Thomas E D
Department of Medicine, University of Washington, and Fred Hutchinson Cancer Research Center, Seattle 98109, USA.
Semin Hematol. 1999 Oct;36(4 Suppl 7):95-103.
Bone marrow transplantation has evolved over a period of 50 years. Laboratory observations and animal studies defined the essentials of transplantation biology. The first attempts to transfer these studies to patients met with little success. The definition of the complexities of the human leukocyte antigen (HLA) system made it possible to select compatible sibling donors and more recently unrelated donors. Transplantation of stem cells from marrow, blood, or cord blood is now the treatment of choice for a variety of hematological and genetic diseases. Transplantation using less toxic preparative regimens to induce mixed chimerism makes possible an application to autoimmune diseases. Laboratory and clinical research directed toward induction of tolerance and elimination of malignant cells point the way to a wider application of hematopoietic cell transplantation in the next decade.
骨髓移植已经历了50年的发展历程。实验室观察和动物研究明确了移植生物学的要点。最初将这些研究应用于患者的尝试收效甚微。人类白细胞抗原（HLA）系统复杂性的明确使得选择匹配的同胞供体以及最近的非血缘供体成为可能。如今，来自骨髓、血液或脐带血的干细胞移植是多种血液学和遗传性疾病的首选治疗方法。采用毒性较小的预处理方案诱导混合嵌合体的移植方法使得其在自身免疫性疾病中的应用成为可能。旨在诱导免疫耐受和清除恶性细胞的实验室和临床研究为造血细胞移植在未来十年更广泛的应用指明了方向。
