Front Oncol. 2013 Feb 07;3:17. doi: 10.3389/fonc.2013.00017. eCollection 2013.

Immunotherapy of invasive fungal infection in hematopoietic stem cell transplant recipients.

Frontiers in oncology

Thomas Lehrnbecher, Stanislaw Schmidt, Lars Tramsen, Thomas Klingebiel

PMID: 23404543 PMCID: PMC3566394 DOI: 10.3389/fonc.2013.00017

Abstract

Despite the availability of new antifungal compounds, invasive fungal infection remains a significant cause of morbidity and mortality in children and adults undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Allogeneic HSCT recipients suffer from a long lasting defect of different arms of the immune system, which increases the risk for and deteriorates the prognosis of invasive fungal infections. In turn, advances in understanding these immune deficits have resulted in promising strategies to enhance or restore critical immune functions in allogeneic HSCT recipients. Potential approaches include the administration of granulocytes, since neutropenia is the single most important risk factor for invasive fungal infection, and preliminary clinical results suggest a benefit of adoptively transferred donor-derived antifungal T cells. In vitro data and animal studies demonstrate an antifungal effect of natural killer cells, but clinical data are lacking to date. This review summarizes and critically discusses the available data of immunotherapeutic strategies in allogeneic HSCT recipients suffering from invasive fungal infection.

Keywords: T cell; allogeneic hematopoietic stem cell transplantation; granulocyte; immunotherapy; invasive fungal infection; natural killer cell

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• Journal Article