Emerging drugs for prevention of graft failure after allogeneic hematopoietic stem cell transplantation.
Expert Opin Emerg Drugs
; 18(2): 173-92, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23663037
INTRODUCTION: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the treatment of choice for many patients suffering from hematological malignancies, severe hemoglobinopathies, bone marrow failures or severe primary immunodeficiencies. Graft rejection/failure (GF) is a life-threatening complication following allo-HSCT that is most commonly caused by the reactivity of recipient T cells, natural killer (NK) cells or antibodies against donor grafted hematopoietic cells. The increasing use of allo-HSCT following reduced-intensity conditioning (RIC) and the increasing use of alternative donors (unrelated cord blood and human leukocyte antigen (HLA)-mismatched donor) have resulted in higher frequency of GF. AREAS COVERED: This review describes the pathogenesis and current prevention and treatment of GF as well as agents in development for GF prevention or treatment. EXPERT OPINION: The risk of GF may be reduced in the future by optimizing the conditioning regimens and post-grafting immunosuppression, increasing the number of hematopoietic stem cells (HSCs) and/or immune cells transplanted, optimizing HSC homing and better detecting patients at high risk of GF by searching for pre-transplant donor-specific anti-HLA antibodies in patients given grafts from HLA-mismatched donors, or by closely monitoring donor T- and/or NK-cell chimerism after allo-HSCT following RIC.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Células-Tronco Hematopoéticas
/
Doença Enxerto-Hospedeiro
Limite:
Animals
/
Humans
Idioma:
En
Revista:
Expert Opin Emerg Drugs
Assunto da revista:
TERAPIA POR MEDICAMENTOS
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Bélgica