{Reference Type}: Case Reports
{Title}: Unusual expansion of CD3+CD56+ natural killer T-like cells in peripheral blood after anticytokine treatment for graft-versus-host disease: A case report.
{Author}: Sheng L;Fu H;Tan Y;Hu Y;Mu Q;Luo Y;Shi J;Cai Z;Ouyang G;Huang H;
{Journal}: Medicine (Baltimore)
{Volume}: 97
{Issue}: 38
{Year}: Sep 2018
{Factor}: 1.817
{DOI}: 10.1097/MD.0000000000012429
{Abstract}: <B>BACKGROUND: </B>Basiliximab and etanercept have achieved promising responses in steroid-refractory graft versus host disease (SR-GVHD). However, the in vivo immune changes following the treatment have not been elucidated.<BR><B>METHODS: </B>A 14-year-old boy presented with skin rash and diarrhea 20 days after haploidentical hemotopoietic stem cell transplantation.<BR><B>METHODS: </B>We made the diagnose of grade 3 acute GVHD with skin and gastrointestinal involvement.<BR><B>METHODS: </B>After the failure of the first-line treatment with methylprednisolone, combined anti-cytokine therapies with basiliximab and etanercept were prescibed.<BR><B>RESULTS: </B>He achieved complete remission by basiliximab and etanercept. Furthermore, we detected that donor CD3CD56 Natural killer T(NKT)-like cells expanded gradually after the period of lymphocytopenia caused by GVHD and anti-cytokine therapy. The expansion of NKT-like cells was in association with high serum IFN-γ. NKT-like cells showed preferred proliferation in response to IFN-γ and potent cytotoxicity against leukemia cells. The expansion persisted > 2 years and the patient had a leukemia-free survival of 66 months.<BR><B>CONCLUSIONS: </B>Our case indicated that combined anti-cytokine treatment may reset the immune system and cause NKT-like cells to exhibit a predilection for expansion.