+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Immune Dysregulation and Pathobiology Working Group Report

, : National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: The Immune Dysregulation and Pathobiology Working Group Report. Biology of Blood and Marrow Transplantation

NlmCategory="UNASSIGNED">Immune reconstitution after hematopoietic stem cell transplantation (HCT) beyond 1 year is not completely understood. Many transplant recipients who are free of graft-versus-host disease (GVHD) and not receiving any immunosuppression more than 1 year after transplantation seem to be able to mount appropriate immune responses to common pathogens and respond adequately to immunizations. However, 2 large registry studies over the last 2 decades seem to indicate that infection is a significant cause of late mortality in some patients, even in the absence of concomitant GVHD. Research on this topic is particularly challenging for several reasons. First, there are not enough long-term follow-up clinics able to measure even basic immune parameters late after HCT. Second, the correlation between laboratory measurements of immune function and infections is not well known. Third, accurate documentation of infectious episodes is notoriously difficult. Finally, it is unclear what measures can be implemented to improve the immune response in a clinically relevant way. A combination of long-term multicenter prospective studies that collect detailed infectious data and store samples as well as a national or multinational registry of clinically significant infections (eg, vaccine-preventable severe infections, opportunistic infections) could begin to address our knowledge gaps. Obtaining samples for laboratory evaluation of the immune system should be both calendar and eventdriven. Attention to detail and standardization of practices regarding prophylaxis, diagnosis, and definitions of infections would be of paramount importance to obtain clean reliable data. Laboratory studies should specifically address the neogenesis, maturation, and exhaustion of the adaptive immune system and, in particular, how these are influenced by persistent alloreactivity, inflammation, and viral infection. Ideally, some of these long-term prospective studies would collect information on long-term changes in the gut microbiome and their influence on immunity. Regarding enhancement of immune function, prospective measurement of the response to vaccines late after HCT in a variety of clinical settings should be undertaken to better understand the benefits as well as the limitations of immunizations. The role of intravenous immunoglobulin is still not well defined, and studies to address it should be encouraged.


PMID: 27751936

DOI: 10.1016/j.bbmt.2016.10.001

Other references

Klimmer, O.R., 1956: Simple apparatus for keeping gas concentrations constant in toxicological studies. Naunyn-Schmiedebergs Archiv für Experimentelle Pathologie und Pharmakologie 227(5): 467-469

Zetrenne, E.; Kosins, A.M.; Wirth, G.A.; Bui, A.; Evans, G.R.D.; Wells, J.H., 2008: Academic plastic surgery: a study of current issues and future challenges. The objectives of this study were (1) to evaluate the role of a full-time academic plastic surgeon, (2) to define the indicators predictive of a successful career in academic plastic surgery, and (3) to understand the current issues that will affe...

Orera; Sanjuán; Chen, 1990: H-Ca+]0 defect in thermochemically reduced CaO: A static and dynamical EPR study. Physical Review. B, Condensed Matter 42(12): 7604-7609

Durley, R.; Chen, L.; Lim, L.W.; Mathews, F.S.; Davidson, V.L., 1993: Crystal structure analysis of amicyanin and apoamicyanin from Paracoccus denitrificans at 2.0 A and 1.8 A resolution. The crystal structure of amicyanin, a cupredoxin isolated from Paracoccus denitrificans, has been determined by molecular replacement. The structure has been refined at 2.0 ANG resolution using energy-restrained least-squares procedures to a cryst...

Okamura, T.; Yokoyama, S.; Kou, E.; Inoue, N.; Kuriyama, T.; Matsumuro, A.; Fujita, H.; Tanaka, T.; Miyao, K., 1998: CABG after patch angioplasty of the left main coronary: artery report of a case. A 57-year-old man was admitted to our hospital because of restenosis of the left main coronary trunk (LMT) after patch angioplasty for the LMT lesion. PTCA was repeated four times during three years after patch angioplasty, but recent coronary ang...

Jacques Angelier; Françoise Bergerat; Hao Tsu Chu; Wen Shing Juang; Chia Y.L., 1990: Paleostress analysis as a key to margin extension; the Penghu Islands, South China Sea. The Penghu Islands belong to the Eurasian passive margin, west of the collision zone of Taiwan. From south to north, the South China Sea basins become narrower and disappear in the Taiwan Strait area. The presence of the Penghu Islands allow descr...

Jones Davey L.; Farrar John F.; Newsham Kevin K., 2004: Rapid amino acid cycling in Arctic and Antarctic soils. Amino acids constitute one of the largest inputs of organic nitrogen (N) to most polar soils and have been hypothesized to be important in regulating vegetational succession and productivity in Arctic ecosystems. Our understanding of amino acid cy...

Yu, S-Li.; Xie, X.C.; Li, J-Xin., 2011: Mott physics and topological phase transition in correlated dirac fermions. We investigate the interplay between the strong correlation and the spin-orbit coupling in the Kane-Mele-Hubbard model and obtain the qualitative phase diagram via the variational cluster approach. We identify, through an increase of the Hubbard U...

Dicyan, E., 1964: Dr. Lemuel Gulliver Returns. Perspectives in Biology and Medicine 7: 450-456

Ramezani J.; Bowring Samuel A.; Pringle Malcolm S.; Winslow F.D.I.I.I.; Rasbury E.T., 2005: The Manicouagan impact melt rock; a proposed standard for the intercalibration of U-Pb and (super 40) Ar/ (super 39) Ar isotopic systems. Geochimica et Cosmochimica Acta 69(10, Suppl