Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Nov 16;7(8):901-916.
doi: 10.1080/21505594.2016.1208866. Epub 2016 Jul 6.

Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection

Rohtesh S Mehta  1 , Katayoun Rezvani  2
Affiliations
Review

Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection

Rohtesh S Mehta et al. Virulence. .

Abstract

Infection is the leading cause of non-relapse mortality after allogeneic haematopoietic cell transplantation (HCT). This occurs as a result of dysfunction to the host immune system from the preparative regimen used prior to HCT, combined with a delay in reconstitution of the donor-derived immune system after HCT. In this article, we elaborate on the process of immune reconstitution post-HCT that begins with the innate system and is followed by recovery of adaptive immunity. Simultaneously, we describe how the tempo of immune reconstitution influences the risk of various infections. We explain some of the key differences in immune reconstitution and the consequent risk of infections in recipients of peripheral blood stem cell, bone marrow or umbilical cord blood grafts. Other factors that impact on immune recovery are also highlighted. Finally, we allude to various strategies that are being tested to enhance immune reconstitution post-HCT.

Keywords: adaptive immunity; allogeneic haematopoietic stem cell transplant; immune reconstitution; infection; innate immunity.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Infections encountered at different phases after HCT.
Figure 2.
Figure 2.
General tempo of immune recovery after myeloablative HCT.
See this image and copyright information in PMC

References

    1. Majhail NS, Farnia SH, Carpenter PA, Champlin RE, Crawford S, Marks DI, Omel JL, Orchard PJ, Palmer J, Saber W, et al.. Indications for autologous and allogeneic hematopoietic cell transplantation: guidelines from the american society for blood and marrow transplantation. Biol Blood Marrow Transplant 2015; 21:1863-9; PMID:26256941; http://dx.doi.org/10.1016/j.bbmt.2015.07.032 - DOI - PMC - PubMed
    1. Komanduri KV, St John LS, de Lima M, McMannis J, Rosinski S, McNiece I, Bryan SG, Kaur I, Martin S, Wieder ED, et al.. Delayed immune reconstitution after cord blood transplantation is characterized by impaired thymopoiesis and late memory T-cell skewing. Blood 2007; 110:4543-51; PMID:17671230; http://dx.doi.org/10.1182/blood-2007-05-092130 - DOI - PMC - PubMed
    1. Ringhoffer S, Rojewski M, Dohner H, Bunjes D, Ringhoffer M. T-cell reconstitution after allogeneic stem cell transplantation: assessment by measurement of the sjTREC/betaTREC ratio and thymic naive T cells. Haematologica 2013; 98:1600-8; PMID:23585532; http://dx.doi.org/10.3324/haematol.2012.072264 - DOI - PMC - PubMed
    1. Majhail NS, Rizzo JD, Lee SJ, Aljurf M, Atsuta Y, Bonfim C, Burns LJ, Chaudhri N, Davies S, Okamoto S, et al.. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Biol Blood Marrow Transplant 2012; 18:348-71; PMID:22178693; http://dx.doi.org/10.1016/j.bbmt.2011.12.519 - DOI - PMC - PubMed
    1. Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, Wingard JR, Young JA, Boeckh MJ, Center for International B, et al.. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant 2009; 15:1143-238; PMID:19747629; http://dx.doi.org/10.1016/j.bbmt.2009.06.019 - DOI - PMC - PubMed