Pediatric Hematology and Oncology, Children's Hospital, Johann Wolfgang Goethe University Frankfurt, Germany.
Front Oncol. 2013 Feb 7;3:17. doi: 10.3389/fonc.2013.00017. eCollection 2013.
Despite the availability of new antifungal compounds, invasive fungal infection remains a significant cause of morbidity and mortality in children and adults undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Allogeneic HSCT recipients suffer from a long lasting defect of different arms of the immune system, which increases the risk for and deteriorates the prognosis of invasive fungal infections. In turn, advances in understanding these immune deficits have resulted in promising strategies to enhance or restore critical immune functions in allogeneic HSCT recipients. Potential approaches include the administration of granulocytes, since neutropenia is the single most important risk factor for invasive fungal infection, and preliminary clinical results suggest a benefit of adoptively transferred donor-derived antifungal T cells. In vitro data and animal studies demonstrate an antifungal effect of natural killer cells, but clinical data are lacking to date. This review summarizes and critically discusses the available data of immunotherapeutic strategies in allogeneic HSCT recipients suffering from invasive fungal infection.
尽管有新的抗真菌化合物可用，但侵袭性真菌感染仍然是接受异基因造血干细胞移植（HSCT）的儿童和成人发病率和死亡率的重要原因。异基因 HSCT 受者存在免疫系统不同分支的长期缺陷，这增加了侵袭性真菌感染的风险并恶化了其预后。反过来，对这些免疫缺陷的深入了解已导致增强或恢复异基因 HSCT 受者关键免疫功能的有前途的策略。潜在的方法包括粒细胞的给药，因为中性粒细胞减少症是侵袭性真菌感染的唯一最重要的危险因素，初步临床结果表明，过继转移供体来源的抗真菌 T 细胞有益。体外数据和动物研究表明自然杀伤细胞具有抗真菌作用，但目前尚无临床数据。这篇综述总结并批判性地讨论了患有侵袭性真菌感染的异基因 HSCT 受者的免疫治疗策略的现有数据。
