Factors affecting immune recovery after transplant.
| Factor . | Effect . |
|---|---|
| Abbreviations: GVHD, graft-versus-host disease; GVL, graft versus leukemia; IL, interleukin; NK, natural killer; Th, T helper. | |
| Immunosuppression to prevent or treat GVHD | Impairment of GVL and antiviral responses |
| GVHD | Immunodeficiency, thymic damage delays tolerance |
| Recipient age (thymic age) | Younger age favors full and rapid thymic recovery |
| T lymphocyte dose | High doses widen repertoire |
| Profound host immunoablation | Favors T-cell clonal expansion |
| Immunodominance | Favors T-cell clonal expansion |
| T regulatory cells | Reduce GVHD retain GVL? |
| Th1/Th2 balance | Reduce GVHD retain GVL? |
| Growth factors IL-2, IL-12, IL-7 | Favor T-cell expansion and thymic recovery |
| Lymphoid chimerism | Mixed chimerism reduces GVL and GVHD |
| HLA mismatching | NK cell alloreactivity favors GVL without GVHD |
| Cytokine gene polymorphisms | Affect GVHD, GVL, immune reconstitution |
| Factor . | Effect . |
|---|---|
| Abbreviations: GVHD, graft-versus-host disease; GVL, graft versus leukemia; IL, interleukin; NK, natural killer; Th, T helper. | |
| Immunosuppression to prevent or treat GVHD | Impairment of GVL and antiviral responses |
| GVHD | Immunodeficiency, thymic damage delays tolerance |
| Recipient age (thymic age) | Younger age favors full and rapid thymic recovery |
| T lymphocyte dose | High doses widen repertoire |
| Profound host immunoablation | Favors T-cell clonal expansion |
| Immunodominance | Favors T-cell clonal expansion |
| T regulatory cells | Reduce GVHD retain GVL? |
| Th1/Th2 balance | Reduce GVHD retain GVL? |
| Growth factors IL-2, IL-12, IL-7 | Favor T-cell expansion and thymic recovery |
| Lymphoid chimerism | Mixed chimerism reduces GVL and GVHD |
| HLA mismatching | NK cell alloreactivity favors GVL without GVHD |
| Cytokine gene polymorphisms | Affect GVHD, GVL, immune reconstitution |