title: Immune Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation: Time To T Up the Thymus.
abstract: The success of allogeneic hematopoietic stem cell transplantation, a key treatment for many disorders, is intertwined with T cell immune reconstitution. The thymus plays a key role post allogeneic hematopoietic stem cell transplantation in the generation of a broad but self-tolerant T cell repertoire, but it is exquisitely sensitive to a range of insults during the transplant period, including conditioning regimens, corticosteroids, infections, and graft-versus-host disease. Although endogenous thymic repair is possible it is often suboptimal, and there is a need to develop exogenous strategies to help regenerate the thymus. Therapies currently in clinical trials in the transplant setting include keratinocyte growth factor, cytokines (IL-7 and IL-22), and hormonal modulation including sex steroid inhibition and growth hormone administration. Such regenerative strategies may ultimately enable the thymus to play as prominent a role after transplant as it once did in early childhood, allowing a more complete restoration of the T cell compartment.
authors.affiliation: Immunology Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Chaudhry
authors.affiliation: Immunology Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065.
authors.forename: Enrico
authors.identifier: 0000-0001-8383-0453
authors.initials: E
authors.lastname: Velardi
authors.affiliation: Immunology Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065.
authors.forename: Florent
authors.initials: F
authors.lastname: Malard
authors.affiliation: Immunology Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065; vandenbm@mskcc.org.|Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065; and.|Department of Immunology and Microbial Pathogenesis, Weill Cornell Medical College, New York, NY 10021.
authors.forename: Marcel R M
authors.identifier: 0000-0003-0696-4401
authors.initials: MR
authors.lastname: van den Brink
mesh_terms: D000818:Animals; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D012038:Regeneration / Q000276:immunology*; D013950:Thymus Gland / Q000276:immunology*; D014184:Transplantation, Homologous