Cyclophosphamide-Induced Tolerance in Allogeneic Transplantation: From Basic Studies to Clinical Application

Abstract

Immune tolerance against alloantigens plays an important role in the success of clinical organ and allogeneic hematopoietic stem cell transplantation. The mechanisms of immune tolerance to alloantigens have gradually been elucidated over time. Although there have been numerous reports to date on the induction of tolerance to alloantigens, the establishment of mixed chimerism is well-known to be crucial in the induction and maintenance of immune tolerance for either of the methods. Since the early 1980s, the murine system of cyclophosphamide (Cy)-induced tolerance has also been examined extensively. The present review focuses on studies conducted on Cy-induced immune tolerance. Clinical data of patients with allogeneic transplantation suggest that the posttransplant Cy method to induce immune tolerance has been successfully translated from basic studies into clinical practice.

Post-Transplant Surveillance and Management of Chronic Active Antibody-Mediated Rejection in Renal Transplant Patients in Europe

“…Previously, poorly HLA-matched transplants and transplantation of poorer quality organs [ 12 ] were too high risk for transplantation. Recent advancements in transplant science, including preservation and tolerance techniques, are allowing for transplantation of these suboptimal organs.…”

“…Recent advancements in transplant science, including preservation and tolerance techniques, are allowing for transplantation of these suboptimal organs. These types of transplants are at greater risk of post-transplant complications [ 12 ]; therefore, the need for effective surveillance post-transplant has increased.…”

A Review of Cyclophosphamide-Induced Transplantation Tolerance in Mice and Its Relationship With the HLA-Haploidentical Bone Marrow Transplantation/Post-Transplantation Cyclophosphamide Platform

“…Instead, the first clinical trial in BMT examined haplo-identical combinations. Based on the promising results of PTCy in haploBMT (haploBMT/PTCy), many groups now use the same strategy in the setting of HLA-matched donors because of its safety, simplicity, and low cost (60)(61)(62)(63).…”

The Nitrogen Mustards

“…Cyclophosphamide-induced tolerance is currently being investigated in the fields of allo-SCT and kidney transplantation. Renal allograft tolerance induced by allogeneic stem cells and PTCy allows immunosuppressive drugs to be discontinued in two-thirds of patients (Kato et al, 2020).…”