title: Will post-transplantation cell therapies for pediatric patients become standard of care?
abstract: Although allogeneic hematopoietic stem cell transplantation (HSCT) is a curative approach for many pediatric patients with hematologic malignancies and some nonmalignant disorders, some critical obstacles remain to be overcome, including relapse, engraftment failure, graft-versus-host disease (GVHD), and infection. Harnessing the immune system to induce a graft-versus-tumor effect or rapidly restore antiviral immunity through the use of donor lymphocyte infusion (DLI) has been remarkably successful in some settings. Unfortunately, however, the responses to DLI can be variable, and GVHD is common. Thus, manipulations to minimize GVHD while restoring antiviral immunity and enhancing the graft-versus-tumor effect are needed to improve outcomes after allogeneic HSCT. Cellular therapies, defined as treatment modalities in which hematopoietic or nonhematopoietic cells are used as therapeutic agents, offer this promise for improving outcomes post-HSCT. This review presents an overview of the field for pediatric cell therapies in the transplant setting and discusses how we can broaden applicability beyond phase I.
authors: Division of Stem Cell Transplantation, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.lankester@lumc.nl.
authors: Arjan C
authors: AC
authors: Lankester
authors: Department of Pediatric Hematology and Oncology, IRCCS Istituto Di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico, Bambino Gesù, Rome, Italy.
authors: Franco
authors: F
authors: Locatelli
authors: Department of Stem Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main, Germany.
authors: Peter
authors: P
authors: Bader
authors: Department of Stem Cell Transplantation and Immunology, Hospital for Children and Adolescents, Frankfurt am Main, Germany.
authors: Eva
authors: E
authors: Rettinger
authors: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors: Maarten
authors: M
authors: Egeler
authors: Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors: Satyendra
authors: S
authors: Katewa
authors: Primary Children's Hospital, Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute/University of Utah School of Medicine, Salt Lake City, Utah.
authors: Michael A
authors: MA
authors: Pulsipher
authors: Utrecht-Dendritic cells AgaiNst CancEr (U-DANCE), Lab Translational Immunology, Utrecht center for Diagnostic Advances in Immunology Research (U-DAIR), Lab Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Stefan
authors: S
authors: Nierkens
authors: BC Children's Hospital, Division of Oncology, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Kirk
authors: K
authors: Schultz
authors: Department of Pediatric Hematology/Oncology, Children's University Hospital, University of Tübingen, Tübingen, Germany.
authors: Rupert
authors: R
authors: Handgretinger
authors: Division of Oncology, The Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Stephan A
authors: SA
authors: Grupp
authors: Department of Pediatrics, Blood and Marrow Transplantation Program, Utrecht-Dendritic cells AgaiNst CancEr (U-DANCE), Lab Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Jaap Jan
authors: JJ
authors: Boelens
authors: Departments of Pediatrics and Microbiology, Immunology and Tropical Medicine, Children's National Health System and George Washington University, Division of Pediatric Hematology-Oncology, Washington, DC.
authors: Catherine M
authors: CM
authors: Bollard
mesh_terms: D000293:Adolescent; D064591:Allografts; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology / Q000517:prevention & control*; D006086:Graft vs Host Disease / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D020350:Graft vs Tumor Effect; D019337:Hematologic Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D017710:Lymphocyte Transfusion; D008297:Male
keywords: Adoptive cellular therapy; Chimeric antigen receptor; Pediatrics; Stem cell transplantation