移植单倍体造血干细胞的原理。

IF 2 4区 医学 Q3 HEMATOLOGY Hematology Pub Date : 2024-12-01 Epub Date: 2024-05-07 DOI:10.1080/16078454.2024.2347673
Richard T Maziarz, Rachel J Cook
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引用次数: 0

摘要

能够跨越主要组织相容性复合体障碍进行造血细胞移植,可以大大增加供体的可用性,让全球更多患者能够通过移植手术治愈潜在的血液病。早期使用广泛反应性 T 细胞耗竭方法进行单倍体移植的尝试,因移植物排斥反应、移植物抗宿主疾病和长期免疫缺陷而受到影响。单倍体移植的发展重点是扩大移植的造血祖细胞,以及使用反应较弱的广义 T 细胞去除法。随着技术的进步,可以有选择性地清除供体异体特异性 T 细胞,最初是体外清除,后来发展到目前的体内清除,即在移植手术后输注高免疫抑制性化疗药物环磷酰胺。目前的方法简便易行,可以为世界各地的患者(包括以前得不到充分服务的人群)扩大异体造血细胞移植的范围。
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The rationale behind grafting haploidentical hematopoietic stem cells.

The ability to perform hematopoietic cell transplant across major histocompatibility complex barriers can dramatically increase the availability of donors and allow more patients across the world to pursue curative transplant procedures for underlying hematologic disorders. Early attempts at haploidentical transplantation using broadly reactive T-cell depletion approaches were compromised by graft rejection, graft-versus-host disease and prolonged immune deficiency. The evolution of haploidentical transplantation focused on expanding transplanted hematopoietic progenitors as well as using less broadly reactive T-cell depletion. Significant outcome improvements were identified with technology advances allowing selective depletion of donor allospecific T cells, initially ex-vivo with evolution to its current in-vivo approach with the infusion of the highly immunosuppressive chemotherapy agent, cyclophosphamide after transplantation procedure. Current approaches are facile and portable, allowing expansion of allogeneic hematopoietic cell transplantation for patients across the world, including previously underserved populations.

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来源期刊
Hematology
Hematology 医学-血液学
CiteScore
2.60
自引率
5.30%
发文量
140
审稿时长
3 months
期刊介绍: Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.
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