Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Peking-Tsinghua Center for Life Sciences, Beijing, China.
Biol Blood Marrow Transplant. 2014 Apr;20(4):440-9. doi: 10.1016/j.bbmt.2013.11.028. Epub 2013 Dec 4.
Haploidentical hematopoietic stem cell transplantation (HSCT) offers the benefits of rapid and nearly universal donor availability and has been accepted worldwide as an alternative treatment for patients with hematologic malignancies who do not have a completely HLA-matched sibling or who require urgent transplantation. Unfortunately, serious infections and leukemia relapse resulting from slow immune reconstitution remain the 2 most frequent causes of mortality in patients undergoing haploidentical HSCT, particularly in those receiving extensively T cell-depleted megadose CD34(+) allografts. This review summarizes advances in immune recovery after haploidentical HSCT, focusing on the immune subsets likely to have the greatest impact on clinical outcomes. The progress made in accelerating immune reconstitution using different strategies after haploidentical HSCT is also discussed. It is our belief that a predictive immune subset-guided strategy to improve immune recovery might represent a future clinical direction.
单倍体造血干细胞移植（HSCT）具有供者来源迅速且几乎普遍的优势，已被全球范围内接受为血液系统恶性肿瘤患者的一种替代治疗方法，这些患者没有完全 HLA 匹配的同胞，或需要紧急移植。不幸的是，免疫重建缓慢导致的严重感染和白血病复发仍然是接受单倍体 HSCT 患者死亡的两个最常见原因，特别是在接受广泛 T 细胞清除的大剂量 CD34(+)同种异体移植物的患者中。这篇综述总结了单倍体 HSCT 后免疫恢复的进展，重点介绍了对临床结果影响最大的免疫亚群。还讨论了使用不同策略加速单倍体 HSCT 后免疫重建所取得的进展。我们相信，一种预测性免疫亚群指导的策略来改善免疫恢复可能代表未来的临床方向。
