Kolb H J, Holler E
BMT-Unit, Klinikum Grosshadern, Ludwig Maximilians Universität München, Germany.
Stem Cells. 1997;15 Suppl 1:151-7; discussion 158. doi: 10.1002/stem.5530150819.
Bone marrow transplantation has developed from an experimental therapy for a small group of patients to a well-established form of treatment with well-defined indications for a large group of patients with hematological and non-hematological neoplasia. The availability of suitable donors has more than doubled due to large registries of persons volunteering for marrow donation. With improved techniques for histocompatibility typing, it has become possible to study the role of specific histoincompatibilities for graft-versus-host disease and graft-versus-leukemia reactions. The source of hematopoietic stem cells now comprises not only bone marrow, but also stem cells mobilized into the peripheral blood and stem cells from cord blood. Hematopoietic growth factors have found a large distribution in the mobilization of stem cells and support for hematological reconstitution. They are studied for the expansion of pools of stem cells. Reconstitution of antileukemia and antiviral activity has been achieved by adoptive immunotherapy using lymphocytes and dendritic cells cultured in vitro. The way from transplantation of bone marrow to cellular and genetic engineering leads to new indications such as treatment of severe autoimmune disease. Hematopoietic transplantation has come a long way and it still has possible new areas of application.
骨髓移植已从针对一小部分患者的实验性疗法发展成为一种成熟的治疗方式，适用于一大批患有血液系统和非血液系统肿瘤的患者，且有明确的适应症。由于大量骨髓捐赠志愿者登记在册，合适供体的可获得性增加了一倍多。随着组织相容性分型技术的改进，研究特定组织不相容性在移植物抗宿主病和移植物抗白血病反应中的作用成为可能。造血干细胞的来源现在不仅包括骨髓，还包括动员到外周血中的干细胞和脐带血干细胞。造血生长因子在干细胞动员和支持血液重建方面得到了广泛应用。人们正在研究它们对干细胞池的扩增作用。通过使用体外培养的淋巴细胞和树突状细胞进行过继免疫治疗，已实现抗白血病和抗病毒活性的重建。从骨髓移植到细胞和基因工程的发展，带来了如治疗严重自身免疫性疾病等新的适应症。造血移植已经走过了漫长的道路，并且仍有新的潜在应用领域。
