Donor bone marrow transplantation: chimerism and tolerance.
Infusion of donor bone marrow (DBM)-derived cells continue to be tested in clinical protocols intended to induce specific immunologic tolerance. Central clonal deletion of donor-specific alloreactive cells associated with mixed chimerism reliably produced long-term graft tolerance. In this setting, depletion of recipient T cells by antilymphocyte antibodies and subsequent repopulation by donor hematopoietic cells after donor bone marrow infusion (DBMI) are prerequisites for tolerance induction. Major advances have been made in animal models and in pilot clinical trials and the key questions with the future perspectives are presented in this article.
Delis
Spiros
S
Department of Surgery, Division of Kidney, Kidney/Pancreas Transplant, University of Miami School of Medicine, Miami, FL, USA.
Ciancio
Gaetano
G
Burke
George W
GW
Garcia-Morales
Rolando
R
Miller
Joshua
J
D000818:Animals; D016026:Bone Marrow Transplantation; D002986:Clinical Trials as Topic; D003888:Desensitization, Immunologic; D006085:Graft Survival / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007108:Immune Tolerance; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000276:immunology; D016031:Liver Transplantation / Q000276:immunology; D008213:Lymphocyte Activation; D051379:Mice; D016035:Pancreas Transplantation / Q000276:immunology; D010865:Pilot Projects; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000637:transplantation*; D014019:Tissue Donors; D018183:Transplantation Chimera; D014184:Transplantation, Homologous / Q000276:immunology*