Dekker Linde, de Koning Coco, Lindemans Caroline, Nierkens Stefan
Princess Máxima Center for Pediatric Oncology, Utrecht University, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands.
Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Cancers (Basel). 2020 Jul 20;12(7):1974. doi: 10.3390/cancers12071974.
Allogeneic (allo) hematopoietic cell transplantation (HCT) is the only curative treatment option for patients suffering from chemotherapy-refractory or relapsed hematological malignancies. The occurrence of morbidity and mortality after allo-HCT is still high. This is partly correlated with the immunological recovery of the T cell subsets, of which the dynamics and relations to complications are still poorly understood. Detailed information on T cell subset recovery is crucial to provide tools for better prediction and modulation of adverse events. Here, we review the current knowledge regarding CD4 and CD8 T cells, γδ T cells, iNKT cells, Treg cells, MAIT cells and naive and memory T cell reconstitution, as well as their relations to outcome, considering different cell sources and immunosuppressive therapies. We conclude that the T cell subsets reconstitute in different ways and are associated with distinct adverse and beneficial events; however, adequate reconstitution of all the subsets is associated with better overall survival. Although the exact mechanisms involved in the reconstitution of each T cell subset and their associations with allo-HCT outcome need to be further elucidated, the data and suggestions presented here point towards the development of individualized approaches to improve their reconstitution. This includes the modulation of immunotherapeutic interventions based on more detailed immune monitoring, aiming to improve overall survival changes.
异基因造血细胞移植（allo-HCT）是化疗难治性或复发性血液系统恶性肿瘤患者唯一的治愈性治疗选择。异基因造血细胞移植后发病率和死亡率仍然很高。这部分与T细胞亚群的免疫恢复相关，而T细胞亚群的动态变化及其与并发症的关系仍知之甚少。关于T细胞亚群恢复的详细信息对于提供更好地预测和调节不良事件的工具至关重要。在此，我们回顾了有关CD4和CD8 T细胞、γδ T细胞、iNKT细胞、调节性T细胞（Treg细胞）、黏膜相关恒定T细胞（MAIT细胞）以及初始和记忆T细胞重建的现有知识，以及它们与预后的关系，同时考虑了不同的细胞来源和免疫抑制疗法。我们得出结论，T细胞亚群以不同方式重建，并与不同的不良和有益事件相关；然而，所有亚群的充分重建与更好的总生存率相关。尽管每个T细胞亚群重建所涉及的确切机制及其与异基因造血细胞移植结果的关联需要进一步阐明，但本文提供的数据和建议表明需要开发个性化方法来改善它们的重建。这包括基于更详细的免疫监测调整免疫治疗干预措施，旨在改善总生存变化。
