Centre Hospitalier et Universitaire de Nantes, France.
Best Pract Res Clin Haematol. 2010 Jun;23(2):275-82. doi: 10.1016/j.beha.2010.05.004.
Umbilical cord blood transplantation (UCBT) is increasingly being used as an alternative to conventional allogeneic stem cell transplantation. However, despite significant improvements, an appreciable proportion of patients (especially adults) receiving UCBT will still face some form of severe acute and/or chronic graft-versus-host disease (GVHD). Moreover, poor engraftment and delayed immune recovery are still challenging issues. Therefore, in terms of both GVHD and engraftment kinetics, the immunosuppressive potency of the conditioning regimen prior to UCBT may play an important role. Anti-thymocyte globulin (ATG, Thymoglobulin™) provides multifaceted immunomodulation suggesting that the use of ATG may be of interest towards improving engraftment and GVHD outcome. However, the role of ATG in UCBT is still under debate. This report will review the incidence and severity of GVHD after UCBT, and will discuss the potential role of ATG towards improving outcome (GVHD and engraftment) when used as part of the conditioning regimen prior to UCBT.
脐带血移植（UCBT）越来越多地被用作传统异基因干细胞移植的替代方法。然而，尽管取得了显著进展，但相当一部分接受 UCBT 的患者（尤其是成年人）仍将面临某种形式的严重急性和/或慢性移植物抗宿主病（GVHD）。此外，植入不良和免疫恢复延迟仍然是具有挑战性的问题。因此，就 GVHD 和植入动力学而言，UCBT 前预处理方案的免疫抑制效力可能起着重要作用。抗胸腺细胞球蛋白（ATG，Thymoglobulin™）提供了多方面的免疫调节作用，这表明 ATG 的使用可能有助于改善植入和 GVHD 结局。然而，ATG 在 UCBT 中的作用仍存在争议。本报告将回顾 UCBT 后 GVHD 的发生率和严重程度，并讨论 ATG 在作为 UCBT 前预处理方案的一部分使用时改善结局（GVHD 和植入）的潜在作用。
