Tse William, Bunting Kevin D, Laughlin Mary J
Division of Medical Oncology, Department of Medicine, University of Colorado Health Sciences Center, Aurora, Colorado, USA
Curr Opin Hematol. 2008 Jul;15(4):279-84. doi: 10.1097/MOH.0b013e328304ae2c.
To review the available clinical and biological advances of umbilical cord blood allogeneic stem cell transplantation in pediatric and adult patients.
Recent large international studies suggested that allogeneic umbilical cord blood transplantation may potentially emerge as the frontline stem cell source for pediatric patients with hematopoietic malignancies because of its ability to confer superior overall and relapse-free survival compared with matched marrow stem cells. In adults, umbilical cord blood transplantation, double umbilical cord blood units and nonmyeloablative engraftment strategies have attracted further attention in clinical practice with the advantages of possible stronger graft-versus-leukemia effect and expanding transplantation indications. Additional advances in the basic biology of umbilical cord blood also appear very promising in development of enhanced engraftment approaches for limiting hematopoietic stem cell numbers or expansion of repopulating cells.
Umbilical cord blood is a valuable alternative source of hematopoietic stem cells for patients that require allogeneic transplantation in the absence of readily available human leukocyte antigen matched marrow or blood hematopoietic stem cells. The current advances in clinical and biological research will further expand its application in pediatric and adult hematopoietic stem cells transplantation for treating hematologic disorders.
回顾儿科和成人患者脐带血同种异体干细胞移植的现有临床和生物学进展。
近期大型国际研究表明，同种异体脐带血移植可能会成为患有造血系统恶性肿瘤的儿科患者的一线干细胞来源，因为与匹配的骨髓干细胞相比，它能带来更高的总生存率和无复发生存率。在成人中，脐带血移植、双份脐带血单位和非清髓性植入策略在临床实践中受到了更多关注，其优势在于可能具有更强的移植物抗白血病效应并扩大移植适应症。脐带血基础生物学的其他进展在开发用于限制造血干细胞数量或扩增再增殖细胞的增强植入方法方面也显得非常有前景。
对于那些在缺乏易于获得的人类白细胞抗原匹配骨髓或血液造血干细胞的情况下需要进行同种异体移植的患者，脐带血是一种宝贵的造血干细胞替代来源。临床和生物学研究的当前进展将进一步扩大其在儿科和成人造血干细胞移植治疗血液系统疾病中的应用。
