Article (Scientific journals)
Emerging drugs for prevention of graft failure after allogeneic hematopoietic stem cell transplantation
SERVAIS, Sophie; Beguin, Yves; Baron, Frédéric
2013In Expert Opinion on Emerging Drugs, 18 (2), p. 173-192
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Keywords :
alemtuzumab; anti-thymocyte globulin; chimerism; costimulation; CTLA4; fludarabine; graft failure; graft rejection; hematopoietic cell transplantation; mesenchymal stromal cells; reduced-intensity conditioning; total body irradiation; treosulfan
Abstract :
[en] 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.
Disciplines :
Hematology
Author, co-author :
SERVAIS, Sophie ;  Centre Hospitalier Universitaire de Liège - CHU > Frais communs médecine
Beguin, Yves  ;  Université de Liège - ULiège > GIGA-R : Hématologie
Baron, Frédéric  ;  Université de Liège - ULiège > GIGA-R : Hématologie
Language :
English
Title :
Emerging drugs for prevention of graft failure after allogeneic hematopoietic stem cell transplantation
Publication date :
2013
Journal title :
Expert Opinion on Emerging Drugs
ISSN :
1472-8214
eISSN :
1744-7623
Publisher :
Informa Healthcare, London, United Kingdom
Volume :
18
Issue :
2
Pages :
173-192
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 May 2013

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