脐带血移植:现状与不断发展的疗法
Umbilical Cord Blood Transplants: Current Status and Evolving Therapies.
作者信息
Gupta Ashish O, Wagner John E
机构信息
Division of Pediatric Blood and Marrow Transplant, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.
出版信息
Front Pediatr. 2020 Oct 2;8:570282. doi: 10.3389/fped.2020.570282. eCollection 2020.
Hematopoietic cell transplants using stem cells from umbilical cord blood are used worldwide for the treatment of malignant and non-malignant disorders. Transplant procedures from this stem cell source have shown promising outcomes in successfully treating various hematologic, immunologic, malignant, and inherited metabolic disorders. Rapid availability of these stem cells is an important advantage over other unrelated donor transplants, especially in situations where waiting can adversely affect the prognosis. The umbilical cord blood is rich in CD34+ stem cells, though with a limited cell dose and usually takes longer to engraft. Limitations around this have been addressed by and expansion techniques as well as enhanced engraftment kinetics. Development of adoptive immunotherapy using other components of umbilical cord blood such as regulatory T cells, virus-specific T cells, and natural killer cells has further transformed the field and enhanced the utility of umbilical cord blood unit.
全世界都在使用来自脐带血干细胞的造血细胞移植来治疗恶性和非恶性疾病。来自这种干细胞来源的移植程序在成功治疗各种血液学、免疫学、恶性和遗传性代谢疾病方面已显示出有希望的结果。与其他无关供体移植相比,这些干细胞的快速可用性是一个重要优势,特别是在等待会对预后产生不利影响的情况下。脐带血富含CD34+干细胞,尽管细胞剂量有限,且通常需要更长时间才能植入。围绕这一点的限制已通过细胞扩增技术以及增强的植入动力学得到解决。使用脐带血的其他成分(如调节性T细胞、病毒特异性T细胞和自然杀伤细胞)开发过继性免疫疗法进一步改变了该领域,并提高了脐带血单位的效用。
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N Engl J Med. 2020-2-6
Expert Rev Hematol. 2020-2
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