History of hematopoietic cell transplantation: challenges and progress

Granot, Noa; Storb, Rainer

doi:10.3324/haematol.2019.245688

Cited by 83 publications

(55 citation statements)

References 175 publications

(160 reference statements)

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“…Hematopoietic cell transplantation (HCT) is a potentially curative treatment for high-risk hematopoietic neoplastic disorders, metabolic, genetic and immune-mediated diseases. It involves eradication or suppression of the recipient's hematopoietic cells using a conditioning regimen followed by infusion of stem cells collected from the bone marrow, placenta (cord blood) or peripheral blood (1). The source of hematopoietic cells can be either autologous (auto, recipientderived) or allogeneic (allo, matched related or unrelated donor-derived) hematopoietic cells.…”

Section: Introductionmentioning

confidence: 99%

Experimental Models of Infectious Pulmonary Complications Following Hematopoietic Cell Transplantation

Zhou

Moore

2021

Front. Immunol.

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Pulmonary infections remain a major cause of morbidity and mortality in hematopoietic cell transplantation (HCT) recipients. The prevalence and type of infection changes over time and is influenced by the course of immune reconstitution post-transplant. The interaction between pathogens and host immune responses is complex in HCT settings, since the conditioning regimens create periods of neutropenia and immunosuppressive drugs are often needed to prevent graft rejection and limit graft-versus-host disease (GVHD). Experimental murine models of transplantation are valuable tools for dissecting the procedure-related alterations to innate and adaptive immunity. Here we review mouse models of post-HCT infectious pulmonary complications, primarily focused on three groups of pathogens that frequently infect HCT recipients: bacteria (often P. aeruginosa), fungus (primarily Aspergillus fumigatus), and viruses (primarily herpesviruses). These mouse models have advanced our knowledge regarding how the conditioning and HCT process negatively impacts innate immunity and have provided new potential strategies of managing the infections. Studies using mouse models have also validated clinical observations suggesting that prior or occult infections are a potential etiology of noninfectious pulmonary complications post-HCT as well.

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Section: Introductionmentioning

confidence: 99%

Experimental Models of Infectious Pulmonary Complications Following Hematopoietic Cell Transplantation

Zhou

Moore

2021

Front. Immunol.

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“…A study in the USA found significantly greater 1-year post-alloHSCT costs for patients with aGvHD compared to those without aGvHD ($466,720 vs. $263,568; P < 0.001), with inpatient care being the primary cost driver [43]. A Swedish real-world study found that the cumulative direct medical costs over 3 years post-alloHSCT for patients Table 1 Summary of graft-versus-host disease (GvHD) in allogeneic haematopoietic stem cell transplantation (alloHSCT) Note: AlloHSCT outcomes are dependent on multiple factors, making it difficult to provide generally applicable ranges, especially when considering recent trends of improved alloHSCT procedures and regimens [31,36]. Relevant factors include recipient age, patient fitness/co-morbidities, underlying malignant/non-malignant disease, graft source, donor type/age, conditioning regimen, pre alloHSCT treatment, GvHD prophylaxis and post-alloHSCT treatment a Transplant-related mortality defined as death unrelated to relapse or disease progression…”

Section: Key Pointsmentioning

confidence: 99%

“… Note: AlloHSCT outcomes are dependent on multiple factors, making it difficult to provide generally applicable ranges, especially when considering recent trends of improved alloHSCT procedures and regimens [ 31 , 36 ]. Relevant factors include recipient age, patient fitness/co-morbidities, underlying malignant/non-malignant disease, graft source, donor type/age, conditioning regimen, pre alloHSCT treatment, GvHD prophylaxis and post-alloHSCT treatment a Transplant-related mortality defined as death unrelated to relapse or disease progression …”

