scholarly journals Successful Treatment with Intrathecal Tocilizumab(IL-6 antibody) for 2 Cases of Graft-Versus Host Disease of the Central Nervous System after a Second Allogeneic HSCT from Haploidentical Donor

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5730-5730
Author(s):  
Ruirui Gui ◽  
Juanjuan Zhao ◽  
Yingling Zu ◽  
Lu Han ◽  
Yanli Zhang ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Cell Transplantation ◽  
Graft Versus Host Disease ◽  
Peripheral Blood ◽  
Intrathecal Injection ◽  
Graft Versus Host ◽  
Hematopoietic Recovery ◽  
The Central Nervous System

Abstract Graft-versus-host disease (GVHD) of central nervous system (CNS) is a rare complication after allogeneic hematopoietic cell transplantation (allo-HSCT), which is easily misdiagnosed and has limited treatment and poor efficacy. In this study, we reported two children(1 case of severe aplastic anemia and 1 case of acute myeloid leukemia) who were subjected to the secondary haploid hematopoietic stem cell transplantation of another door after the first implantation failure. Two patients developed epileptic seizures during hematopoietic recovery. Peripheral blood and cerebrospinal fluid cytokines were detected and diagnosed as acute GVHD in the central nervous system. The cytokine elevation is mainly IL-6(IL-6 level in peripheral blood was 2276.25 pg/ml, and in cerebrospinal fluid was 2353.89pg/ml of case 1). We administered multiply consecutive plasmapheresis, intravenous infusion of tocilizumab combined with intrathecal injection of tocilizumab and dexamethasone. The epileptic symptoms of 2 cases are effectively controlled after the first dose. The IL-6 levels in peripheral blood and cerebrospinal fluid of both patients decreased significantly after 4(IL-6 level in peripheral blood was 6.74 pg/ml, and in cerebrospinal fluid was 195.72pg/ml of case 1) and 5 doses, respectively. Central nervous system aGVHD is prone to hematopoietic recovery after secondary transplantation; intrathecal injection of tocilizumab is safe and effective in the treatment of central nervous system aGVHD with elevated IL-6 mainly, which is worth further exploring. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

CHAPTER 9: Immunology of TBEV-Infections

2020 ◽  
Keyword(s):  
Central Nervous System ◽  
T Cells ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Nk Cells ◽  
Peripheral Blood ◽  
Sample Collection ◽  
Tick Borne Encephalitis ◽  
Viral Infectious Disease ◽  
The Central Nervous System

Tick-borne encephalitis (TBE) is a viral infectious disease of the central nervous system caused by the tick-borne encephalitis virus (TBEV). TBE is usually a biphasic disease and in humans the virus can only be detected during the first (unspecific) phase of the disease. Pathogenesis of TBE is not well understood, but both direct viral effects and immune-mediated tissue damage of the central nervous system may contribute to the natural course of TBE. The effect of TBEV on the innate immune system has mainly been studied in vitro and in mouse models. Characterization of human immune responses to TBEV is primarily conducted in peripheral blood and cerebrospinal fluid, due to the inaccessibility of brain tissue for sample collection. Natural killer (NK) cells and T cells are activated during the second (meningo-encephalitic) phase of TBE. The potential involvement of other cell types has not been examined to date. Immune cells from peripheral blood, in particular neutrophils, T cells, B cells and NK cells, infiltrate into the cerebrospinal fluid of TBE patients.

Chapter 9: Immunology of TBEV-Infection

2021 ◽  
Author(s):  
Sara Gredmark-Russ ◽  
Renata Varnaite
Keyword(s):  
Central Nervous System ◽  
T Cells ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Nk Cells ◽  
Peripheral Blood ◽  
Sample Collection ◽  
Tick Borne Encephalitis ◽  
Viral Infectious Disease ◽  
The Central Nervous System

Tick-borne encephalitis (TBE) is a viral infectious disease of the central nervous system caused by the tick-borne encephalitis virus (TBEV). TBE is usually a biphasic disease and in humans the virus can only be detected during the first (unspecific) phase of the disease. Pathogenesis of TBE is not well understood, but both direct viral effects and immune-mediated tissue damage of the central nervous system may contribute to the natural course of TBE. The effect of TBEV on the innate immune system has mainly been studied in vitro and in mouse models. Characterization of human immune responses to TBEV is primarily conducted in peripheral blood and cerebrospinal fluid, due to the inaccessibility of brain tissue for sample collection. Natural killer (NK) cells and T cells are activated during the second (meningo-encephalitic) phase of TBE. The potential involvement of other cell types has not been examined to date. Immune cells from peripheral blood, in particular neutrophils, T cells, B cells and NK cells, infiltrate into the cerebrospinal fluid of TBE patients.

scholarly journals Possible graft-versus-host disease involving the central nervous system soon after cord blood transplantation

2009 ◽  
Vol 84 (11) ◽  
pp. 764-766 ◽  
Author(s):  
Hisashi Yamamoto ◽  
Naoyuki Uchida ◽  
Kazuya Ishiwata ◽  
Hideki Araoka ◽  
Shinsuke Takagi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cord Blood ◽  
Graft Versus Host Disease ◽  
Cord Blood Transplantation ◽  
Host Disease ◽  
Graft Versus Host ◽  
Blood Transplantation ◽  
The Central Nervous System

Graft-versus-Host Disease in the Central Nervous System: A Real Entity?

1988 ◽  
Vol 89 (4) ◽  
pp. 543-546 ◽  
Author(s):  
Emilie Rouah ◽  
Regina Gruber ◽  
William Shearer ◽  
Dawna Armstrong ◽  
Edith P. Hawkins
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Graft Versus Host Disease ◽  
Host Disease ◽  
Graft Versus Host ◽  
System A ◽  
The Central Nervous System ◽  
Real Entity

scholarly journals Successful treatment with fingolimod of graft-versus-host disease of the central nervous system

2018 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Jordan Gauthier ◽  
Patrick Vermersch ◽  
Paul Chauvet ◽  
Pauline Varlet ◽  
Valérie Coiteux ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Graft Versus Host Disease ◽  
Successful Treatment ◽  
Host Disease ◽  
Graft Versus Host ◽  
Receptor Agonists ◽  
Key Points ◽  
Sphingosine 1 Phosphate ◽  
The Central Nervous System

Key Points Fingolimod could be efficient to treat GVHD of the central nervous system. Further research should explore the use of fingolimod and other sphingosine-1-phosphate receptor agonists to prevent or treat GVHD.

scholarly journals A Case Report of Central Nervous System Graft-Versus-Host Disease and Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Mingming Li ◽  
Yue Zhang ◽  
Yujia Guan ◽  
Zunwei Zhang ◽  
Hanbing Dong ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Graft Versus Host Disease ◽  
Clinical Manifestations ◽  
Fatal Disease ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Diffuse White Matter ◽  
The Central Nervous System

As an adverse immune phenomenon, graft-versus-host disease often occurs after allogeneic hematopoietic stem cell transplantation. The incidence of acute and chronic graft-versus-host disease is about 40–60% and the mortality rate can reach 15%, which is a potentially fatal disease. There are rare GvHD cases involving the central nervous system. We reported a rare case of diffuse white matter changes after haploid bone marrow transplantation, summarizing its clinical manifestations and diagnosis and treatment in conjunction with the literature.

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