Reconstitution of T-cell-mediated immunity in patients after allogeneic stem cell transplantation
https://doi.org/10.35754/0234-5730-2020-65-1-24-38
Abstract
Background. The timely reconstitution of the donor-derived immune system is a key factor in the prevention of such post-transplant complications as graft versus host disease, relapse or secondary tumours and various infections. These complications affect the long-term survival of patients after allogeneic stem cell transplantation.
Aim — to describe the main stages of T Cell–mediated immune recovery in patients after allogeneic stem cell transplantation.
General findings. T-cell–mediated immunity is responsible for anti-infective and anti-tumour immune response. The early post-transplant period is characterized by the thymus-independent pathway of T-cell recovery largely involving proliferation of mature donor T cells, which were transplanted to the patient together with hematopoietic stem cells. To a lesser extent, this recovery pathway is realized through the expansion of host naïve and memory T cells, which survived after conditioning. Thymus-dependent reconstitution involves generation of de novo naïve T cells and subsequent formation of a pool of memory T-cells providing the main immunological effects — graft versus tumour and graft versus host reactions. A better understanding of the T-cell immune reconstitution process is important for selecting optimized pre-transplant conditioning regimens and patient-specific immunosuppressive therapy approaches, thus reducing the risks of post-transplant complications and improving the long-term survival of patients after allogeneic stem cell transplantation.
Keywords
allogeneic stem cell transplantation,
immune reconstitution,
T-cell-mediated immunity,
T memory cells,
adaptive immunity
Supporting agencies: The authors express their gratitude to Mikhail Yu. Drokov.
About the Authors
N. N. Popova
National Research Center for Hematology
Russian Federation
Russian Federation
Natalia N. Popova – Hematologist, High-Dose Chemotherapy and Bone Marrow Transplantation.
125167, Moscow
tel. +7 (495) 614-90-42
V. G. Savchenko
National Research Center for Hematology
Russian Federation
Russian Federation
Valeriy G. Savchenko – Dr. Sci. (Med.), Prof., RAS Academician, General Director.
125167, Moscow
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Popova N.N., Savchenko V.G. Reconstitution of T-cell-mediated immunity in patients after allogeneic stem cell transplantation. Russian journal of hematology and transfusiology. 2020;65(1):24-38. (In Russ.) https://doi.org/10.35754/0234-5730-2020-65-1-24-38
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