Caocci Giovanni, Greco Marianna, La Nasa Giorgio
Hematology Unit, Bone Marrow Transplant Center, R. Binaghi Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Mediterr J Hematol Infect Dis. 2017 Apr 19;9(1):e2017032. doi: 10.4084/MJHID.2017.032. eCollection 2017.
Homing of hematopoietic stem cells (HSC) to their microenvironment niches in the bone marrow is a complex process with a critical role in repopulation of the bone marrow after transplantation. This active process allows for migration of HSC from peripheral blood and their successful anchoring in bone marrow before proliferation. The process of engraftment starts with the onset of proliferation and must, therefore, be functionally dissociated from the former process. In this overview, we analyze the characteristics of stem cells (SCs) with particular emphasis on their plasticity and ability to find their way home to the bone marrow. We also address the problem of graft failure which remains a significant contributor to morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Within this context, we discuss non-malignant and malignant hematological disorders treated with reduced-intensity conditioning regimens or grafts from human leukocyte antigen (HLA)-mismatched donors.
造血干细胞（HSC）归巢至骨髓中的微环境龛位是一个复杂的过程，在移植后骨髓的重新填充中起着关键作用。这个活跃的过程允许造血干细胞从外周血迁移，并在增殖前成功锚定在骨髓中。植入过程始于增殖的开始，因此，必须在功能上与前一个过程分开。在本综述中，我们分析了干细胞（SC）的特征，特别强调了它们的可塑性以及归巢至骨髓的能力。我们还探讨了移植物失败的问题，这仍然是异基因造血干细胞移植（HSCT）后发病和死亡的一个重要因素。在此背景下，我们讨论了采用降低强度预处理方案或来自人类白细胞抗原（HLA）不匹配供体的移植物治疗的非恶性和恶性血液疾病。
