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巨细胞病毒感染和单倍体造血干细胞移植后的巨细胞病毒特异性免疫重建:最新进展。

CMV Infection and CMV-Specific Immune Reconstitution Following Haploidentical Stem Cell Transplantation: An Update.

机构信息

Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Hematology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.

出版信息

Front Immunol. 2021 Oct 28;12:732826. doi: 10.3389/fimmu.2021.732826. eCollection 2021.

Abstract

Haploidentical stem cell transplantation (haploSCT) has advanced to a common procedure for treating patients with hematological malignancies and immunodeficiency diseases. However, cure is seriously hampered by cytomegalovirus (CMV) infections and delayed immune reconstitution for the majority of haploidentical transplant recipients compared to HLA-matched stem cell transplantation. Three major approaches, including T-cell depletion (TCD) using antithymocyte globulin for haploSCT ( TCD-haploSCT), TCD using CD34 + positive selection for haploSCT ( TCD-haploSCT), and T-cell replete haploSCT using posttransplant cyclophosphamide (PTCy-haploSCT), are currently used worldwide. We provide an update on CMV infection and CMV-specific immune recovery in this fast-evolving field. The progress made in cellular immunotherapy of CMV infection after haploSCT is also addressed. Groundwork has been prepared for the creation of personalized avenues to enhance immune reconstitution and decrease the incidence of CMV infection after haploSCT.

摘要

单倍体造血干细胞移植(haploSCT)已发展成为治疗血液系统恶性肿瘤和免疫缺陷疾病患者的常用方法。然而,与 HLA 匹配的干细胞移植相比,大多数单倍体移植受者的巨细胞病毒(CMV)感染和延迟免疫重建严重阻碍了其治愈。目前,全世界主要采用三种方法,包括用抗胸腺细胞球蛋白进行 T 细胞耗竭(TCD-haploSCT)、用 CD34+阳性选择进行 T 细胞耗竭(TCD-haploSCT)和用环磷酰胺后移植进行 T 细胞充足的单倍体造血干细胞移植(PTCy-haploSCT)。我们提供了这个快速发展领域中 CMV 感染和 CMV 特异性免疫恢复的最新信息。还介绍了单倍体造血干细胞移植后 CMV 感染的细胞免疫治疗进展。为增强单倍体造血干细胞移植后免疫重建和降低 CMV 感染的发生率,已经为个性化途径的创建奠定了基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb30/8580860/c3450b329ae4/fimmu-12-732826-g001.jpg

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