Strategies to optimize the outcome of children given T-cell depleted HLA-haploidentical hematopoietic stem cell transplantation

Franco Locatelli, Luciana Vinti, Giuseppe Palumbo, Francesca Rossi, Alice Bertaina, Angela Mastronuzzi, Maria Ester Bernardo, Sergio Rutella, Paolo Dellabona, Giovanna Giorgiani, Alessandro Moretta, Lorenzo Moretta

Research output: Contribution to journalArticle

Abstract

The most advanced frontier of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is represented by the use of an HLA-partially matched relative as donor. In this type of transplantation, donor-derived natural killer (NK) cells, which are alloreactive towardtoward recipient cells, significantly contribute to the eradication of leukemia blasts. Alloreactive NK cells may also kill host dendritic cells and T lymphocytes, thus preventing graft-versus-host disease and graft rejection, respectively. Sophisticated strategies of adoptive infusion of T-cell lines/clones specific for the most life-threatening pathogens (namely cytomegalovirus, Epstein-Barr virus, Aspergillus and Adenovirus) have been envisaged, and successfully tested in a few pilot trials, to protect the recipient in the early post-transplantation period. In these patients, also ex-vivo expanded mesenchymal stromal cells have been shown to be beneficial for preventing graft failure. Novel and effective strategies aimed at further augmenting the graft-versus-leukemia effect and at optimizing prevention/treatment of opportunistic/viral infections are warranted.

Original languageEnglish
Pages (from-to)339-349
Number of pages11
JournalBest Practice and Research: Clinical Haematology
Volume24
Issue number3
DOIs
Publication statusPublished - Sep 2011

Keywords

  • cellular therapy
  • graft-versus-leukemia effect
  • invariant NKT cells
  • mesenchymal stromal cells
  • NK alloreactivity
  • pathogen-specific T cells

ASJC Scopus subject areas

  • Oncology
  • Clinical Biochemistry

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