Immunologia del TMO-Allogenico

Allogeneic hematopoietic cell transplantation (HCT) remains a curative approach for many patients with malignant and non-malignant hematologic indications. However, early after allo-HCT, infections and acute graft versus- host disease (GVHD) are major causes of death. In particular, transplant outcomes are directly related to the achievement of an acceptable restoration of the immune system. Several cell subsets play a key role in the protection toward infections and disease recurrence. In general, innate immunity recovers early after transplant and represents the first line of defense against pathogens. Adaptive immunity mediated by T and B cell lymphocytes recovers later and is crucial for both immune tolerance maintenance and long-term protection against infections and disease relapse [3] . T cell reconstitution can occur through two different mechanisms: thymus-independent T cell peripheral expansion of infused donor memory T cells and thymus-dependent de novo generation of donor T cells from donor hematopoietic progenitors. The main area of interest of this research group is the immunobiology of Allogeneic Hematopoietic Stem Cell Transplantation. In particular, this grouped aimed to better understand the immune-reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation, evaluating the B and T-cells subpopulations, the incidence of infectious complications and the pathogenesis and treatment of acute and chronic graft versus host disease. The research group is constituted by experts in Hematology and Bone Marrow Transplantation (Prof Russo and Prof Malagola), as well as expert in microbiology (Prof. Fiorentini), allowing to better investigate the relationship between immune reconstitution after allo-HCT, infectious and GVHD. Recently, some papers were published by the group exploring the different area of interest. In particular, it has been explored the role of sequential monitoring of lymphocyte subsets and of T-and-B cell neogenesis as indexes to identify time-varying immunologic profiles in relation to GVHD and relapse after allo-HCT, as well as the risk factors and incidences of infections after allo-HCT. Recently new studies have been developed evaluating T and B-cells subset in patients receiving CAR-T cells therapy.