Munoz Javier, Shah Nina, Rezvani Katayoun, Hosing Chitra, Bollard Catherine M, Oran Betul, Olson Amanda, Popat Uday, Molldrem Jeffrey, McNiece Ian K, Shpall Elizabeth J
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA.
Department of Hematology-Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona, USA; Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA; Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital System, and Department of Pediatrics and Department of Microbiology, Immunology and Tropical Medicine, George Washington University, Washington, D.C., USA
Stem Cells Transl Med. 2014 Dec;3(12):1435-43. doi: 10.5966/sctm.2014-0151. Epub 2014 Nov 5.
Allogeneic hematopoietic stem cell transplantation is an important treatment option for fit patients with poor-risk hematological malignancies; nevertheless, the lack of available fully matched donors limits the extent of its use. Umbilical cord blood has emerged as an effective alternate source of hematopoietic stem cell support. Transplantation with cord blood allows for faster availability of frozen sample and avoids invasive procedures for donors. In addition, this procedure has demonstrated reduced relapse rates and similar overall survival when compared with unrelated allogeneic hematopoietic stem cell transplantation. The limited dose of CD34-positive stem cells available with single-unit cord transplantation has been addressed by the development of double-unit cord transplantation. In combination with improved conditioning regimens, double-unit cord transplantation has allowed for the treatment of larger children, as well as adult patients with hematological malignancies. Current excitement in the field revolves around the development of safer techniques to improve homing, engraftment, and immune reconstitution after cord blood transplantation. Here the authors review the past, present, and future of cord transplantation.
异基因造血干细胞移植是适合患有高危血液系统恶性肿瘤患者的重要治疗选择；然而，缺乏可用的完全匹配供体限制了其使用范围。脐带血已成为造血干细胞支持的有效替代来源。脐带血移植可使冷冻样本更快可用，并避免供体的侵入性操作。此外，与无关供体异基因造血干细胞移植相比，该方法已显示出复发率降低和总体生存率相似。单单位脐带移植可用的CD34阳性干细胞剂量有限，通过双单位脐带移植的发展得到了解决。结合改进的预处理方案，双单位脐带移植已可用于治疗年龄较大的儿童以及患有血液系统恶性肿瘤的成年患者。该领域目前的热点围绕着开发更安全的技术，以改善脐带血移植后的归巢、植入和免疫重建。本文作者回顾了脐带移植的过去、现在和未来。
