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Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia
Allogeneic hematopoietic stem cell transplantation (HSCT) has been an important and efficacious treatment for acute leukemia in children for over 60 years. It works primarily through the graft-vs.-leukemia (GVL) effect, in which donor T-cells and other immune cells act to eliminate residual leukemia...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10534014/ https://www.ncbi.nlm.nih.gov/pubmed/37780051 http://dx.doi.org/10.3389/fped.2023.1232281 |
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author | Borrill, Roisin Poulton, Kay Wynn, Robert |
author_facet | Borrill, Roisin Poulton, Kay Wynn, Robert |
author_sort | Borrill, Roisin |
collection | PubMed |
description | Allogeneic hematopoietic stem cell transplantation (HSCT) has been an important and efficacious treatment for acute leukemia in children for over 60 years. It works primarily through the graft-vs.-leukemia (GVL) effect, in which donor T-cells and other immune cells act to eliminate residual leukemia. Cord blood is an alternative source of stem cells for transplantation, with distinct biological and immunological characteristics. Retrospective clinical studies report superior relapse rates with cord blood transplantation (CBT), when compared to other stem cell sources, particularly for patients with high-risk leukemia. Xenograft models also support the superiority of cord blood T-cells in eradicating malignancy, when compared to those derived from peripheral blood. Conversely, CBT has historically been associated with an increased risk of transplant-related mortality (TRM) and morbidity, particularly from infection. Here we discuss clinical aspects of CBT, the unique immunology of cord blood T-cells, their role in the GVL effect and future methods to maximize their utility in cellular therapies for leukemia, honing and harnessing their antitumor properties whilst managing the risks of TRM. |
format | Online Article Text |
id | pubmed-10534014 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105340142023-09-29 Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia Borrill, Roisin Poulton, Kay Wynn, Robert Front Pediatr Pediatrics Allogeneic hematopoietic stem cell transplantation (HSCT) has been an important and efficacious treatment for acute leukemia in children for over 60 years. It works primarily through the graft-vs.-leukemia (GVL) effect, in which donor T-cells and other immune cells act to eliminate residual leukemia. Cord blood is an alternative source of stem cells for transplantation, with distinct biological and immunological characteristics. Retrospective clinical studies report superior relapse rates with cord blood transplantation (CBT), when compared to other stem cell sources, particularly for patients with high-risk leukemia. Xenograft models also support the superiority of cord blood T-cells in eradicating malignancy, when compared to those derived from peripheral blood. Conversely, CBT has historically been associated with an increased risk of transplant-related mortality (TRM) and morbidity, particularly from infection. Here we discuss clinical aspects of CBT, the unique immunology of cord blood T-cells, their role in the GVL effect and future methods to maximize their utility in cellular therapies for leukemia, honing and harnessing their antitumor properties whilst managing the risks of TRM. Frontiers Media S.A. 2023-09-13 /pmc/articles/PMC10534014/ /pubmed/37780051 http://dx.doi.org/10.3389/fped.2023.1232281 Text en © 2023 Borrill, Poulton and Wynn. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Borrill, Roisin Poulton, Kay Wynn, Robert Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
title | Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
title_full | Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
title_fullStr | Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
title_full_unstemmed | Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
title_short | Immunology of cord blood T-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
title_sort | immunology of cord blood t-cells favors augmented disease response during clinical pediatric stem cell transplantation for acute leukemia |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10534014/ https://www.ncbi.nlm.nih.gov/pubmed/37780051 http://dx.doi.org/10.3389/fped.2023.1232281 |
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