Immune-Mediated Complications after Hematopoietic Stem Cell Transplantation.
Hematopoietic stem cell transplantation (HSCT) has an integral role in the treatment of malignant and nonmalignant diseases. Long-term complications after HSCT have been well established and include graft-versus-host disease (GVHD), conditioning regimen-related toxicities, disease relapse, and infections. Immune-mediated phenomena are increasingly described after HSCT with clinically significant sequelae. Diagnosis is challenging because of features that overlap with other commonly reported post-transplantation complications. Patients who experience immune-mediated disease after HSCT tend to have poor outcomes. Early recognition of immune-mediated complications is imperative to reduce preventable morbidity and mortality. This review looks at the currently available literature on pathogenesis, incidence, risk factors, treatment, and outcomes of immune-mediated disease (other than GVHD) after HSCT.
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Zhuoyan
Z
Li
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Samuel M
SM
Rubinstein
Hematology and Stem Cell Transplantation Section, Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, Tennessee.
Ramya
R
Thota
University of Tennessee Heath Science Center, College of Medicine, Memphis, Tennessee.
Malvi
M
Savani
Department of Haematology, Saint Antoine Hospital, Paris, France; INSERM UMR 938, Paris, France; Université Pierre et Marie Curie, Paris, France.
Eolia
E
Brissot
Center for International Blood and Marrow Transplant Research and Froedtert and the Medical College of Wisconsin, Wisconsin.
Bronwen E
BE
Shaw
Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio.
Navneet S
NS
Majhail
Department of Haematology, Saint Antoine Hospital, Paris, France; INSERM UMR 938, Paris, France; Université Pierre et Marie Curie, Paris, France.
Mohamad
M
Mohty
Hematology and Stem Cell Transplantation Section, Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, Tennessee. Electronic address: Bipin.Savani@vanderbilt.edu.
Bipin N
BN
Savani
D001327:Autoimmune Diseases / Q000139:chemically induced / Q000628:therapy; D003937:Diagnosis, Differential; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D011379:Prognosis; D012307:Risk Factors; D014181:Transplantation Immunology
Hematopoietic cell transplantation; Immune complications; Late effects; Survivorship