Bone marrow transplantation

New approaches to immunosuppression and management of acute graft-versus-host disease

Jeffery J. Auletta, Kenneth R Cooke

Research output: Contribution to journalArticle

Abstract

Purpose of review Acute graft-versus-host disease (GVHD) significantly limits the application and the success of allogeneic hematopoietic stem cell transplantation (HSCT). Novel therapies that target the aberrant immune response underlying GVHD are reviewed with particular emphasis on immunomodulatory agents currently incorporated into clinical trials. In addition, regenerative stromal cellular therapy (RSCT) is discussed as an emerging form of novel GVHD therapy. Recent findings Knowledge for transplant immunology, particularly as it relates to underlying pathophysiology of GVHD, has dramatically increased over the last decade. As a result, new immunomodulatory therapies have been used to treat steroid-refractory GVHD. However, their success has been limited by their lack of clinical experience during HSCT as well as by their associated toxicity profiles. RSCT uniquely offers the potential to enhance donor-derived hematopoiesis and immunity and to ameliorate adverse sequelae associated with GVHD. Summary An exciting era incorporating the use of cellular therapeutics during HSCT has arrived. As the experience and understanding for cellular therapies, in general, and RSCT, in particular, increases, so too will their success in benefiting the HSCT recipient beyond limitations of current pharmaceutical agents.

Original languageEnglish (US)
Pages (from-to)30-38
Number of pages9
JournalCurrent Opinion in Pediatrics
Volume21
Issue number1
DOIs
StatePublished - Feb 2009
Externally publishedYes

Fingerprint

Graft vs Host Disease
Bone Marrow Transplantation
Immunosuppression
Hematopoietic Stem Cell Transplantation
Therapeutics
Immunomodulation
Hematopoiesis
Therapeutic Uses
Allergy and Immunology
Immunity
Steroids
Clinical Trials
Transplants
Pharmaceutical Preparations

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Graft-versus-host disease
  • Mesenchymal stem cell
  • Multipotent adult progenitor cell
  • Regenerative stromal cellular therapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Bone marrow transplantation : New approaches to immunosuppression and management of acute graft-versus-host disease. / Auletta, Jeffery J.; Cooke, Kenneth R.

In: Current Opinion in Pediatrics, Vol. 21, No. 1, 02.2009, p. 30-38.

Research output: Contribution to journalArticle

@article{8905ae44151d4a3496796b17bbd24c97,
title = "Bone marrow transplantation: New approaches to immunosuppression and management of acute graft-versus-host disease",
abstract = "Purpose of review Acute graft-versus-host disease (GVHD) significantly limits the application and the success of allogeneic hematopoietic stem cell transplantation (HSCT). Novel therapies that target the aberrant immune response underlying GVHD are reviewed with particular emphasis on immunomodulatory agents currently incorporated into clinical trials. In addition, regenerative stromal cellular therapy (RSCT) is discussed as an emerging form of novel GVHD therapy. Recent findings Knowledge for transplant immunology, particularly as it relates to underlying pathophysiology of GVHD, has dramatically increased over the last decade. As a result, new immunomodulatory therapies have been used to treat steroid-refractory GVHD. However, their success has been limited by their lack of clinical experience during HSCT as well as by their associated toxicity profiles. RSCT uniquely offers the potential to enhance donor-derived hematopoiesis and immunity and to ameliorate adverse sequelae associated with GVHD. Summary An exciting era incorporating the use of cellular therapeutics during HSCT has arrived. As the experience and understanding for cellular therapies, in general, and RSCT, in particular, increases, so too will their success in benefiting the HSCT recipient beyond limitations of current pharmaceutical agents.",
keywords = "Allogeneic hematopoietic stem cell transplantation, Graft-versus-host disease, Mesenchymal stem cell, Multipotent adult progenitor cell, Regenerative stromal cellular therapy",
author = "Auletta, {Jeffery J.} and Cooke, {Kenneth R}",
year = "2009",
month = "2",
doi = "10.1097/MOP.0b013e3283207b2f",
language = "English (US)",
volume = "21",
pages = "30--38",
journal = "Current Opinion in Pediatrics",
issn = "1040-8703",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Bone marrow transplantation

T2 - New approaches to immunosuppression and management of acute graft-versus-host disease

AU - Auletta, Jeffery J.

AU - Cooke, Kenneth R

PY - 2009/2

Y1 - 2009/2

N2 - Purpose of review Acute graft-versus-host disease (GVHD) significantly limits the application and the success of allogeneic hematopoietic stem cell transplantation (HSCT). Novel therapies that target the aberrant immune response underlying GVHD are reviewed with particular emphasis on immunomodulatory agents currently incorporated into clinical trials. In addition, regenerative stromal cellular therapy (RSCT) is discussed as an emerging form of novel GVHD therapy. Recent findings Knowledge for transplant immunology, particularly as it relates to underlying pathophysiology of GVHD, has dramatically increased over the last decade. As a result, new immunomodulatory therapies have been used to treat steroid-refractory GVHD. However, their success has been limited by their lack of clinical experience during HSCT as well as by their associated toxicity profiles. RSCT uniquely offers the potential to enhance donor-derived hematopoiesis and immunity and to ameliorate adverse sequelae associated with GVHD. Summary An exciting era incorporating the use of cellular therapeutics during HSCT has arrived. As the experience and understanding for cellular therapies, in general, and RSCT, in particular, increases, so too will their success in benefiting the HSCT recipient beyond limitations of current pharmaceutical agents.

AB - Purpose of review Acute graft-versus-host disease (GVHD) significantly limits the application and the success of allogeneic hematopoietic stem cell transplantation (HSCT). Novel therapies that target the aberrant immune response underlying GVHD are reviewed with particular emphasis on immunomodulatory agents currently incorporated into clinical trials. In addition, regenerative stromal cellular therapy (RSCT) is discussed as an emerging form of novel GVHD therapy. Recent findings Knowledge for transplant immunology, particularly as it relates to underlying pathophysiology of GVHD, has dramatically increased over the last decade. As a result, new immunomodulatory therapies have been used to treat steroid-refractory GVHD. However, their success has been limited by their lack of clinical experience during HSCT as well as by their associated toxicity profiles. RSCT uniquely offers the potential to enhance donor-derived hematopoiesis and immunity and to ameliorate adverse sequelae associated with GVHD. Summary An exciting era incorporating the use of cellular therapeutics during HSCT has arrived. As the experience and understanding for cellular therapies, in general, and RSCT, in particular, increases, so too will their success in benefiting the HSCT recipient beyond limitations of current pharmaceutical agents.

KW - Allogeneic hematopoietic stem cell transplantation

KW - Graft-versus-host disease

KW - Mesenchymal stem cell

KW - Multipotent adult progenitor cell

KW - Regenerative stromal cellular therapy

UR - http://www.scopus.com/inward/record.url?scp=62849091765&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62849091765&partnerID=8YFLogxK

U2 - 10.1097/MOP.0b013e3283207b2f

DO - 10.1097/MOP.0b013e3283207b2f

M3 - Article

VL - 21

SP - 30

EP - 38

JO - Current Opinion in Pediatrics

JF - Current Opinion in Pediatrics

SN - 1040-8703

IS - 1

ER -