Immunological reconstitution after hematopoietic cell transplantation - its relation to the contents of the graft.

摘要

BACKGROUND: After hematopoietic cell transplantation (HCT), there is a prolonged period of immune deficiency. OBJECTIVE: To review the recovery of immunity after HCT, including how it is influenced by the cellular contents of the graft, and therapeutic implications. METHODS: Literature review using Medline. RESULTS/CONCLUSION: Whereas innate immunity (e.g., epithelial barriers, phagocytes, natural killer cells) typically recovers within weeks post-transplant, the recovery of adaptive immunity takes longer, months for B cells and years for T cells. The recovery is influenced by the graft contents. For example the number of CD34 cells given with the graft affects the tempo of neutrophil recovery, and the number of CD4 T cells given with the graft affects CD4 T cell counts post-transplant. Improved understanding of the relationship between graft contents and immune reconstitution could lead to graft engineering improving transplant outcomes.