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成人血液系统恶性肿瘤中用于单倍体相合干细胞移植及移植后环磷酰胺的未处理的富含T细胞移植物的选择:外周血还是骨髓——已发表文献综述

Choice of Unmanipulated T Cell Replete Graft for Haploidentical Stem Cell Transplant and Posttransplant Cyclophosphamide in Hematologic Malignancies in Adults: Peripheral Blood or Bone Marrow-Review of Published Literature.

作者信息

Farhan Shatha, Peres Edward, Janakiraman Nalini

机构信息

Stem Cell Transplant Program, Henry Ford Hospital, Detroit, MI 48202, USA.

出版信息

Adv Hematol. 2016;2016:6950346. doi: 10.1155/2016/6950346. Epub 2016 Mar 28.

Abstract

Allogeneic hematopoietic stem cell transplantation (SCT) is often the only curative option for many patients with malignant and benign hematological stem cell disorders. However, some issues are still of concern regarding finding a donor like shrinking family sizes in many societies, underrepresentation of the ethnic minorities in the registries, genetic variability for some races, and significant delays in obtaining stem cells after starting the search. So there is a considerable need to develop alternate donor stem cell sources. The rapid and near universal availability of the haploidentical donor is an advantage of the haploidentical SCT and an opportunity that is being explored currently in many centers especially using T cell replete graft and posttransplant cyclophosphamide. This is probably because it does not require expertise in graft manipulation and because of the lower costs. However, there are still lots of unanswered questions, like the effect of use of bone marrow versus peripheral blood as the source of stem cells on graft-versus-host disease, graft versus tumor, overall survival, immune reconstitution, and quality of life. Here we review the available publications on bone marrow and peripheral blood experience in the haploidentical SCT setting.

摘要

异基因造血干细胞移植(SCT)通常是许多患有恶性和良性血液系统干细胞疾病患者的唯一治愈选择。然而,在寻找供体方面仍存在一些问题,比如许多社会中家庭规模缩小、登记处中少数族裔代表性不足、某些种族的基因变异性以及开始寻找后获取干细胞的显著延迟。因此,迫切需要开发替代供体干细胞来源。单倍体相合供体的快速且近乎普遍可得性是单倍体相合SCT的一个优势,目前许多中心正在探索这一机会,特别是使用富含T细胞的移植物和移植后环磷酰胺。这可能是因为它不需要移植物操作方面的专业知识且成本较低。然而,仍然有许多未解决的问题,例如使用骨髓与外周血作为干细胞来源对移植物抗宿主病、移植物抗肿瘤作用、总生存期、免疫重建以及生活质量的影响。在此,我们回顾了关于单倍体相合SCT中骨髓和外周血经验的现有出版物。

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