, but his psoriasis remains in remission for the first time in 21 years. The anti-psoriasis effect of the conditioning is mild and transient, while the graft-versus-autoimmunity effect, related to the induction of complete donor-type chimerism and GVHD, is more profound and persisting. A graft-versus-autoimmunity effect lies in the delicate balance between alloimmunity and immunosuppressant used for GVHD prophylaxis/treatment.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalBone Marrow Transplantation
Volume32
Issue number4
DOIs
Publication statusPublished - 2003 Aug
Externally publishedYes

Fingerprint

Chimerism
Hematopoietic Stem Cell Transplantation
Graft vs Host Disease
Psoriasis
Autoimmune Diseases
Tissue Donors
Transplants
Cyclosporine
Autoimmunity
Busulfan
Mucositis
Immunosuppressive Agents
Prednisolone
Exanthema
Methotrexate
Siblings
Transplantation

Keywords

  • Graft-versus-autoimmunity effect
  • Graft-versus-host disease
  • Psoriasis
  • Reduced-intensity stem cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Induction of graft-versus-autoimmune (GVA) disease effect against refractory psoriasis by complete donor-type chimerism and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. / Kojima, R.; Kami, M.; Kim, S. W.; Murashige, N.; Kishi, Y.; Hori, A.; Imataki, O.; Hamaki, T.; Sakiyama, M.; Masuo, S.; Fujisawa, Y.; Makimoto, A.; Heike, Y.; Tanosaki, Ryuji; Takaue, Y.

In: Bone Marrow Transplantation, Vol. 32, No. 4, 08.2003, p. 439-442.

Research output: Contribution to journalArticle

Kojima, R, Kami, M, Kim, SW, Murashige, N, Kishi, Y, Hori, A, Imataki, O, Hamaki, T, Sakiyama, M, Masuo, S, Fujisawa, Y, Makimoto, A, Heike, Y, Tanosaki, R & Takaue, Y 2003, 'Induction of graft-versus-autoimmune (GVA) disease effect against refractory psoriasis by complete donor-type chimerism and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation', Bone Marrow Transplantation, vol. 32, no. 4, pp. 439-442. https://doi.org/10.1038/sj.bmt.1704146
Kojima, R. ; Kami, M. ; Kim, S. W. ; Murashige, N. ; Kishi, Y. ; Hori, A. ; Imataki, O. ; Hamaki, T. ; Sakiyama, M. ; Masuo, S. ; Fujisawa, Y. ; Makimoto, A. ; Heike, Y. ; Tanosaki, Ryuji ; Takaue, Y. / Induction of graft-versus-autoimmune (GVA) disease effect against refractory psoriasis by complete donor-type chimerism and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. In: Bone Marrow Transplantation. 2003 ; Vol. 32, No. 4. pp. 439-442.
@article{750ae575f4214fc5bf34661106555a5b,
title = "Induction of graft-versus-autoimmune (GVA) disease effect against refractory psoriasis by complete donor-type chimerism and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation",
abstract = "A 67-year-old man with AML, who had a 21-year history of psoriasis without remission, received a reduced-intensity transplantation from an HLA-identical sibling. The preparative regimen consisted of busulfan and fludarabine. Graft-versus-host-disease (GVHD) prophylaxis was cyclosporine and methotrexate. Psoriasis was completely resolved on day 18. The subsequent clinical course was uneventful until day 42, when psoriasis recurred at the same sites as before RIST. Peripheral blood examined on day 63 showed mixed chimerism with 54{\%} recipient type. Cyclosporine was rapidly tapered off over the next 2 weeks. On day 90, 100{\%} donor-type chimerism was confirmed. Subsequently, psoriasis improved simultaneously with the occurrence of mucositis and rash as a manifestation of GVHD. Scattered erythematous patches of psoriasis disappeared again by day 105. We initiated 0.5 mg/kg prednisolone on day 119, and resumed cyclosporine on day 133. At 7 months after RIST, he still suffers from chronic GVHD, but his psoriasis remains in remission for the first time in 21 years. The anti-psoriasis effect of the conditioning is mild and transient, while the graft-versus-autoimmunity effect, related to the induction of complete donor-type chimerism and GVHD, is more profound and persisting. A graft-versus-autoimmunity effect lies in the delicate balance between alloimmunity and immunosuppressant used for GVHD prophylaxis/treatment.",
keywords = "Graft-versus-autoimmunity effect, Graft-versus-host disease, Psoriasis, Reduced-intensity stem cell transplantation",
author = "R. Kojima and M. Kami and Kim, {S. W.} and N. Murashige and Y. Kishi and A. Hori and O. Imataki and T. Hamaki and M. Sakiyama and S. Masuo and Y. Fujisawa and A. Makimoto and Y. Heike and Ryuji Tanosaki and Y. Takaue",
year = "2003",
month = "8",
doi = "10.1038/sj.bmt.1704146",
language = "English",
volume = "32",
pages = "439--442",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "4",

