实用医学杂志 ›› 2025, Vol. 41 ›› Issue (5): 641-647.doi: 10.3969/j.issn.1006-5725.2025.05.004

• 专题笔谈 • 上一篇    

异基因造血干细胞移植后的免疫相关研究进展

陈星驰,朱小玉()   

  1. 中国科学技术大学附属第一医院(安徽省立医院)血液科、中国科学技术大学生命科学与医学部血液和细胞 治疗研究所、血细胞研究及应用安徽省重点实验室 (安徽 合肥 230001 )
  • 收稿日期:2024-07-18 出版日期:2025-03-10 发布日期:2025-03-20
  • 通讯作者: 朱小玉 E-mail:xiaoyuz@ustc.edu.cn
  • 作者简介:朱小玉,医学博士,主任医师,博士研究生(博士后)导师,中国科学技术大学附属第一医院血液内科行政主任,中国科学技术大学生命科学与医学部血液和细胞治疗研究所副所长。安徽省血液内科质控中心主任,安徽省学术技术带头人后备人选、安徽省第九批“特支计划”卫生创新领军人才,中华医学会血液学分会第九届、第十届青年委员会委员;现任中国血液病专科联盟再障协作组副组长、中华医学会血液学分会造血干细胞移植学组委员、安徽省血液内科质控中心主任、安徽省血液学分会第八届委员会副主任委员、安徽省造血干细胞移植联盟理事长等多项任职。近5年来以第一作者/通信作者(含共同)发表中文核心/SCI论文20余篇,主编专著1部,长期致力于造血干细胞移植尤其是脐血移植治疗恶性血液病的基础研究和临床探索。
  • 基金资助:
    国家自然科学基金面上项目(82270223)

Advances in immunological research on hematopoietic stem cell transplantation

Xingchi CHEN,Xiaoyu. ZHU()   

  1. Department of Hematology,the First Affiliated Hospital of USTC,Blood and Cell Therapy Institute,Division of Life Sciences and Medicine,University of Science and Technology of China,Anhui Provincial Key Laboratory of Blood Research and Applications,Hefei 230001,Anhui,China
  • Received:2024-07-18 Online:2025-03-10 Published:2025-03-20
  • Contact: Xiaoyu. ZHU E-mail:xiaoyuz@ustc.edu.cn

摘要:

异基因造血干细胞移植(allo-HSCT)是一种通过输注异基因造血干细胞来重建移植受者造血及免疫功能的方法,已经发展成为一种有效的过继细胞免疫疗法,有望治愈多种疾病包括恶性血液病、造血衰竭性疾病、先天免疫缺陷病及遗传代谢性疾病等。免疫学在allo-HSCT中起着重要作用,移植后免疫生物学是相对独特的,因为它涉及供体和宿主之间潜在的免疫识别和攻击。本文综述了allo-HSCT后免疫重建的特点,探讨了移植物抗宿主病(GVHD)与移植物抗白血病(GVL)效应的免疫基础,并分析了新型治疗策略如何调控这些免疫反应,加强移植相关并发症的管理,提高患者预后。最后,本文提出了GVHD与GVL效应调控中面临的挑战,并展望了未来的研究方向。

关键词: 异基因造血干细胞移植, 免疫机制, 恶性血液病

Abstract:

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a therapeutic approach that restores hematopoietic and immune functions in recipients through the infusion of allogeneic hematopoietic stem cells. It has evolved into an effective form of adoptive cellular immunotherapy, offering curative potential for various diseases, including malignant hematologic disorders, hematopoietic failure syndromes, congenital immunodeficiencies, and genetic metabolic disorders. Immunology plays a pivotal role in allo-HSCT, as post-transplant immunobiology is uniquely characterized by the potential for immune recognition and attack between donor and host cells. This review elucidates the distinctive features of immune reconstitution following allo-HSCT, examines the immunological underpinnings of graft-versus-host disease (GVHD) and the graft-versus-leukemia (GVL) effect, and evaluates how novel therapeutic strategies modulate these immune responses to improve the management of transplant-related complications and enhance patient outcomes. Additionally, the review addresses the challenges in balancing GVHD and GVL effects and outlines potential directions for future research.

Key words: hematopoietic stem cell transplantation, immunological mechanisms, malignant hematological diseases

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