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Related Collections Transplantation Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 April 2001, Vol. 97, No. 8, pp. 2514-2521 TRANSPLANTATION Postgrafting administration of granulocyte colony-stimulating factor impairs functional immune recovery in recipients of human leukocyte antigen haplotype-mismatched hematopoietic transplants Isabella Volpi, Katia Perruccio, Antonella Tosti, Marusca Capanni, Loredana Ruggeri, Sabrina Posati, Franco Aversa, Antonio Tabilio, Luigina Romani, Massimo F. Martelli, and Andrea Velardi From the Division of Hematology and Clinical Immunology, Department of Clinical and Experimental Medicine, and the Division of Microbiology, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Italy. In human leukocyte antigen haplotype-mismatched transplantation, extensive T-cell depletion prevents graft-versus-host disease (GVHD) but delays immune recovery. Granulocyte colony-stimulating factor (G-CSF) is given to donors to mobilize stem cells and to recipients to ensure engraftment. Studies have shown that G-CSF promotes T-helper (Th)-2 immune deviation which, unlike Th1 responses, does not protect against intracellular pathogens and fungi. The effect of administration of G-CSF to recipients of mismatched hematopoietic transplants with respect to transplantation outcome and functional immune recovery was investigated. In 43 patients with acute leukemia who received G-CSF after transplantation, the engraftment rate was 95%. However, the patients had a long-lasting type 2 immune reactivity, ie, Th2-inducing dendritic cells not producing interleukin 12 (IL-12) and high frequencies of IL-4- and IL-10-producing CD4+ cells not expressing the IL-12 receptor 2 chain. Similar immune reactivity patterns were observed on exposure of donor cells to G-CSF. Elimination of postgrafting administration of G-CSF in a subsequent series of 36 patients with acute leukemia, while not adversely affecting engraftment rate (93%), resulted in the anticipated appearance of IL-12-producing dendritic cells (1-3 months after transplantation versus > 12 months in transplant recipients given G-CSF), of CD4+ cells of a mixed Th0/Th1 phenotype, and of antifungal T-cell reactivity in vitro. Moreover, CD4+ cell counts increased in significantly less time. Finally, elimination of G-CSF-mediated immune suppression did not significantly increase the incidence of GVHD (< 15%). Thus, this study found that administration of G-CSF to recipients of T-cell-depleted hematopoietic transplants was associated with abnormal antigen-presenting cell functions and T-cell reactivity. Elimination of postgrafting administration of G-CSF prevented immune dysregulation and accelerated functional immune recovery. © 2001 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: L. Vago, B. Forno, M. P. Sormani, R. Crocchiolo, E. Zino, S. Di Terlizzi, M. T. Lupo Stanghellini, B. Mazzi, S. K. Perna, A. Bondanza, et al. Temporal, quantitative, and functional characteristics of single-KIR-positive alloreactive natural killer cell recovery account for impaired graft-versus-leukemia activity after haploidentical hematopoietic stem cell transplantation Blood, October 15, 2008; 112(8): 3488 - 3499. [Abstract] [Full Text] [PDF] F. Locatelli, M. Zecca, A. Pession, G. Morreale, D. Longoni, P. Di Bartolomeo, F. Porta, F. Fagioli, B. Nobili, M. E. Bernardo, et al. 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	Copyright © 2001 by American Society of Hematology         Online ISSN: 1528-0020