Gunsilius E, Petzer A, Gastl G
Abteilung für Hämatologie und Onkologie, Universitätsklinik für Innere Medizin, Innsbruck.
Acta Med Austriaca. 1997;24(3):97-101.
High-dose therapy with peripheral stem cell rescue is increasingly being used as a salvage or consolidation therapy for patients with malignant disease. The accelerated hemopoietic recovery and the collection of peripheral stem cells in an outpatient setting are the main advantages. Recent findings on tumor cell contamination of autografts stimulated the development of techniques for tumor cell reduction, based on negative selection (purging) of tumor cells or positive selection of CD34+ progenitor cells. Purging and CD34 selection could probably result in increased cure rates. CD34 selection is also imperative for the successful expansion of progenitor cells in vitro. Using various mixtures of cytokines, different cell lineages may be preferentially expanded. A further area of interest is gene transfer into hematopoietic cells, where a purified cell population is a prerequisite for success. Future directions are the increase of cure rates by sequential administration of chemotherapeutic drugs at their maximum tolerated doses, the evaluation of new antineoplastic drugs and improved supportive care.
高剂量外周血干细胞救援疗法越来越多地被用作恶性疾病患者的挽救或巩固治疗。其主要优点是造血恢复加速以及可在门诊环境中采集外周血干细胞。近期关于自体移植物肿瘤细胞污染的研究结果推动了肿瘤细胞减少技术的发展，这些技术基于肿瘤细胞的阴性选择（清除）或CD34+祖细胞的阳性选择。清除和CD34选择可能会提高治愈率。CD34选择对于祖细胞在体外的成功扩增也至关重要。使用各种细胞因子混合物，可优先扩增不同的细胞谱系。另一个感兴趣的领域是将基因转移到造血细胞中，在此过程中纯化的细胞群体是成功的前提条件。未来的方向是通过以最大耐受剂量序贯给药化疗药物来提高治愈率，评估新的抗肿瘤药物并改善支持治疗。
