脐血移植后移植物抗宿主病的预防和管理指南。
Guidelines for the Prevention and Management of Graft-versus-Host Disease after Cord Blood Transplantation.
机构信息
Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College; New York, New York.
Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College; New York, New York.
出版信息
Transplant Cell Ther. 2021 Jul;27(7):540-544. doi: 10.1016/j.jtct.2021.03.012.
The incidence of graft-versus-host disease (GVHD) after cord blood (CB) transplantation (CBT) is lower than expected given the marked degree of human leukocyte antigen (HLA)-mismatch of CB grafts. While the exact mechanism that underlies this biology remains unclear, it is hypothesized to be due to the low number of mostly immature T-cells infused as part of the graft1,2, and increased tolerance of CB-derived lymphocytes induced by the state of pregnancy. Nevertheless, acute GVHD (aGVHD) is a significant complication of CBT. In contrast, the incidence of chronic GVHD (cGVHD) following CBT is lower than what is observed following matched related or unrelated donor HSC transplantation (HSCT)3-6. This review outlines the guidelines for the prevention and management of acute and chronic GVHD following CBT.
相较于预期，脐带血（CB）移植（CBT）后移植物抗宿主病（GVHD）的发生率较低，这是由于 CB 移植物的人类白细胞抗原（HLA）错配程度明显。虽然这种生物学现象的确切机制尚不清楚，但据推测是由于输注的大多数幼稚 T 细胞数量较少，这是移植物的一部分1,2，以及妊娠状态下 CB 来源的淋巴细胞诱导的耐受性增加。尽管如此，CBT 后的急性 GVHD（aGVHD）仍是一个重大并发症。相比之下，CBT 后慢性 GVHD（cGVHD）的发生率低于匹配相关或无关供体造血干细胞移植（HSCT）后观察到的发生率3-6。这篇综述概述了 CBT 后预防和管理急性和慢性 GVHD 的指南。
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