Unrelated umbilical cord blood transplantation and immune reconstitution.
This review highlights the unique features of immune reconstitution following unrelated cord blood transplantation (UCBT) that lead to heightened risk of infection-related mortality in the early post-UCBT period. There is no evidence that innate immunity is uniquely compromised after UCBT, but the development of antigen-specific cellular immunity is affected by numerical and qualitative deficits, primarily within the first 100 days. Nevertheless, beyond the first few months after UCBT there is no evidence for reduced graft-versus-leukemia (GVL) or anti-viral immunity compared to other hematopoietic cell therapy (HCT) modalities. Novel cellular therapies that are about to enter the clinical setting in the form of natural killer (NK) cell and T-cell therapies in the form of donor lymphocyte infusion (DLI) are also discussed.
Szabolcs
Paul
P
Department of Pediatrics, Division of Pediatric Bone Marrow Transplantation, Duke University Medical Center, Durham, NC, USA.
Cairo
Mitchell S
MS
D000328:Adult; D001782:Blood Donors / Q000600:supply & distribution*; D002648:Child; D003141:Communicable Diseases / Q000276:immunology / Q000401:mortality; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006402:Hematologic Diseases / Q000276:immunology / Q000601:surgery*; D019337:Hematologic Neoplasms / Q000276:immunology / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007694:Killer Cells, Natural / Q000276:immunology; D016131:Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology* / Q000637:transplantation; D019653:Myeloablative Agonists / Q000627:therapeutic use; D018579:Patient Selection; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome
D019653:Myeloablative Agonists