Research ArticleGraft-Versus-Host Disease

Graft-versus-host disease, but not graft-versus-leukemia immunity, is mediated by GM-CSF–licensed myeloid cells

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Science Translational Medicine  28 Nov 2018:
Vol. 10, Issue 469, eaat8410
DOI: 10.1126/scitranslmed.aat8410

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Keeping the baby but not the bathwater

The reconstituted immune system of an allogeneic hematopoietic cell transplant patient is responsible for preventing leukemia relapse by means of graft-versus-leukemia (GvL) activity. This same reconstituted immune system can turn on the recipient in the form of graft-versus-host disease (GvHD). Tugues et al. used multiple mouse transplant models to decipher the mechanisms driving GvHD and GvL. They discovered that GM-CSF–activated myeloid cells mediated GvHD, but did not contribute to GvL, which is largely carried out by T cells. These results suggest that blocking GM-CSF in hematopoietic cell transplant recipients may be able to specifically target cells that promote GvHD, without hampering those that enact GvL.