title: Immunotherapeutic strategies against mucormycosis in haematopoietic stem cell transplantation.
abstract: Mucormycoses remain a serious complication in patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT). In these patients, mortality rates of mucormycosis reach up to 90%, which is due, at least in part, to the severe and prolonged immunosuppression after transplantation. Although prolonged neutropaenia is one of the most important risk factors for mucormycosis, other cell populations, such as CD4(+) T cells may also provide critical defence mechanisms against this infection. The management of mucormycosis includes antifungal therapy, surgery and, most importantly, the control of the underlying predisposing conditions, such as the correction of an impaired immune system. Here, we review the current data of granulocytes, antifungal T cells and natural killer cells regarding their activity against mucormycetes and regarding a potential immunotherapeutic approach. It is hoped that further animal studies and clinical trials assessing immunotherapeutic strategies will ultimately improve the poor prognosis of allogeneic HSCT recipients suffering from mucormycosis.
authors.affiliation: Pediatric Hematology and Oncology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Schmidt
authors.forename: Lars
authors.initials: L
authors.lastname: Tramsen
authors.forename: Andreas
authors.initials: A
authors.lastname: Schneider
authors.forename: Ada
authors.initials: A
authors.lastname: Balan
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehrnbecher
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D006098:Granulocytes / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D009091:Mucormycosis / Q000188:drug therapy* / Q000517:prevention & control; D009503:Neutropenia / Q000382:microbiology
chemical_list: D000935:Antifungal Agents
keywords: Mucormycosis; T cell; granulocyte; haematopoietic stem cell transplantation; natural killer cell