Clinical strategies to enhance thymic recovery after allogeneic hematopoietic stem cell transplantation Review uri icon

Overview

MeSH Major

  • Hematopoietic Stem Cell Transplantation
  • Precursor Cells, T-Lymphoid
  • Thymus Gland

abstract

  • The thymus is particularly sensitive to injury caused by cytoreductive chemo- or radiation therapy, shock, infection and graft versus host disease. Insufficient thymic recovery has been directly correlated with increased risk of opportunistic infections and poor clinical outcomes in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Prolonged immune deficiency is particularly pronounced in older patients whose thymi are already significantly impaired due to age-related thymic involution. Preclinical and clinical studies have revealed several strategies that can enhance thymic function and immune reconstitution after transplant, including sex steroid ablation, growth factors (growth hormone, keratinocyte growth factor, insulin-like growth factor 1, interleukin-7) and ex vivo generated precursor T cells. In addition, recent studies have shown that other approaches, such as interleukein-22 and nutritional changes, may represent additional candidates to enhance thymic regeneration. In this review we provide updates on these strategies and comment on their potential to be translated into clinical therapies.

publication date

  • September 2013

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC3871183

Digital Object Identifier (DOI)

  • 10.1016/j.imlet.2013.09.016

PubMed ID

  • 24120996

Additional Document Info

start page

  • 31

end page

  • 5

volume

  • 155

number

  • 1-2