Department of Pediatrics, Division of Pediatric Bone Marrow Transplantation, Duke University Medical Center, Durham, NC, USA.
Semin Hematol. 2010 Jan;47(1):22-36. doi: 10.1053/j.seminhematol.2009.10.009.
This review highlights the unique features of immune reconstitution following unrelated cord blood transplantation (UCBT) that lead to heightened risk of infection-related mortality in the early post-UCBT period. There is no evidence that innate immunity is uniquely compromised after UCBT, but the development of antigen-specific cellular immunity is affected by numerical and qualitative deficits, primarily within the first 100 days. Nevertheless, beyond the first few months after UCBT there is no evidence for reduced graft-versus-leukemia (GVL) or anti-viral immunity compared to other hematopoietic cell therapy (HCT) modalities. Novel cellular therapies that are about to enter the clinical setting in the form of natural killer (NK) cell and T-cell therapies in the form of donor lymphocyte infusion (DLI) are also discussed.
本综述强调了无关脐带血移植（UCBT）后免疫重建的独特特征，这些特征导致 UCBT 后早期感染相关死亡率升高。没有证据表明 UCBT 后固有免疫受到独特的损害，但抗原特异性细胞免疫的发展受到数量和质量缺陷的影响，主要发生在 100 天内。然而，与其他造血细胞治疗（HCT）方式相比，UCBT 后几个月以上并没有证据表明移植物抗白血病（GVL）或抗病毒免疫降低。也讨论了即将以自然杀伤（NK）细胞和供者淋巴细胞输注（DLI）形式的 T 细胞疗法的新型细胞疗法进入临床应用的情况。
