Graft-versus-Leukemia Effect of Nonmyeloablative Stem Cell Transplantation
The Korean Journal of Internal Medicine
;
: 287-298, 2009.
Article
Dans Anglais
| WPRIM
| ID: wpr-106752
ABSTRACT
Nonmyeloablative stem cell transplantation (NST) is increasingly used with beneficial effects because it can be applied to older patients with hematological malignancies and those with various complications who are not suitable for conventional myeloablative stem cell transplantation (CST). Various conditioning regimens differ in their myeloablative and immunosuppressive intensity. Regardless of the type of conditioning regimen, graft-versus- host disease (GVHD) in NST occurs almost equally in CST, although a slightly delayed development of acute GVHD is observed in NST. Although graft-versus-hematological malignancy effects (i.e., graft-versus-leukemia effect, graft-versus-lymphoma effect, and graft-versus-myeloma effect) also occur in NST, completely eradicating residual malignant cells through allogeneic immune responses is insufficient in cases with rapidly growing disease or uncontrolled progressive disease. Donor lymphocyte infusion (DLI) is sometimes combined to support engraftment and to augment the graft-versus-hematological malignancy effect, such as the graft-versus-leukemia effect. DLI is especially effective for controlling relapse in the chronic phase of chronic myelogenous leukemia, but not so effective against other diseases. Indeed, NST is a beneficial procedure for expanding the opportunity of allogeneic hematopoietic stem cell transplantation to many patients with hematological malignancies. However, a more sophisticated improvement in separating graft-versus-hematological malignancy effects from GVHD is required in the future.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Lymphome malin non hodgkinien
/
Leucémies
/
Transfusion de lymphocytes
/
Transplantation de cellules souches hématopoïétiques
/
Conditionnement pour greffe
/
Réaction du greffon contre la leucémie
/
Maladie du greffon contre l'hôte
/
Myélome multiple
/
Cellules présentatrices d'antigène
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
The Korean Journal of Internal Medicine
Année:
2009
Type:
Article
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