Recent advances in transplantation for primary immune deficiency diseases

A comprehensive review

M. Teresa De La Morena, Robert Nelson

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Hematopoietic cell transplantation (HCT) is a curative therapeutic option for severe combined immunodeficiency (SCID), a group of diseases which otherwise carry life expectancies that are of limited duration and quality. Survival following HCT for SCID has improved from approximately 23 to 91 % over the last 40 years. Success with SCID prompted efforts to apply HCT to the therapeutic challenge of well over 20 molecularly defined primary immune deficiency diseases (PID). Such success is due to both early recognition of PIDs and advances in the field of transplantation. Such advances include high-resolution HLA DNA donor-recipient matching, expansion of donor sources, better tolerated conditioning, new antibiotics, and wider availability. International collaborative efforts have provided patients and caregivers information that permit better treatment decisions now, and direct clinicians and investigators to ensure progress in the future. Pioneers in screening for SCID have taken steps to correct the fundamental challenge to successful treatment, which is the rapid discovery and characterization of cases and offering the transplant option to an affected child early in life; blood spot testing for T and B cell receptor quantification is now available to a growing fraction of newborns. Organizations including the Primary Immune Deficiency Treatment Consortium in the USA, The European Society for Primary Immunodeficiency, the European Group for Blood and Marrow Transplantation, the Pediatric Blood and Marrow Transplant Consortium, the United States Immunodeficiency Network, the Immune Deficiency Foundation, and the Jeffrey Modell Foundation are contributing mightily to increase awareness and standardize optimal utilization to the benefit of patients. This review will update the allergist-immunologist concerning disease presentations, indications for transplantation, methodologies, conditioning regimens, and clinical outcomes for patients with PID for which timely HCT is critical.

Original languageEnglish (US)
Pages (from-to)131-144
Number of pages14
JournalClinical Reviews in Allergy and Immunology
Volume46
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Severe Combined Immunodeficiency
Cell Transplantation
Transplantation
Transplantation Conditioning
Tissue Donors
Transplants
Therapeutics
T-Cell Antigen Receptor
Life Expectancy
Caregivers
B-Lymphocytes
Bone Marrow
Research Personnel
Immune Deficiency Disease
Organizations
Newborn Infant
Pediatrics
Anti-Bacterial Agents
Survival
DNA

Keywords

  • Bone marrow transplantation
  • Immunodeficiency
  • Primary immune deficiency
  • Stem cell transplantation

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Recent advances in transplantation for primary immune deficiency diseases : A comprehensive review. / De La Morena, M. Teresa; Nelson, Robert.

In: Clinical Reviews in Allergy and Immunology, Vol. 46, No. 2, 2014, p. 131-144.

Research output: Contribution to journalReview article

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