title: Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection.
abstract: Infection is the leading cause of non-relapse mortality after allogeneic haematopoietic cell transplantation (HCT). This occurs as a result of dysfunction to the host immune system from the preparative regimen used prior to HCT, combined with a delay in reconstitution of the donor-derived immune system after HCT. In this article, we elaborate on the process of immune reconstitution post-HCT that begins with the innate system and is followed by recovery of adaptive immunity. Simultaneously, we describe how the tempo of immune reconstitution influences the risk of various infections. We explain some of the key differences in immune reconstitution and the consequent risk of infections in recipients of peripheral blood stem cell, bone marrow or umbilical cord blood grafts. Other factors that impact on immune recovery are also highlighted. Finally, we allude to various strategies that are being tested to enhance immune reconstitution post-HCT.
authors.affiliation: a Division of Hematology, Oncology and Transplantation, University of Minnesota , Minneapolis , MN , USA.
authors.forename: Rohtesh S
authors.initials: RS
authors.lastname: Mehta
authors.affiliation: b Department of Stem Cell Transplantation and Cellular Therapy , MD Anderson Cancer Center , Houston , TX , USA.
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rezvani
mesh_terms: D056704:Adaptive Immunity; D001402:B-Lymphocytes / Q000276:immunology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D056724:Immunity, Humoral; D007113:Immunity, Innate; D007239:Infections / Q000209:etiology / Q000276:immunology*; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology; D014184:Transplantation, Homologous / Q000009:adverse effects
keywords: adaptive immunity; allogeneic haematopoietic stem cell transplant; immune reconstitution; infection; innate immunity