A systematic review of transfusion-associated graft-versus-host disease

Ilana Kopolovic, Jackie Ostro, Hideki Tsubota, Yulia Lin, Christine M. Cserti-Gazdewich, Hans A. Messner, Amy K. Keir, Neal DenHollander, Walter S. Dzik, Jeannie Callum

Research output: Contribution to journalReview article

54 Citations (Scopus)

Abstract

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of blood transfusion. The clinicolaboratory features of TA-GVHD and the relative contributions of recipient and component factors remain poorly understood. We conducted a systematic review of TA-GVHD reports. The HLA relationship between donor and recipient was classified as D = 0 when no donor antigens were foreign to the recipient vs D ≥ 1 when ≥1 donor antigen disparity occurred. We identified 348 unique cases. Criteria for component irradiation were met in 48.9% of cases (34.5% immune-compromised, 14.4% related-donor), although nonirradiated components were transfused in the vast majority of these (97.6%). Components were typically whole blood and red cells. When reported, component storage duration was ≤10 days in 94%, and 23 (6.6%) were leukoreduced (10 bedside, 2 prestorage, and 11 unknown). Among 84 cases with HLA data available, the category of D = 0 was present in 60 patients (71%) at either HLA class I or II loci and was more common among recipients without traditional indications for component irradiation. These data challenge the historic emphasis on host immune defects in the pathogenesis of TA-GVHD. The dominant mechanism of TA-GVHD in both immunocompetent and compromised hosts is exposure to viable donor lymphocytes not recognized as foreign by, but able to respond against, the recipient.

LanguageEnglish
Pages406-414
Number of pages9
JournalBlood
Volume126
Issue number3
DOIs
Publication statusPublished - 16 Jul 2015

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Kopolovic, I., Ostro, J., Tsubota, H., Lin, Y., Cserti-Gazdewich, C. M., Messner, H. A., ... Callum, J. (2015). A systematic review of transfusion-associated graft-versus-host disease. Blood, 126(3), 406-414. https://doi.org/10.1182/blood-2015-01-620872
Kopolovic, Ilana ; Ostro, Jackie ; Tsubota, Hideki ; Lin, Yulia ; Cserti-Gazdewich, Christine M. ; Messner, Hans A. ; Keir, Amy K. ; DenHollander, Neal ; Dzik, Walter S. ; Callum, Jeannie. / A systematic review of transfusion-associated graft-versus-host disease. In: Blood. 2015 ; Vol. 126, No. 3. pp. 406-414.
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abstract = "Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of blood transfusion. The clinicolaboratory features of TA-GVHD and the relative contributions of recipient and component factors remain poorly understood. We conducted a systematic review of TA-GVHD reports. The HLA relationship between donor and recipient was classified as D = 0 when no donor antigens were foreign to the recipient vs D ≥ 1 when ≥1 donor antigen disparity occurred. We identified 348 unique cases. Criteria for component irradiation were met in 48.9{\%} of cases (34.5{\%} immune-compromised, 14.4{\%} related-donor), although nonirradiated components were transfused in the vast majority of these (97.6{\%}). Components were typically whole blood and red cells. When reported, component storage duration was ≤10 days in 94{\%}, and 23 (6.6{\%}) were leukoreduced (10 bedside, 2 prestorage, and 11 unknown). Among 84 cases with HLA data available, the category of D = 0 was present in 60 patients (71{\%}) at either HLA class I or II loci and was more common among recipients without traditional indications for component irradiation. These data challenge the historic emphasis on host immune defects in the pathogenesis of TA-GVHD. The dominant mechanism of TA-GVHD in both immunocompetent and compromised hosts is exposure to viable donor lymphocytes not recognized as foreign by, but able to respond against, the recipient.",
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Kopolovic, I, Ostro, J, Tsubota, H, Lin, Y, Cserti-Gazdewich, CM, Messner, HA, Keir, AK, DenHollander, N, Dzik, WS & Callum, J 2015, 'A systematic review of transfusion-associated graft-versus-host disease', Blood, vol. 126, no. 3, pp. 406-414. https://doi.org/10.1182/blood-2015-01-620872

A systematic review of transfusion-associated graft-versus-host disease. / Kopolovic, Ilana; Ostro, Jackie; Tsubota, Hideki; Lin, Yulia; Cserti-Gazdewich, Christine M.; Messner, Hans A.; Keir, Amy K.; DenHollander, Neal; Dzik, Walter S.; Callum, Jeannie.

In: Blood, Vol. 126, No. 3, 16.07.2015, p. 406-414.

Research output: Contribution to journalReview article

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AU - Kopolovic, Ilana

AU - Ostro, Jackie

AU - Tsubota, Hideki

AU - Lin, Yulia

AU - Cserti-Gazdewich, Christine M.

AU - Messner, Hans A.

AU - Keir, Amy K.

AU - DenHollander, Neal

AU - Dzik, Walter S.

AU - Callum, Jeannie

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Y1 - 2015/7/16

N2 - Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of blood transfusion. The clinicolaboratory features of TA-GVHD and the relative contributions of recipient and component factors remain poorly understood. We conducted a systematic review of TA-GVHD reports. The HLA relationship between donor and recipient was classified as D = 0 when no donor antigens were foreign to the recipient vs D ≥ 1 when ≥1 donor antigen disparity occurred. We identified 348 unique cases. Criteria for component irradiation were met in 48.9% of cases (34.5% immune-compromised, 14.4% related-donor), although nonirradiated components were transfused in the vast majority of these (97.6%). Components were typically whole blood and red cells. When reported, component storage duration was ≤10 days in 94%, and 23 (6.6%) were leukoreduced (10 bedside, 2 prestorage, and 11 unknown). Among 84 cases with HLA data available, the category of D = 0 was present in 60 patients (71%) at either HLA class I or II loci and was more common among recipients without traditional indications for component irradiation. These data challenge the historic emphasis on host immune defects in the pathogenesis of TA-GVHD. The dominant mechanism of TA-GVHD in both immunocompetent and compromised hosts is exposure to viable donor lymphocytes not recognized as foreign by, but able to respond against, the recipient.

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Kopolovic I, Ostro J, Tsubota H, Lin Y, Cserti-Gazdewich CM, Messner HA et al. A systematic review of transfusion-associated graft-versus-host disease. Blood. 2015 Jul 16;126(3):406-414. https://doi.org/10.1182/blood-2015-01-620872