Unrelated umbilical cord blood transplantation and immune reconstitution

Semin Hematol. 2010 Jan;47(1):22-36. doi: 10.1053/j.seminhematol.2009.10.009.

Abstract

This review highlights the unique features of immune reconstitution following unrelated cord blood transplantation (UCBT) that lead to heightened risk of infection-related mortality in the early post-UCBT period. There is no evidence that innate immunity is uniquely compromised after UCBT, but the development of antigen-specific cellular immunity is affected by numerical and qualitative deficits, primarily within the first 100 days. Nevertheless, beyond the first few months after UCBT there is no evidence for reduced graft-versus-leukemia (GVL) or anti-viral immunity compared to other hematopoietic cell therapy (HCT) modalities. Novel cellular therapies that are about to enter the clinical setting in the form of natural killer (NK) cell and T-cell therapies in the form of donor lymphocyte infusion (DLI) are also discussed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Blood Donors / supply & distribution*
  • Child
  • Communicable Diseases / immunology
  • Communicable Diseases / mortality
  • Cord Blood Stem Cell Transplantation* / adverse effects
  • Cord Blood Stem Cell Transplantation* / mortality
  • Hematologic Diseases / immunology
  • Hematologic Diseases / surgery*
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / surgery
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / mortality
  • Humans
  • Immunosuppression* / adverse effects
  • Killer Cells, Natural / immunology
  • Lymphocyte Subsets / drug effects
  • Lymphocyte Subsets / immunology*
  • Lymphocyte Subsets / transplantation
  • Myeloablative Agonists / therapeutic use
  • Patient Selection
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • T-Lymphocyte Subsets / immunology
  • Time Factors
  • Treatment Outcome

Substances

  • Myeloablative Agonists