Fruchtman Steven
Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029, USA.
Mt Sinai J Med. 2003 May;70(3):166-70.
Historically, a variety of hematological disorders of the bone marrow, such as acute leukemia, chronic myelocytic leukemia and severe aplastic anemia, were invariably fatal. In the past two decades, basic and clinical scientists have been able to change this grim reality into a more hopeful outcome by replacing the diseased bone marrow with stem cells from either a family donor or an unrelated volunteer donor with identical human leukocyte antigens (HLA). Because of progress in this field, the initial experience of mainly using sibling donors has now been expanded to the use of either unrelated adult donors or cord blood cells as a source of hematopoietic cells. These approaches have created ethical concerns for donors and families, concerns that need to be discussed and understood by patients, volunteer donors and health care professionals.
从历史上看，各种骨髓血液疾病，如急性白血病、慢性粒细胞白血病和严重再生障碍性贫血，无一例外都是致命的。在过去二十年里，基础科学家和临床科学家已经能够通过用来自家族供体或具有相同人类白细胞抗原（HLA）的无关志愿者供体的干细胞替代患病骨髓，将这一严峻现实转变为更有希望的结果。由于该领域的进展，最初主要使用同胞供体的经验现在已扩大到使用无关成年供体或脐带血细胞作为造血细胞来源。这些方法引发了供体和家庭的伦理担忧，患者、志愿者供体和医疗保健专业人员需要讨论并理解这些担忧。
