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异基因干细胞移植治疗急性髓系白血病:障碍与机遇概述

Allogeneic stem cell transplantation in the treatment of acute myeloid leukemia: An overview of obstacles and opportunities.

作者信息

Chen Yong-Feng, Li Jing, Xu Ling-Long, Găman Mihnea-Alexandru, Zou Zhen-You

机构信息

Department of Basic Medical Sciences, School of Medicine of Taizhou University, Taizhou University, Taizhou 318000, Zhejiang Province, China.

Department of Histology and Embryology, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.

出版信息

World J Clin Cases. 2023 Jan 16;11(2):268-291. doi: 10.12998/wjcc.v11.i2.268.

Abstract

As an important treatment for acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation (allo-HSCT) plays an important role in reducing relapse and improving long-term survival. With rapid advancements in basic research in molecular biology and immunology and with deepening understanding of the biological characteristics of hematopoietic stem cells, allo-HSCT has been widely applied in clinical practice. During allo-HSCT, preconditioning, the donor, and the source of stem cells can be tailored to the patient's conditions, greatly broadening the indications for HSCT, with clear survival benefits. However, the risks associated with allo-HSCT remain high, hematopoietic reconstitution failure, delayed immune reconstitution, graft-versus-host disease, and post-transplant relapse, which are bottlenecks for further improvements in allo-HSCT efficacy and have become hot topics in the field of HSCT. Other bottlenecks recognized in the current treatment of individuals diagnosed with acute myeloid leukemia and subjected to allo-HSCT include the selection of the most appropriate conditioning regimen and post-transplantation management. In this paper, we reviewed the progress of relevant research regarding these aspects.

摘要

作为急性髓系白血病的一种重要治疗方法,异基因造血干细胞移植(allo-HSCT)在降低复发率和提高长期生存率方面发挥着重要作用。随着分子生物学和免疫学基础研究的迅速进展以及对造血干细胞生物学特性认识的不断深入,allo-HSCT已在临床实践中得到广泛应用。在allo-HSCT过程中,预处理、供体和干细胞来源可根据患者情况进行调整,极大地拓宽了HSCT的适应证,具有明确的生存获益。然而,allo-HSCT相关风险仍然很高,包括造血重建失败、免疫重建延迟、移植物抗宿主病和移植后复发,这些都是进一步提高allo-HSCT疗效的瓶颈,已成为HSCT领域的热点话题。目前诊断为急性髓系白血病并接受allo-HSCT治疗的个体在当前治疗中认识到的其他瓶颈包括最合适的预处理方案的选择和移植后管理。在本文中,我们综述了关于这些方面的相关研究进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0af/9850970/075445947b29/WJCC-11-268-g001.jpg

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