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Anti-CD4 monoclonal antibody prevents chronic graft-versus-host disease in mice by inducing immune tolerance of CD8 T cells and alleviating thymus injury.
Front Immunol
January 2025
Department of Hematology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
Background: Chronic graft-versus-host disease (cGVHD) manifests with characteristics of autoimmune disease with organs attacked by pathogenic helper T cells. Recent studies have highlighted the role of T cells in cGVHD pathogenesis. Due to limited understanding of underlying mechanisms, preventing cGVHD after allogenic hematopoietic cell transplantation (HCT) has become a major challenge.
View Article and Find Full Text PDFHow I Treat AML relapse after allogeneic HCT.
Blood
December 2024
Dana-Farber Cancer Institute, BOSTON, Massachusetts, United States.
Allogeneic hematopoietic stem-cell transplantation (HCT) is one of the principal curative approaches in the treatment of acute myeloid leukemia (AML); however, relapse post-transplantation remains a catastrophic event with poor prognosis. The incidence of relapse has remained unchanged over the last three decades despite an evolving understanding of the immunobiology of the graft-versus leukemia effect and the immune escape mechanisms that lead to post-HCT relapse. The approach to post-transplant relapse is highly individualized and is dictated both by disease biology and genomics as well as the patient's clinical status at the time of relapse and the interval between relapse and transplantation.
View Article and Find Full Text PDFDNA barcoded peptide-MHC multimers to measure and monitor minor histocompatibility antigen-specific T cells after allogeneic stem cell transplantation.
J Immunother Cancer
December 2024
Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
Allogeneic stem cell transplantation (alloSCT) provides a curative treatment option for hematological malignancies. After HLA-matched alloSCT, donor-derived T cells recognize minor histocompatibility antigens (MiHAs), which are polymorphic peptides presented by HLA on patient cells. MiHAs are absent on donor cells due to genetic differences between patient and donor.
View Article and Find Full Text PDFNovel conditioning and prophylaxis regimens for relapse prevention.
Hematology Am Soc Hematol Educ Program
December 2024
Division of Hematology, Department of Medicine and Surgery, University of Perugia, Italy.
Article Synopsis
- Recent advancements in hematopoietic cell transplantation (HCT) for leukemia have improved safety and patient outcomes through better conditioning regimens and graft-versus-host disease management.
- Despite these improvements, leukemia relapse remains a significant challenge, prompting research into its mechanisms and ways to enhance graft-versus-leukemia (GVL) effects.
- The review highlights criteria for selecting donors that boost GVL activity, innovative conditioning approaches to reduce disease burden, and strategies to manipulate grafts for effective antileukemic action while minimizing immune suppression.
Maintenance strategies for relapse prevention and treatment.
Hematology Am Soc Hematol Educ Program
December 2024
Hematology and Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Posttransplant relapse is the most significant challenge in allogeneic stem cell transplantation (alloSCT). Posttransplant interventions, in conjunction with optimal conditioning regimens and donor selection, are increasingly supported by evidence for their potential to prolong patient survival by promoting antileukemia or graft-versus-leukemia effects. Our review begins by highlighting the current evidence supporting maintenance therapy for relapse prevention in acute myeloid leukemia and acute lymphocytic leukemia.
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