Ballen Karen K, Lazarus Hillard
Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, USA.
Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
Br J Haematol. 2016 Apr;173(1):25-36. doi: 10.1111/bjh.13926. Epub 2016 Jan 13.
Umbilical cord blood is a haematopoietic progenitor cell source for patients with acute myeloid leukaemia (AML), other haematological malignancies and metabolic diseases who can be cured by allogeneic haematopoietic cell transplantation, but who do not have a human leucocyte antigen compatible related or unrelated donor. Although the first cord blood transplants were done in children, there are currently more cord blood transplants performed in adults. In this review, we explore the history of umbilical cord blood transplantation, paediatric and adult outcome results, and novel trends to improve engraftment and reduce infection. Umbilical cord blood transplantation cures approximately 30-40% of adults and 60-70% of children with AML. Controversial issues, including the use of double versus single cord blood units for transplantation, optimal cord blood unit selection, infection prophylaxis, conditioning regimens and graft versus host disease prophylaxis, will be reviewed. Finally, comparison to other graft sources, cost, access to care, and the ideal graft source are discussed.
脐带血是急性髓系白血病（AML）、其他血液系统恶性肿瘤以及可通过异基因造血细胞移植治愈的代谢性疾病患者的造血祖细胞来源，这些患者没有人类白细胞抗原相匹配的相关或无关供体。尽管首例脐带血移植是在儿童中进行的，但目前成人接受脐带血移植的情况更多。在本综述中，我们探讨了脐带血移植的历史、儿科和成人的治疗结果，以及改善植入和减少感染的新趋势。脐带血移植可治愈约30%-40%的成年AML患者和60%-70%的儿童AML患者。还将对一些有争议的问题进行综述，包括移植使用双份脐带血单位与单份脐带血单位、最佳脐带血单位选择、感染预防、预处理方案以及移植物抗宿主病预防等。最后，将讨论与其他移植物来源的比较、成本、医疗可及性以及理想的移植物来源。
