单倍体相合供者与脐带血异基因造血细胞移植后的免疫重建
Immune Reconstitution after Haploidentical Donor and Umbilical Cord Blood Allogeneic Hematopoietic Cell Transplantation.
作者信息
Elmariah Hany, Brunstein Claudio G, Bejanyan Nelli
机构信息
Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL 33612, USA.
Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA.
出版信息
Life (Basel). 2021 Jan 29;11(2):102. doi: 10.3390/life11020102.
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is the only potentially curative therapy for a variety of hematologic diseases. However, this therapeutic platform is limited by an initial period when patients are profoundly immunocompromised. There is gradual immune recovery over time, that varies by transplant platform. Here, we review immune reconstitution after allogeneic HCT with a specific focus on two alternative donor platforms that have dramatically improved access to allogeneic HCT for patients who lack an HLA-matched related or unrelated donor: haploidentical and umbilical cord blood HCT. Despite challenges, interventions are available to mitigate the risks during the immunocompromised period including antimicrobial prophylaxis, modified immune suppression strategies, graft manipulation, and emerging adoptive cell therapies. Such interventions can improve the potential for long-term overall survival after allogeneic HCT.
摘要
异基因造血细胞移植（HCT）是多种血液系统疾病唯一具有潜在治愈可能的疗法。然而，这一治疗平台受到患者处于严重免疫功能低下的初始阶段的限制。随着时间推移，免疫功能会逐渐恢复，且因移植平台而异。在此，我们回顾异基因HCT后的免疫重建，特别关注两种替代供体平台，它们显著改善了缺乏HLA匹配的相关或无关供体的患者接受异基因HCT的机会：单倍体相合和脐带血HCT。尽管存在挑战，但仍有干预措施可降低免疫功能低下期间的风险，包括抗菌预防、改良免疫抑制策略、移植物操作以及新兴的过继性细胞疗法。此类干预措施可提高异基因HCT后长期总体生存的可能性。
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