Adult Bone Marrow Transplantation (BMT) Service, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Department of Medicine, Weill Cornell Medical College, New York, NY, United States.
Front Immunol. 2021 Apr 19;12:674093. doi: 10.3389/fimmu.2021.674093. eCollection 2021.
Older patients with hematologic malignancies are increasingly considered for allogeneic hematopoietic cell transplantation with encouraging outcomes. While aging-related thymic dysfunction remains a major obstacle to optimal and timely immune reconstitution post- transplantation, recent accumulating evidence has suggested that various aging hallmarks such as cellular senescence, inflamm-aging, and hematopoietic stem cell exhaustion, could also impact immune reconstitution post-transplantation in both thymic-dependent and independent manner. Here we review molecular and cellular aspects of immune senescence and immune rejuvenation related to allogeneic hematopoietic cell transplantation among older patients and discuss potential strategies for mechanism-based therapeutic intervention.
越来越多患有血液系统恶性肿瘤的老年患者被考虑接受异基因造血细胞移植，其结果令人鼓舞。尽管与年龄相关的胸腺功能障碍仍然是移植后获得最佳和及时免疫重建的主要障碍，但最近越来越多的证据表明，各种衰老特征，如细胞衰老、炎症衰老和造血干细胞衰竭，也可能以依赖和不依赖于胸腺的方式影响移植后的免疫重建。在这里，我们回顾了与老年患者异基因造血细胞移植相关的免疫衰老和免疫更新的分子和细胞方面，并讨论了基于机制的治疗干预的潜在策略。
