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

Jordan Gauthier, Patrick Vermersch, Paul Chauvet, Pauline Varlet, Valérie Coiteux, Leonardo Magro and Ibrahim Yakoub-Agha

Article Figures & Data

Figures

  • Figure 1.

    Clinical and morphologic response to fingolimod and steroids in a patient with CNS GVHD. *MRI images are T2-FLAIR weighted; arrowheads indicate main periventricular lesions, which gradually disappeared on treatment. †Scores were not evaluated at the time of the first episode of CNS GVHD. Any MMSE score ≥24 points (out of 30) indicates normal cognition. Any FAB score ≥16 points (out of 18 points) indicates normal executive functions. T0, time of the first episode of CNS GVHD (10 months after allo-HCT).

  • Figure 2.

    Immunophenotyping analysis of immune cells in the peripheral blood of a patient treated with fingolimod and corticosteroids for CNS GVHD. (A) Total lymphocyte counts, lymphocyte subsets absolute counts and changes in subset proportions of B and T cells were determined by flow cytometry. Fingolimod and corticosteroids were associated with lymphopenia and decreased B-cell, T-cell, and natural killer cell absolute counts. Treatment with fingolimod and corticosteroids was followed by an increase in the proportion of naive B cells (B), CD4+ (C), and CD8+ (D) effector memory T cells in the peripheral blood. T0, time of treatment initiation with fingolimod and corticosteroids to treat the second episode of CNS GVHD. Pretreatment samples were drawn at the time of diagnosis of the second episode of CNS GVHD, 17 months after allo-HCT.