New ways to separate Graft-versus-Host Disease and Graft-versus-Tumour effects after allogeneic haematopoietic stem cell transplantation

Authors

  • Eleni Kotsiou,

    1. Centre for Haemato-Oncology, Barts Cancer Institute – a CR-UK Centre of Excellence, Queen Mary University of London, London, UK
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  • Jeff K. Davies

    Corresponding author
    • Centre for Haemato-Oncology, Barts Cancer Institute – a CR-UK Centre of Excellence, Queen Mary University of London, London, UK
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Correspondence: Jeff K. Davies, 3rd Flr John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK.

E-mail: j.k.davies@qmul.ac.uk

Summary

A major challenge to transplant immunologists and physicians remains the separation of harmful graft-versus-host disease (GvHD) and beneficial graft-versus-tumour (GvT) effects after allogeneic haematopoietic stem cell transplantation. Recent advances in our understanding of the allogeneic immune response provide potential new opportunities to achieve this goal. Three potential new approaches that capitalize on this new knowledge are considered in depth; the manipulation of organ-specific cytokines and other pro-inflammatory signals, the selective manipulation of donor effector T cell migration, and the development of cell-mediated immunosuppressive strategies using donor-derived regulatory T cells. These new approaches could provide strategies for local control of allogeneic immune responses, a new paradigm to separate GvHD and GvT effects. Although these strategies are currently in their infancy and have challenges to successful translation to clinical practice, all have exciting potential for the future.

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