Yafteh

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Although hematopoietic stem cell transplantation is a potential solution in the treatment of many blood malignancies and immune disorders, graft versus host disease (GVHD) has posed many challenges. Chronic (c)GVHD is one of the leading causes of death in acute GVHD survivors. Up to 70% of transplanted patients will experience cGVHD. Various studies have demonstrated the essential role of B cells in the development of cGVHD. These cells use various mechanisms in triggering cGVHD, including production of alloantibodies, activation of complement system, promoting antibody-dependent cell cytotoxicity, and cross-presentation of antigens and immune complexes to CD4+ T and CD8+ T cells. B cells can also interfere the peripheral tolerance of T cells. High level of alloreactive and autoreactive B cells as well as low level of regulatory B cells are observed in cGVHD patients, and are associated with the cGVHD severity. Therefore, B cell subsets should be considered in the transplantation procedure. B cell manipulation and targeting in allogeneic transplantation could be a promising approach to prevent and control cGVHD. In this article, we reviewed the roles of B cells in the pathophysiology of cGVHD.

Keywords: B cells, chronic graft versus host disease, HSCT

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