Abstract

Umbilical cord blood transplantation (UCBT) is increasingly being used as an alternative to conventional allogeneic stem cell transplantation. However, despite significant improvements, an appreciable proportion of patients (especially adults) receiving UCBT will still face some form of severe acute and/or chronic graft-versus-host disease (GVHD). Moreover, poor engraftment and delayed immune recovery are still challenging issues. Therefore, in terms of both GVHD and engraftment kinetics, the immunosuppressive potency of the conditioning regimen prior to UCBT may play an important role. Anti-thymocyte globulin (ATG, Thymoglobulin?) provides multifaceted immunomodulation suggesting that the use of ATG may be of interest towards improving engraftment and GVHD outcome. However, the role of ATG in UCBT is still under debate. This report will review the incidence and severity of GVHD after UCBT, and will discuss the potential role of ATG towards improving outcome (GVHD and engraftment) when used as part of the conditioning regimen prior to UCBT.

    脐血移植作为传统异基因干细胞移植的替代方法，应用量日益增加。但是尽管效果显著，仍然有很多患者（特别是成人）面临急慢性GVHD。此外，植入难及免疫重建延迟也是一个难题。因此就GVHD和植入而言，免疫抑制的预处理方法可以起到重要的作用。抗胸腺细胞球蛋白（ATG）因发挥多方面的免疫调节作用，可以用来促进植入和改善GVHD。然而，ATG的作用仍然在争论中。本文将回顾脐血移植后GVHD的发病率和严重程度，并讨论作为预处理方案使用的ATG在改进移植效果（GVHD和植入）方面的作用。