Unrelated and related cord blood banking and hematopoietic graft engineering
Unrelated and related cord blood banking and hematopoietic graft engineering
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DOI：
10.1023/a:1026379514314
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发表时间：
2003-01-01
影响因子：
1.5
通讯作者：
Nagler, Arnon
中科院分区：
文献类型：
--
作者：
Cohen, Yossi;Kreiser, Doron;Nagler, Arnon
1988年，首次成功地进行了脐带血移植，以治疗一名患有范科尼贫血的男孩，使用的是他的人类白细胞抗原完全匹配的妹妹的脐带血。几年后，脐带血移植(CBT)也在成年受者身上进行，但主要障碍仍然阻碍了CBT在这个年龄段的广泛应用。主要的限制因素是与典型的骨髓(BM)/外周血(PB)异基因移植相比，可用于移植的有核(NC)和CD34+细胞数量较少，导致移植成功率较低，并延迟了造血恢复，其特有的并发症包括感染和移植相关死亡率(TRM)。其他问题包括移植物抗白血病(GVL)/肿瘤效应在此类移植中的效力和疗效的不确定性，考虑到RAFT抗宿主病(GvHD)表现的减少和免疫性早熟。对这些主题进行了综述，以指导改进CB移植物和接枝工程的技术方法。
The first successful transplantation of umbilical-cord blood (CB) was performed in 1988 to treat a boy with Fanconi's anemia, using CB from his HLA full-matched sister. A few years later, CB transplantation (CBT) was also performed in an adult recipient, however major obstacles still prevent a wider application of CBT in this age group. The principle limiting-factor is the low numbers of nucleated (NC) and CD34+ cells available for transplantation compared to a typical bone marrow (BM)/peripheral blood (PB) allograft, resulting in a lower engraftment success as well as delayed hematopoietic recovery with its characteristic complications, including infections and transplant related mortality (TRM). Other problems include uncertainty regarding potency and efficacy of graft versus leukemia (GvL)/tumor effects in this kind of transplant, considering the reduced raft versus host disease (GvHD) manifestations and immunologic prematurity. These Subjects are reviewed with orientation to technical methods directed to improve CB grafts and graft engineering.