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Reconstituting T Cell Immunity Following Hematopoietic Stem Cell Transplantation

  • S. R. Solomon
  • A. J. Barrett
Conference paper
Part of the Developments in Hematology and Immunology book series (DIHI, volume 38)

Abstract

Impaired recovery of T cell immune function is a major source of morbidity and mortality following allogeneic haematopoietic stem cell transplantation (HSCT). Although natural immunity (NK cells, monocytes, neutrophils) function normally within weeks after transplant, helper T cell activity and T cell-dependent B cell responses remain impaired for months to years. The etiology of the immune defect is multifactorial. Attempts to reduce graft-versus-host disease (GvHD) through T cell depletion or immunosuppressive drug therapy significantly impair immune reconstitution. GvHD itself has a negative impact on immune function due to both decreased thymopoiesis [1,2] and increased apoptosis of peripheral blood T cells [3,4]. Furthermore, tissue damage from total body irradiation (TBI) and other intensive conditioning regimens damages important stromal elements of the thymus, as well as the BM, secondary lymphoid organs, and other tissues in which T cell generation and proliferation take place. The composite impact of these factors leads to T cell immunodeficiency following allogeneic HSCT, which can contribute to unacceptably high rates of opportunistic infection and relapse. Improving the results of allogeneic HSCT requires better understanding of the mechanisms involved in post-transplant T cell reconstitution.

Keywords

Hematopoietic Stem Cell Transplantation Immune Reconstitution Peripheral Blood Stem Cell Transplantation Preparative Regimen Allogeneic Haematopoietic Stem Cell Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media Dordrecht 2003

Authors and Affiliations

  • S. R. Solomon
  • A. J. Barrett
    • 1
  1. 1.Stem Cell Allotransplantation Section, Hematology Branch, NHLBINational Institutes of HealthBethesdaUSA

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