Graft-vs-Host Disease

摘要: The transplantation of healthy hematopoietic stem cells into a patient with aplastic anemia or leukemia is potentially curative therapy, but the development acute graftvs-host disease (GVHD), which often occurs even when donor and recipient are siblings fully matched at human leukocyte antigen (HLA) loci, significantly limits survival.The first descriptions GVHD, following allogeneic bone marrow transplant (allo-BMT) in humans, were made 1960s. Significant strides prophylaxis GVHD have been over past four decades by use pharmacologic agents such as methotrexate (MTX) cyclosporine (CSP), manipulation cell inoculum, to limit infusion effector lymphocytes. However, given extensive clinical observations investigations on nature this complication, it remarkable that diagnosis still clinically challenging, complication continues pose formidable obstacle successful (allo-HSCT). On other hand, patients improved leukemia-free survival (the graft-vsleukemia effect [GVL]) graft-vs-malignancy effect, beneficial byproduct alloreactivity cells, may extend lymphomas, myeloma, solid tumors (1–4). Thus, major question HSCT biology how preserve while eliminating GVHD. This chapter reviews some critical issues manifestations pathobiology including results recent using an vitro lymphocyte–skin adhesion assay better define mechanisms Advances during decade, prevention treatment evidence for role cellular modulation also reviewed.