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国际血液和骨髓移植研究中心(CIBMTR)2010年报告:造血细胞移植在血液和骨髓疾病中的当前应用及结果

2010 report from the Center for International Blood and Marrow Transplant Research (CIBMTR): current uses and outcomes of hematopoietic cell transplants for blood and bone marrow disorders.

作者信息

Pasquini Marcelo C, Wang Zhiwei, Horowitz Mary M, Gale Robert Peter

机构信息

Center for Blood and Marrow Transplant Research (CIBMTR), and the Medical College of Wisconsin Clinical Cancer Center, Milwaukee, Wisconsin, USA.

出版信息

Clin Transpl. 2010:87-105.

Abstract

These data indicate increasing use of HCT for persons with blood and bone marrow disorders. Recent trends include increasing use of alternative donors including HLA-matched unrelated persons and of HLA-matched umbilical cord blood cells, increasing use of blood cell rather than bone marrow grafts and increasing use of reduced-intensity pretransplant conditioning regimens. Many of these shifts are driven by logistical considerations like the need for donors in persons without an HLA-identical sibling or expanding access to allotransplants to older patients. In other instances, like the shift from bone marrow to blood cell grafts or from conventional to reduced-intensity pretransplant conditioning regimens few randomized clinical trials have been reported to justify these shifts. More data are needed to critically-assess the impact of these changes.

摘要

这些数据表明,造血干细胞移植(HCT)在患有血液和骨髓疾病的人群中的使用越来越多。近期趋势包括使用替代供体(包括人类白细胞抗原(HLA)匹配的无关供者)和HLA匹配的脐带血细胞的情况增加,使用血细胞而非骨髓移植物的情况增加,以及使用强度降低的移植前预处理方案的情况增加。这些转变中的许多都是由后勤方面的考虑因素驱动的,比如在没有HLA相同同胞供者的人群中对供者的需求,或者扩大老年患者同种异体移植的可及性。在其他情况下,比如从骨髓移植转向血细胞移植,或者从传统移植前预处理方案转向强度降低的方案,几乎没有随机临床试验报告来证明这些转变的合理性。需要更多数据来严格评估这些变化的影响。

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