Stem cell transplantation as a dynamical system: are clinical outcomes deterministic?

Publication/Presentation Date

1-1-2014

Abstract

Outcomes in stem cell transplantation (SCT) are modeled using probability theory. However, the clinical course following SCT appears to demonstrate many characteristics of dynamical systems, especially when outcomes are considered in the context of immune reconstitution. Dynamical systems tend to evolve over time according to mathematically determined rules. Characteristically, the future states of the system are predicated on the states preceding them, and there is sensitivity to initial conditions. In SCT, the interaction between donor T cells and the recipient may be considered as such a system in which, graft source, conditioning, and early immunosuppression profoundly influence immune reconstitution over time. This eventually determines clinical outcomes, either the emergence of tolerance or the development of graft versus host disease. In this paper, parallels between SCT and dynamical systems are explored and a conceptual framework for developing mathematical models to understand disparate transplant outcomes is proposed.

Volume

5

First Page

613

Last Page

613

ISSN

1664-3224

Disciplines

Medicine and Health Sciences

PubMedID

25520720

Department(s)

Department of Medicine, Hematology-Medical Oncology Division

Document Type

Article

Share

COinS