Porrata L F, Litzow M R, Markovic S N
Department of Oncology, Mayo Cinic, Rochester, Minn. 55905, USA.
Mayo Clin Proc. 2001 Apr;76(4):407-12. doi: 10.4065/76.4.407.
Autologous hematopoietic stem cell transplantation has proved to be an effective treatment for certain hematologic malignancies. However, relapse rates are high during the first year after transplantation. These relapses are attributed to the failure of high-dose chemotherapy to eradicate minimal residual malignant disease. In allogeneic hematopoietic stem cell transplantation, the higher antitumor effects observed compared with those in autologous hematopoietic stem cell transplantation are based on the immunologically mediated graft-vs-tumor effect. Therefore, a better understanding of the mechanisms involved in immune reconstitution after hematopoietic stem cell transplantation may clarify the importance of various components of the recovery of the immune system as they pertain to eradication of residual tumor, as well as uncover possible interventions directed at maximizing this effect. This review focuses on immune reconstitution after autologous hematopoietic stem cell transplantation. Autologous hematopoietic stem cell transplantation is not affected by graft-vs-host disease or immunosuppressive therapy after transplantation to control graft-vs-host disease, providing a direct insight into the mechanisms involved in immune reconstitution after engraftment.
自体造血干细胞移植已被证明是治疗某些血液系统恶性肿瘤的有效方法。然而，移植后第一年的复发率很高。这些复发归因于大剂量化疗未能根除微小残留恶性疾病。在异基因造血干细胞移植中，与自体造血干细胞移植相比观察到的更高抗肿瘤效果基于免疫介导的移植物抗肿瘤效应。因此，更好地理解造血干细胞移植后免疫重建所涉及的机制，可能会阐明免疫系统恢复的各个组成部分在根除残留肿瘤方面的重要性，以及发现旨在最大化这种效应的可能干预措施。本综述重点关注自体造血干细胞移植后的免疫重建。自体造血干细胞移植不受移植物抗宿主病或移植后用于控制移植物抗宿主病的免疫抑制治疗的影响，这为深入了解植入后免疫重建所涉及的机制提供了直接途径。
