T-cell recovery following marrow transplant: experience with delayed lymphocyte infusions to accelerate immune recovery or treat infectious problems.
All forms of hematopoietic stem-cell transplantation are complicated by delayed immune reconstitution, which results in an increased risk of infectious complications and relapse of disease. Donor lymphocyte infusions have been used in an attempt to enhance immune recovery and for the prevention and treatment of specific infections following transplantation. While there is little data to support the use of donor lymphocytes for the enhancement of general immune function post-transplant, unselected and virus-specific donor T cells may have efficacy for the prophylaxis and treatment of infections and disease caused by Epstein-Barr virus (EBV) and cytomegalovirus (CMV). While donor lymphocyte infusions may cause significant morbidity and mortality, they are a novel and potentially powerful approach for the treatment of frequently fatal post-transplant infectious complications.
Smith
F O
FO
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA. frsmith@iupui.edu
Thomson
B
B
D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007111:Immunity, Cellular / Q000502:physiology; D016219:Immunotherapy, Adoptive; D017710:Lymphocyte Transfusion / Q000379:methods*; D008297:Male; D011379:Prognosis; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors; D014777:Virus Diseases / Q000209:etiology / Q000517:prevention & control*