Tolerance and chimerism

被引:11
作者
Kolb, HJ
Guenther, W
Gyurkocza, B
Hoetzl, F
Simoes, B
Falk, C
Schleuning, M
Ledderose, G
机构
[1] Univ Munich, Dept Med 3, Clin Cooperat Grp Haematopoiet Cell Transplantat, D-81377 Munich, Germany
[2] GSF, Natl Res Ctr Environm & Hlth, Inst Mol Immunol, Munich, Germany
关键词
D O I
10.1097/01.TP.0000067948.90241.82
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Stem-cell transplantation from human leukocyte antigen (HLA)-haploidentical family members carries a high risk of rejection and graft-versus-host disease (GVHD) if donor and recipient differ by more than one HLA antigen. The authors have developed treatment protocols from studies in dog leukocyte antigen-haploidentical dogs that prevent rejection and modify GVHD to the extent that patients with aggressive hematologic neoplasia can be treated with success. Principal improvements have been achieved in the use of cyclophosphamide and total-body irradiation for conditioning and T-cell depletion for prevention of GVHD. More recently, the combination of marrow and CD6-depleted mobilized donor blood cells (MDBC) has been introduced for HLA-haploidentical transplantation on the basis that CD6-depleted MDBC contain immunoregulatory cells besides stem cells and natural killer cells: Clinical results are reported on 36 patients with high-risk hematologic neoplasia. The results encourage the use of HLA-haploidentical stem-cell transplantation at an earlier stage of the disease. This method could also be of use for tolerance induction in organ transplantation.
引用
收藏
页码:26S / 31S
页数:6
相关论文
共 33 条
[1]   EFFECT OF HLA COMPATIBILITY ON ENGRAFTMENT OF BONE-MARROW TRANSPLANTS IN PATIENTS WITH LEUKEMIA OR LYMPHOMA [J].
ANASETTI, C ;
AMOS, D ;
BEATTY, PG ;
APPELBAUM, FR ;
BENSINGER, W ;
BUCKNER, CD ;
CLIFT, R ;
DONEY, K ;
MARTIN, PJ ;
MICKELSON, E ;
NISPEROS, B ;
OQUIGLEY, J ;
RAMBERG, R ;
SANDERS, JE ;
STEWART, P ;
STORB, R ;
SULLIVAN, KM ;
WITHERSPOON, RP ;
THOMAS, ED ;
HANSEN, JA .
NEW ENGLAND JOURNAL OF MEDICINE, 1989, 320 (04) :197-204
[2]  
ASH RC, 1991, BONE MARROW TRANSPL, V7, P443
[3]   Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched HLA haplotype [J].
Aversa, F ;
Tabilio, A ;
Velardi, A ;
Cunningham, I ;
Terenzi, A ;
Falzetti, F ;
Ruggeri, L ;
Barbabietola, G ;
Aristei, C ;
Latini, P ;
Reisner, Y ;
Martelli, MF .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (17) :1186-1193
[4]  
BERENBAUM M. C., 1965, TRANSPLANTATION, V3, P671
[5]   JOINT REPORT OF THE 3RD INTERNATIONAL WORKSHOP ON CANINE IMMUNOGENETICS .1. ANALYSIS OF HOMOZYGOUS TYPING CELLS [J].
DEEG, HJ ;
RAFF, RF ;
GROSSEWILDE, H ;
BIJMA, AM ;
BUURMAN, WA ;
DOXIADIS, I ;
KOLB, HJ ;
KRUMBACHER, K ;
LADIGES, W ;
LOSSLEIN, KL ;
SCHOCH, G ;
WESTBROEK, DL ;
BULL, RW ;
STORB, R .
TRANSPLANTATION, 1986, 41 (01) :111-117
[6]   CD8+TCR+ and CD8+TCR- cells in whole bone marrow facilitate the engraftment of hematopoietic stem cells across allogeneic barriers [J].
Gandy, KL ;
Domen, J ;
Aguila, H ;
Weissman, IL .
IMMUNITY, 1999, 11 (05) :579-590
[7]  
GROSSEWILDE H, 1974, TISSUE ANTIGENS, V4, P229
[8]  
GUENTHER W, 1994, TISSUE ANTIGENS, V34, P198
[9]   Transplantation of anergic histoincompatible bone marrow allografts [J].
Guinan, EC ;
Boussiotis, VA ;
Neuberg, D ;
Brennan, LL ;
Hirano, N ;
Nadler, LM ;
Gribben, JG .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (22) :1704-1714
[10]  
KAUFMAN CL, 1994, BLOOD, V84, P2436