Immune reconstitution and strategies for rebuilding the immune system after haploidentical stem cell transplantation.
Haploidentical hematopoietic stem cell transplantation is a curative alternative option for patients without an otherwise suitable stem cell donor. In order to prevent graft-versus-host disease (GvHD), different in vitro and in vivo T cell-depletion strategies have been developed. A delayed immune reconstitution is common to all these strategies, and an impaired immune function after haploidentical transplantation with subsequent infections is a major cause of deaths in these patients. In addition to in vitro and in vivo T cell-depletion methods, posttransplant strategies to rapidly rebuild the immune system have been introduced in order to improve the outcome. Advances in in vitro and in vivo T cell-depletion methods, and adoptive transfer of immune cells of the innate and specific immune system, will contribute to reduce the risk of GvHD, lethal infections, and the risk of relapse of the underlying malignant disease.
Department of Hematology/Oncology, Children's University Hospital, Tübingen, Germany.
Lena
L
Oevermann
Peter
P
Lang
Tobias
T
Feuchtinger
Michael
M
Schumm
Heiko-Manuel
HM
Teltschik
Patrick
P
Schlegel
Rupert
R
Handgretinger
D019264:Adoptive Transfer; D018941:Antigens, CD19 / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D017252:CD3 Complex / Q000378:metabolism; D003520:Cyclophosphamide / Q000008:administration & dosage; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D006239:Haplotypes / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008212:Lymphocyte Depletion; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology
D018941:Antigens, CD19; D018952:Antigens, CD34; D017252:CD3 Complex; D007166:Immunosuppressive Agents; D016693:Receptors, Antigen, T-Cell, alpha-beta; D003520:Cyclophosphamide