Haematopoietic stem cell transplantation: can our genes predict clinical outcome?

Haematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for many patients with malignant and non-malignant haematological diseases. The success of HSCT is greatly reduced by the development of complications, which include graft-versus-host disease (GVHD), relapse and...

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Published inExpert reviews in molecular medicine Vol. 9; no. 29; pp. 1 - 19
Main Authors Dickinson, Anne M., Harrold, Jane L., Cullup, Hannah
Format Journal Article
LanguageEnglish
Published Cambridge, UK Cambridge University Press 02.11.2007
Subjects
Animals
Chemokines - genetics
Chemokines - immunology
Clinical outcomes
Cohort Studies
Cytokines - genetics
Cytokines - immunology
Donor Selection
Genotype
Graft vs Host Disease - genetics
Graft vs Host Disease - therapy
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
HLA Antigens
Humans
Immunity, Innate - physiology
Pharmacogenetics
Polymorphism, Genetic
Receptors, Chemokine - genetics
Receptors, Chemokine - immunology
Receptors, Cytokine - genetics
Receptors, Cytokine - immunology
Retrospective Studies
Transplantation Conditioning
Treatment Outcome
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Summary:Haematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for many patients with malignant and non-malignant haematological diseases. The success of HSCT is greatly reduced by the development of complications, which include graft-versus-host disease (GVHD), relapse and infection. Human leukocyte antigen (HLA) matching of patients and donors is essential, but does not completely prevent these complications; non-HLA genes may also have an impact upon transplant outcome. Polymorphisms within genes that are associated with an individual's capability to mount an immune response to alloantigen and infectious pathogens and/or response to drugs (pharmacogenomics) are all currently being studied for their association with HSCT outcome. This review summarises the potential role of non-HLA polymorphisms in predicting HSCT outcome, from studies on retrospective transplant cohorts of HLA-identical siblings and matched unrelated donors. The clinical relevance and interpretation of non-HLA genetics, and how these could be used alongside clinical risk factors in HSCT, are also discussed.
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ISSN:1462-3994
1462-3994
DOI:10.1017/S1462399407000488