Graft-versus-host disease versus graft-versus-leukemia
Graft-versus-host disease versus graft-versus-leukemia
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DOI：
10.1182/asheducation-2015.1.225
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发表时间：
2015-12-01
影响因子：
3
通讯作者：
Negrin, Robert S.
中科院分区：
文献类型：
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作者：
Negrin, Robert S.
移植物抗宿主病（GVHD）是同种异体造血细胞移植（HCT）后的一个重要临床问题，与大量发病率和死亡率相关，限制了移植的潜在效用。与GVHD相关的是公认的移植物抗白血病（GVL）效应，其结果是降低疾病复发的风险。在广泛的血液恶性肿瘤治疗后观察到GVL效应。GVHD和GVL都是T细胞效应功能的结果，这构成了这两种现象之间如何联系的主要问题。基础科学和转化研究的一个主要目标是制定策略，在保持或加强GVL的同时降低GVHD的风险。在这篇综述中，将探讨从临床前动物模型中开发的许多不同策略，重点是那些已经扩展到临床的方法，以试图实现这一目标。毋庸置疑，没有行之有效的策略；然而，随着现代技术和临床翻译的使用，在降低GVHD风险的同时促进和增强GVL反应的目标上已经取得了实质性进展。
Graft-versus-host disease (GVHD) is a significant clinical problem after allogenic hematopoietic cell transplantation (HCT) associated with substantial morbidity and mortality that limits the potential utility of transplantation. Associated with GVHD is the well-recognized phenomenon of the graft-versus-leukemia (GVL) effect that results in reduced risk of disease relapse. GVL effects have been observed after treatment for a broad range of hematological malignancies. Both GVHD and GVL are the results of T cell-effector functions that frames a major question in the field of how linked are these two phenomena. A major goal of basic science and translational research has been to develop strategies to reduce the risk of GVHD while maintaining or enhancing GVL. In this review, a number of different strategies developed from preclinical animal models will be explored with a focus on those approaches that have been extended to the clinic in an attempt to achieve this goal. Needless to say, there is no proven strategy; however, with the use of modern technology and clinical translation, there has been substantial progress toward this goal of reducing the risks of GVHD while promoting and enhancing GVL responses.