}

TY - JOUR

T1 - Induction of graft-versus-autoimmune (GVA) disease effect against refractory psoriasis by complete donor-type chimerism and graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

AU - Kojima, R.

AU - Kami, M.

AU - Kim, S. W.

AU - Murashige, N.

AU - Kishi, Y.

AU - Hori, A.

AU - Imataki, O.

AU - Hamaki, T.

AU - Sakiyama, M.

AU - Masuo, S.

AU - Fujisawa, Y.

AU - Makimoto, A.

AU - Heike, Y.

AU - Tanosaki, Ryuji

AU - Takaue, Y.

PY - 2003/8

Y1 - 2003/8

N2 - A 67-year-old man with AML, who had a 21-year history of psoriasis without remission, received a reduced-intensity transplantation from an HLA-identical sibling. The preparative regimen consisted of busulfan and fludarabine. Graft-versus-host-disease (GVHD) prophylaxis was cyclosporine and methotrexate. Psoriasis was completely resolved on day 18. The subsequent clinical course was uneventful until day 42, when psoriasis recurred at the same sites as before RIST. Peripheral blood examined on day 63 showed mixed chimerism with 54% recipient type. Cyclosporine was rapidly tapered off over the next 2 weeks. On day 90, 100% donor-type chimerism was confirmed. Subsequently, psoriasis improved simultaneously with the occurrence of mucositis and rash as a manifestation of GVHD. Scattered erythematous patches of psoriasis disappeared again by day 105. We initiated 0.5 mg/kg prednisolone on day 119, and resumed cyclosporine on day 133. At 7 months after RIST, he still suffers from chronic GVHD, but his psoriasis remains in remission for the first time in 21 years. The anti-psoriasis effect of the conditioning is mild and transient, while the graft-versus-autoimmunity effect, related to the induction of complete donor-type chimerism and GVHD, is more profound and persisting. A graft-versus-autoimmunity effect lies in the delicate balance between alloimmunity and immunosuppressant used for GVHD prophylaxis/treatment.

AB - A 67-year-old man with AML, who had a 21-year history of psoriasis without remission, received a reduced-intensity transplantation from an HLA-identical sibling. The preparative regimen consisted of busulfan and fludarabine. Graft-versus-host-disease (GVHD) prophylaxis was cyclosporine and methotrexate. Psoriasis was completely resolved on day 18. The subsequent clinical course was uneventful until day 42, when psoriasis recurred at the same sites as before RIST. Peripheral blood examined on day 63 showed mixed chimerism with 54% recipient type. Cyclosporine was rapidly tapered off over the next 2 weeks. On day 90, 100% donor-type chimerism was confirmed. Subsequently, psoriasis improved simultaneously with the occurrence of mucositis and rash as a manifestation of GVHD. Scattered erythematous patches of psoriasis disappeared again by day 105. We initiated 0.5 mg/kg prednisolone on day 119, and resumed cyclosporine on day 133. At 7 months after RIST, he still suffers from chronic GVHD, but his psoriasis remains in remission for the first time in 21 years. The anti-psoriasis effect of the conditioning is mild and transient, while the graft-versus-autoimmunity effect, related to the induction of complete donor-type chimerism and GVHD, is more profound and persisting. A graft-versus-autoimmunity effect lies in the delicate balance between alloimmunity and immunosuppressant used for GVHD prophylaxis/treatment.

KW - Graft-versus-autoimmunity effect

KW - Graft-versus-host disease

KW - Psoriasis

KW - Reduced-intensity stem cell transplantation

UR - http://www.scopus.com/inward/record.url?scp=10744224648&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744224648&partnerID=8YFLogxK

U2 - 10.1038/sj.bmt.1704146

DO - 10.1038/sj.bmt.1704146

M3 - Article

VL - 32

SP - 439

EP - 442

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 4

ER -