Immune Reconstitution After Hematopoietic Stem Cell Transplantation: Cellular Dynamics, Clinical Determinants, and Emerging Therapeutic Strategies.

IF 2.3 4区医学 Q3 IMMUNOLOGY

Immunological Investigations Pub Date : 2026-07-01 DOI:10.1080/08820139.2026.2696004

Eida Elmansorry

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引用次数: 0

Abstract

Background: Immune reconstitution following HSCT is a complex process that strongly determines post-transplant outcomes. Delayed or impaired immune recovery increases susceptibility to opportunistic infections, viral reactivation, graft-versus-host disease, relapse, and transplant-related morbidity and mortality.

Objective: This review summarizes current evidence on the kinetics, functional recovery, and clinical significance of innate and adaptive immune reconstitution after HSCT.

Methods: A narrative review of recent literature was performed focusing on immune cell reconstitution dynamics and influencing clinical and biological factors.

Results: Innate immunity (neutrophils, NK cells) recovers early, providing initial defense. Adaptive immunity is delayed, driven by thymic output and peripheral T- and B-cell expansion. Regulatory T cells and γδ T cells support tolerance and graft-versus-leukemia effects. Recovery is influenced by age, conditioning, graft source, GVHD, infections, and microbiome. Numerical recovery may not equal functional immune competence.

Conclusion: Advances in immune profiling, biomarkers, and systems immunology, along with adoptive cellular therapy and microbiome-based interventions, may enable personalized strategies to improve immune reconstitution and long-term outcomes.

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造血干细胞移植后的免疫重建：细胞动力学、临床决定因素和新兴治疗策略。

背景：造血干细胞移植后的免疫重建是一个复杂的过程，在很大程度上决定了移植后的预后。延迟或受损的免疫恢复增加了机会性感染、病毒再激活、移植物抗宿主病、复发和移植相关发病率和死亡率的易感性。目的：本文综述了目前关于造血干细胞移植后先天性和适应性免疫重建的动力学、功能恢复和临床意义的证据。方法：对近年来有关免疫细胞重建动力学及影响临床和生物学因素的文献进行综述。结果：先天免疫（中性粒细胞、NK细胞）恢复较早，提供初步防御。适应性免疫延迟，由胸腺输出和外周T细胞和b细胞扩增驱动。调节性T细胞和γδ T细胞支持耐受性和移植物抗白血病效应。恢复受年龄、条件、移植物来源、GVHD、感染和微生物组的影响。数字恢复可能不等于功能性免疫能力。结论：免疫图谱、生物标志物和系统免疫学的进展，以及过继细胞治疗和基于微生物组的干预，可能使个性化策略能够改善免疫重建和长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Immunological Investigations 医学-免疫学

CiteScore

5.50

自引率

7.10%

发文量

审稿时长

3 months

期刊介绍： Disseminating immunological developments on a worldwide basis, Immunological Investigations encompasses all facets of fundamental and applied immunology, including immunohematology and the study of allergies. This journal provides information presented in the form of original research articles and book reviews, giving a truly in-depth examination of the latest advances in molecular and cellular immunology.