Guidelines for the Prevention and Management of Graft-versus-Host Disease after Cord Blood Transplantation.

• 发表时间: 07 2021
• 来源期刊: Transplant Cell Ther
• DOI: 10.1016/j.jtct.2021.03.012
• PMID: 34210500
• 文章类型: Practice Guideline
• 作者列表: Ponce DM,Politikos I,Alousi A,Carpenter PA,Milano F,MacMillan ML,Barker JN,Horwitz ME,

关键词: Cord blood transplant; Graft-versus-host disease

Mesh: Cord Blood Stem Cell Transplantation / adverse effects; Graft vs Host Disease / prevention & control; HLA Antigens; Hematopoietic Stem Cell Transplantation / adverse effects; Humans; Unrelated Donors

Abstract

The incidence of graft-versus-host disease (GVHD) after cord blood (CB) transplantation (CBT) is lower than expected given the marked degree of human leukocyte antigen (HLA)-mismatch of CB grafts. While the exact mechanism that underlies this biology remains unclear, it is hypothesized to be due to the low number of mostly immature T-cells infused as part of the graft1,2, and increased tolerance of CB-derived lymphocytes induced by the state of pregnancy. Nevertheless, acute GVHD (aGVHD) is a significant complication of CBT. In contrast, the incidence of chronic GVHD (cGVHD) following CBT is lower than what is observed following matched related or unrelated donor HSC transplantation (HSCT)3-6. This review outlines the guidelines for the prevention and management of acute and chronic GVHD following CBT.