Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104, USA.
Biol Blood Marrow Transplant. 2012 Jan;18(1):6-15. doi: 10.1016/j.bbmt.2011.11.014. Epub 2011 Nov 17.
Defective immune reconstitution is a major barrier to successful hematopoietic cell transplantation (HCT), and has important implications in the pediatric population. There are many factors that affect immune recovery, including stem cell source and graft-versus-host disease (GVHD). Complete assessment of immune recovery, including T and B lymphocyte evaluation, innate immunity, and response to neoantigens, may provide insight as to infection risk and optimal time for immunizations. The increasing use of cord blood grafts requires additional study regarding early reconstitution and impact upon survival. Immunization schedules may require modification based upon stem cell source and immune reconstitution, and this is of particular importance as many children have been incompletely immunized, or not at all, before school entry. Additional studies are needed in children post-HCT to evaluate the impact of differing stem cell sources upon immune reconstitution, infectious risks, and immunization responses.
免疫重建缺陷是造血细胞移植（HCT）成功的主要障碍，这在儿科人群中具有重要意义。有许多因素会影响免疫恢复，包括干细胞来源和移植物抗宿主病（GVHD）。对免疫恢复的全面评估，包括 T 和 B 淋巴细胞评估、先天免疫以及对新抗原的反应，可能有助于了解感染风险和免疫接种的最佳时机。越来越多的人使用脐带血移植物，这就需要进一步研究早期重建及其对存活率的影响。免疫接种计划可能需要根据干细胞来源和免疫重建进行修改，这一点非常重要，因为许多儿童在入学前都没有完全接种疫苗，或者根本没有接种疫苗。需要在 HCT 后对儿童进行更多的研究，以评估不同的干细胞来源对免疫重建、感染风险和免疫反应的影响。