Section: Graft-versus-host Disease (Gvhd) Is a Life-threatening And Expensive Complication Of Allogeneic Haematopoietic Stem Cell Transplmentioning

confidence: 99%

Improved Therapeutic Approaches are Needed to Manage Graft-versus-Host Disease

Hooker¹,

Grabe-Heyne

Henne

et al. 2021

Clin Drug Investig

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Allogeneic haematopoietic stem cell transplantation (alloHSCT) offers a potentially curative therapy for patients suffering from diseases of the haematopoietic system but requires a high level of expertise and is both resource intensive and expensive. A frequent and life-threatening complication is graft-versus-host disease (GvHD). Acute GvHD (aGvHD) generally causes skin, gastrointestinal and liver symptoms, but chronic GvHD (cGvHD) has a different pathophysiology and may affect nearly every organ or tissue of the body. In Europe, GvHD prophylaxis is generally a calcineurin inhibitor in combination with methotrexate, with high-dose systemic steroids used for advanced GvHD treatment. Between 39% and 59% of alloHSCT patients will develop aGvHD and around 36-37% will develop cGvHD. Steroid response decreases with increasing disease severity, which in turn leads to an increase in non-relapse mortality. GvHD imposes a financial burden on healthcare systems, significantly increasing post-alloHSCT costs. Increased GvHD disease severity magnifies this. Balancing immunosuppression to control the GvHD whilst maintaining a degree of immunocompetence against infection is critical. European GvHD guidelines acknowledge the lack of evidence to support a standard second-line therapy, and improved long-term outcomes and quality-of-life (QoL) remain an unmet need. Evidence generation for potential treatments is challenging. Issues to overcome include choice of comparator (extensive off-label usage); blinding; selection of relevant patient-reported outcome measures (PROMs); and rarity of the condition, which may infeasibly increase timescales to achieve clinical and statistical relevance.

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“…The use of h-BMSCs as a therapy to modulate immune responses is known. In fact, it has been shown that these cells can express histamine H1, H2, and H4 receptors and histamine itself then stimulating the production of interleukin 6 (IL-6) [ 18 – 20 ]. Finally, several studies mention the role of stem cells in the relationship with periodontitis antibodies and particularly in CVD (cardiovascular disease) biomarkers in the early stages.…”

Section: Introductionmentioning

confidence: 99%

“…To date, three stem cell-based therapies have been considered: (a) already differentiated cell transplantation with specific types of cells that derive from embryonic or somatic stem cells and include patient's own stem cells and grow and differentiate under special processing conditions in the laboratory (e.g., insulin-producing cells for the treatment of diabetes), (b) stimulation of endogenous stem cells in an individual (e.g., by administering growth factors) with the possibility of inducing or increasing the processes of selfrepair, and (c) direct administration of stem cells to the patient, so that a colonization process begins in the desired part of the body and thus the differentiation continues into the desired cell type (Figure 2) [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Stem Cells: A Historical Review about Biological, Religious, and Ethical Issues

Charitos

Ballini

Cantore

et al. 2021

Stem Cells International

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Stem cells can be used to replace damaged cells or regenerate organs and have broadened our knowledge of the development and progression of certain diseases. Despite significant advances in understanding stem cell biology, several problems limit their use. These problems are related not only to the growth of tumors in animal models and their rejection in transplant cases but also to ethical and social issues about the use of embryonic cells. The ethical-scientific debate on this type of cells has taken on great interest both for their application in regenerative medicine and for the potential possibilities in the field of cell and gene therapy. Different points of view often have the expression of a perception that depends on scientific goals or opportunities or on religious traditions and beliefs. Therefore, as the questions and doubts about when life begins, so do the answers for the use of these cells as therapy or otherwise. So, in addition to the origin of stem cells, there are currently some social bioethical (such as political and legislative issues) and religious dilemmas. The purpose of the study is aimed at being a narrative on the history of stem cells and the evolution of their use to date, as well as to clarify the bioethical position of the various religions today in comparison with the social ones regarding the research and use of embryonic and adult ones. Hence, their biological hypostasis regarding the concepts of “conception” and “fertilization” and their development and therapeutic use compared to those of the main theological doctrines.

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History of hematopoietic cell transplantation: challenges and progress

Cited by 83 publications

References 175 publications

Experimental Models of Infectious Pulmonary Complications Following Hematopoietic Cell Transplantation

Experimental Models of Infectious Pulmonary Complications Following Hematopoietic Cell Transplantation

Improved Therapeutic Approaches are Needed to Manage Graft-versus-Host Disease

Stem Cells: A Historical Review about Biological, Religious, and Ethical Issues

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