Advanced Molecular Epidemiology Research Institute, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.
Stem Cells Int. 2011;2011:607569. doi: 10.4061/2011/607569. Epub 2011 Jun 5.
Cord blood transplantation (CBT) is an attractive alternative therapy in adult patients with advanced hematological malignancies in whom matched donors are unavailable. However, the risk of complications, especially infections, post-CBT increases the mortality rates in these patients. Although the incidence of acute and chronic graft versus host disease (GVHD) post-CBT is lower than that following bone marrow transplantation and peripheral blood stem cell transplantation (SCT), the additional immunosuppressive therapy required to treat it could increase the mortality in these patients. Further, chronic GVHD following CBT is milder and responds better to treatment than that occurring after bone marrow transplants. Unlike bone marrow transplantation, the onset of GVHD is a positive prognostic indicator of overall survival in patients receiving CBT, due to the graft versus malignancy (GVM) effect. This paper focuses on the immune reactions following CBT and aims to elucidate a management strategy for acute and chronic GVHD.
脐带血移植（CBT）是一种有吸引力的成人患者中晚期血液恶性肿瘤的替代疗法，在这些患者中无法匹配供体。然而，CBT 后并发症的风险，特别是感染，增加了这些患者的死亡率。尽管 CBT 后急性和慢性移植物抗宿主病（GVHD）的发生率低于骨髓移植和外周血干细胞移植（SCT）后，但为治疗它所需的额外免疫抑制治疗可能会增加这些患者的死亡率。此外，CBT 后慢性 GVHD 比骨髓移植后更轻，对治疗的反应更好。与骨髓移植不同，GVHD 的发生是接受 CBT 的患者总体生存的一个积极预后指标，这是由于移植物抗恶性肿瘤（GVM）效应。本文重点介绍 CBT 后的免疫反应，并旨在阐明急性和慢性 GVHD 的管理策略。
