Xiaohua Chen, Rupert Handgretinger and Gregory A. Hale Pages 75 - 78 ( 4 )
Haploidentical hematopoietic stem cell transplantation from a mismatched family member is an alternative treatment for transplant candidates who lack a HLA-matched related or an appropriate unrelated donor. One of main obstacles to successful haploidentical transplantation is slow immune reconstitution which significantly increases the risk of opportunistic infections, graft-vs-host-disease and disease relapse. Immune reconstitution is conventionally estimated by phenotypic recovery of immune cells according to lineage and/or by in vitro evidence of cell function. The limitations of these approaches include the sensitivity and specificity of phenotype markers, the availability of antibodies, the instability of long-term cell culture and the laborious nature of cell-function assays. Investigators have sought alternative approaches that are more sensitive, specific and simple, and that allow high-throughput testing for use in clinical transplantation. In this mini-review, we briefly introduce the concept of “molecular monitoring of immune-reconstitution” and discuss recent progress in this field achieved by our laboratory and other groups. We also propose future directions for clinical research incorporating these novel concepts.
Molecular monitoring of immune reconstitution, haploidentical stem cell transplantation, T-cell receptor CDR3 size sspectratyping, TCR beta microarray, T-cell receptor excision circles, KIR spectratyping
Division of Bone Marrow Transplantation and Cellular Therapy, Department of Oncology, St Jude Children`s Research Hospital, Memphis, TN, Department of Hematology/Oncology, Children’s University Hospital, University of Tuebingen, Division of Bone Marrow Transplantation and Cellular Therapy, Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN