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Related Concept Videos

Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...
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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...

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Induction of Alloantigen-specific Anergy in Human Peripheral Blood Mononuclear Cells by Alloantigen Stimulation with Co-stimulatory Signal Blockade
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The allogeneic graft-versus-cancer effect.

Olle Ringdén1, Helen Karlsson, Richard Olsson

  • 1Centre for Allogeneic Stem Cell Transplantation and Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden. Olle.Ringden@ki.se

British Journal of Haematology
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Allogeneic stem cell transplantation harnesses immune cells to fight cancer. This immunotherapy approach leverages donor lymphocytes to target and eliminate leukaemia and other malignancies, offering new hope for patients.

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Published on: June 12, 2021

Area of Science:

  • Immunology
  • Oncology
  • Transplantation

Background:

  • Allogeneic haematological stem cell transplantation (HSCT) has evolved into a potent form of immunotherapy.
  • Donor immune cells, including CD4+, CD8+, and natural killer (NK) cells, are key mediators of graft-versus-leukaemia (GVL) effects.
  • Cytokines like IL-2, IFN-γ, and TNF-α enhance the GVL response against malignant cells.

Purpose of the Study:

  • To review current knowledge on graft-versus-cancer (GVC) effects.
  • To explore the mechanisms by which donor immune cells eradicate malignancies.
  • To present future directions in immunotherapy for cancers.

Main Methods:

  • Review of existing literature on HSCT and GVL/GVC effects.
  • Analysis of immune cell subsets (CD4+, CD8+, NK cells) and their mechanisms of action (Fas-dependent killing, perforin degranulation).
  • Discussion of clinical observations linking graft-versus-host disease (GVHD) to GVL and the role of conditioning regimens and donor lymphocyte infusions.

Main Results:

  • GVL effects are mediated by donor T and NK cells through direct killing and cytokine potentiation.
  • Chronic GVHD is associated with a significant GVL effect, while acute GVHD poses a risk.
  • Reduced intensity conditioning and donor lymphocyte infusions enhance GVC effects, with outcomes monitored by minimal residual disease.

Conclusions:

  • HSCT-derived immunotherapy demonstrates efficacy against leukaemia, myeloma, lymphoma, and solid tumours.
  • Balancing immunosuppression, GVHD, and relapse is crucial for successful HSCT.
  • Future strategies include leukaemia-specific CTLs, allo-depleted T-cells, and suicide gene-modified T-cells for enhanced anti-tumour immunotherapy.