Aversa F
Haematopoietic Stem Cell Transplant Unit, Section of Haematology and Immunology, IBIT Foundation, University of Perugia, Perugia, Italy.
Bone Marrow Transplant. 2008 Mar;41(5):473-81. doi: 10.1038/sj.bmt.1705966. Epub 2008 Jan 7.
Work on one haplotype-mismatched transplants has been proceeding for over 20 years all over the world and novel transplant techniques have been developed. Some centres have focused on the conditioning regimens and post transplant immune suppression; others have concentrated on manipulating the graft. Haploidentical transplant modalities are based mainly on high-intensity conditioning regimen, but reduced intensity regimens have recently been introduced. The graft may be a megadose of extensively T cell-depleted or unmanipulated progenitor cells. Excellent engraftment rates are associated with a very low incidence of GVHD- and regimen-related mortality even in patients who are over 50 years old. Overall, event-free survival and transplant-related mortality compare favourably with reports on transplants from sources of stem cells other than the matched sibling. Improvements will come with successful implementation of strategies to accelerate and strengthen post transplant immune reconstitution as well as transplantation of patients in early stage disease.
全世界针对单倍型不匹配移植的研究已经开展了20多年，并且已经开发出了新的移植技术。一些中心专注于预处理方案和移植后免疫抑制；另一些则集中于对移植物进行处理。单倍型相合移植模式主要基于高强度预处理方案，但最近也引入了减低强度预处理方案。移植物可以是大剂量的广泛T细胞去除或未处理的祖细胞。即使在50岁以上的患者中，优异的植入率也与极低的移植物抗宿主病发生率和预处理方案相关死亡率相关。总体而言，无事件生存率和移植相关死亡率与来自匹配同胞以外干细胞来源的移植报告相比具有优势。随着加速和加强移植后免疫重建策略的成功实施以及早期疾病患者的移植，将会取得进一步改善。
