[异基因造血干细胞移植中使用 PTCy 预防移植物抗宿主病的现状]。

Hirohisa Nakamae
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引用次数: 0

摘要

根据最近的随机III期试验结果,移植后环磷酰胺(PTCy)被越来越多的人认为是HLA匹配的外周血干细胞移植中预防移植物抗宿主疾病(GVHD)的新标准。PTCy异基因造血细胞移植(HCT)被认为具有依赖性和非依赖性移植物抗肿瘤(GVT)效应。PTCy引起的异体反应性T细胞功能障碍和HCT后调节性T细胞的优先恢复可能会减弱其GVHD依赖效应,但其GVT效应在病情缓解或病情不严重的患者中似乎并没有明显减弱。在日本,非缓解期患者往往也是移植的候选者,因此有必要以 PTCy 为平台,建立一种对非缓解期患者也有效的策略,并修订供体选择算法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Current state of graft-versus-host disease prophylaxis with PTCy for allogeneic hematopoietic stem cell transplantation].

There is growing recognition of post-transplant cyclophosphamide (PTCy) as the new standard prophylaxis for graft-versus-host disease (GVHD) in HLA-matched peripheral blood stem cell transplants with reduced intensity conditioning, based on recent results of randomized phase III trials of PTCy. Allogeneic hematopoietic cell transplantation (HCT) with PTCy is thought to have GVHD-dependent and -independent graft-versus-tumor (GVT) effects. Its GVHD-dependent effects may be attenuated by PTCy-induced alloreactive T cell dysfunction and preferential recovery of regulatory T cells after HCT, but its GVT effects do not appear to be significantly impaired in patients in remission or with indolent disease. As patients not in remission are often also candidates for transplantation in Japan, it will be necessary to use PTCy as a platform to establish a strategy that could also be effective in patients not in remission and to revise the donor selection algorithm.

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