Characteristics of GVHD after Cord Blood Transplantation: Review Article

Introduction: Bone marrow and umbilical cord both contain hematopoietic stem cells that help rebuild the blood system as well as the immune system. Bone marrow has the highest percentage of hematopoietic stem cells (۱ to ۳%) and umbilical cord blood has ۰.۶ to ۱% of cells is a blood precursor and hematopoietic stem. Umbilical cord blood (UCB), has become an alternative source of stem cells for cell transplantation hematopoietic in adults and children. Graft versus host disease (GVHD) is the leading cause of death after allogeneic hematopoietic stem cell transplantation and donor lymphocyte injection. However, it is not clear whether GVHD after UCB transplantation (UCBT) has similar risk factors and effects on outcomes compared to bone marrow transplantation. The aim of this study was to investigate the incidence of GVHD after UCBT, risk factors and clinical characteristics that occur in patients. Method: In this review, relevant studies were searched in scientific databases fusing Based on their title, keywords associated with GVHD, cord blood and transplantation from ۲۰۱۰ to march ۲۰۲۲. Out of ۱۱۱ studies, ۱۶ articles related to our aim according to the inclusion criteria of this review article, were studied. Results: Numerous laboratory studies have shown that GVHD is less likely to occur with umbilical cord blood transplantation and that the presence of primary and immature immune cells in umbilical cord blood reduces the immunological rejection of the transplant to the bone marrow. Cord blood lymphocytes are less immunogenic than bone marrow and peripheral blood lymphocytes, with severe transplant rejection being seen in about ۶۰% of cord blood transplants and at least ۳.۶ HLA adaptation is required for umbilical cord blood transplantation (adaptation for HLA B, A and DRB) Lack of T lymphocyte production Cytotoxicity, lack of production of proinflammatory cytokines produced by Th۱, interferon-γ and TNF-α in the infant compared to adults, and immunodeficiency or control of immune cells by dendritic cells or natural killer cells in umbilical cord blood are involved. Factors such as donor source, gender, and age are factors that are common to bone marrow and umbilical cord transplants and is effective on both types of transplants, the difference between which is based on the severity of the clinical manifestations and the type of clinical manifestations they show. Conclusion: GVHD is a disease that occurs after a blood stem cell transplant. There are factors that contribute to the development of GVHD but studies showed that the transplantation of cord blood stem cells can reduce, the risk of GVHD in both acute and chronic forms Because of the features mentioned in the results. Future studies may identify more factors influencing GVHD.

کلیدواژه ها:

GVHD ، cord blood ، transplantation