Immune Biology of Allogeneic Hematopoietic Stem Cell Transplantation

This book provides clinical and scientific researchers with a deep understanding of the current research and the implications for translational practice. By providing an overview of immune biology of HSCT, an explanation of immune rejection and detail on antigens and their role in HSCT success, this book embraces biologists and clinicians who need a broad view of the deeply complex processes involved. It then moves on to discuss the immunobiology mechanisms which influence GVHD and GVL and transplantation success. With the use of illustrative figures, highlighted key issues, description of recent successes and discussions of unanswered questions, this book brings together the current state of HSCT to enhance the prospects for the future.

Allogeneic hematopoietic stem cell transplantation (HSCT) is a medical procedure in which a patient receives blood-forming stem cells (cells from which all blood cells develop) from a genetically similar, but not identical, donor. This procedure is most often performed for people with diseases of the blood, bone marrow, or certain cancers. While it is a widely performed procedure, it remains risky with many possible complications. As such, experimental practice is reserved for preclinical animal models including the mouse and dog.

These animal models have been essential in the development of transplant protocols including preclinical testing of conditioning regimens, treatment of graft-versus-host disease (GVHD), and understanding of the pathology of GVHD as well as the immunological mechanisms of GVHD and of the graft-versus-leukemia (GVL) effect. There has been a recent explosion in research which has revealed significant species differences between humans and animal models which need to be considered when drawing conclusions from studies with animal models to relate to clinical allogeneic HSCT scenarios. Some of these issues also apply when attempting to draw broad conclusions from clinical studies.