Barker Juliet N, Wagner John E
Department of Medicine, Blood and Marrow Transplant Program, University of Minnesota School of Medicine, Minneapolis, Minnesota 55455, USA.
Curr Opin Oncol. 2002 Mar;14(2):160-4. doi: 10.1097/00001622-200203000-00004.
Human leukocyte antigen-matched sibling donor umbilical cord blood transplantation, or 0-2 human leukocyte antigen mismatched unrelated donor umbilical cord blood, is now considered an acceptable alternative to the use of bone marrow as a source for hematopoietic stem cells for pediatric hematopoietic stem cell transplantation, and is being investigated in adults. Major advantages of umbilical cord blood include the speed of availability compared with unrelated donor bone marrow, and tolerance of 1-2 human leukocyte antigen mismatch, which offers the opportunity to extend the donor pool. Umbilical cord blood transplantation is associated with durable engraftment and low incidence of severe graft-versus-host disease, even in the 1-2 human leukocyte antigen mismatched setting. Clinical experience has established the importance of graft cell dose in determining engraftment and survival in unrelated donor umbilical cord blood transplantation. More recently, the influence of human leukocyte antigen on outcome has become apparent. This review outlines the state of the art of umbilical cord blood transplantation, with emphasis on practical considerations in umbilical cord blood selection, and describes current research directions for this hematopoietic stem cell source.
人类白细胞抗原匹配的同胞供者脐血移植，或0 - 2个人类白细胞抗原错配的无关供者脐血移植，目前被认为是小儿造血干细胞移植中使用骨髓作为造血干细胞来源的一种可接受的替代方法，并且正在成人中进行研究。脐血的主要优点包括与无关供者骨髓相比获取速度快，以及对1 - 2个人类白细胞抗原错配的耐受性，这为扩大供者库提供了机会。即使在1 - 2个人类白细胞抗原错配的情况下，脐血移植也与持久植入和严重移植物抗宿主病的低发生率相关。临床经验已经证实了移植物细胞剂量在无关供者脐血移植中决定植入和生存的重要性。最近，人类白细胞抗原对结果的影响也变得明显。本综述概述了脐血移植的现状，重点是脐血选择中的实际考虑因素，并描述了这种造血干细胞来源的当前研究方向。
