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| Allogeneic stem cell transplantation |
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| Author(s): Bosi A, Bartolozzi B, Guidi S |
| Source: TRANSPLANTATION PROCEEDINGS Volume: 37 Issue: 6 Pages: 2667-2669 Published: JUL-AUG 2005 |
| Times Cited: 6 References: 9 |
| Abstract: Allogeneic stem cell transplantation (HSCT) requires the harvest of an adequate number of stem cells (SC) from a histocompatible donor and their infusion into a patient following a conditioning regimen. During the past 35 years, the role of HSCT has changed from an experimental procedure for terminally ill patients to a curative treatment. In 2003, 1170 procedures were registered in Italy (Italian Group for Blood and Marrow Transplantation). The main reported indications were as follows: leukemia, lymphoproliferative diseases, myelodysplasia, and nonmalignant diseases such as thalassemia and severe aplastic anemia. Important changes have been observed in the last 5 years: the shift from bone marrow to peripheral blood as the SC source, the increasing number of alternative donors such as unrelated, partially matched family donors and cord blood SC, and the new extra-hematological indications including solid tumors. Moreover, the development of nonmyeloablative conditionig regimens have allowed physicians to perform HSCT in patients with advanced age or important comorbidities. In contrast, the availability of the Tyrosine kinase inhibitor (STI-571) for treatment of patients affected by chronic myelogenous leukemia, which was formerly the main indication for HSCT, has produced a dramatic decrease in the number of transplantations in this setting. HSCT performed in the early phases of disease and in young patients offers more than a 50% cure rate. The transplant-related mortality still represents the greatest obstacle, ranging from 20%-30%, despite the less toxic conditioning regimens, high-resolution HLA typing, and better supportive care. GvHD and infections remain the main causes of morbidity. As regards relapses, they correlate with disease status at the time of transplantation. Promising results have been recently obtained with haploidentical and with cord blood SC transplantation also in adult patients. |
| Document Type: Proceedings Paper |
| Language: English |
| Reprint Address: Bosi, A (reprint author), Univ Florence, Dept Hematol, BMT Unit, Viale Morgagui 85, I-50139 Florence, Italy |
Addresses:
1. Univ Florence, Dept Hematol, BMT Unit, I-50139 Florence, Italy |
| Publisher: ELSEVIER SCIENCE INC, 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA |
| Subject Category: Immunology; Surgery; Transplantation |
| IDS Number: 961VE |
| ISSN: 0041-1345 |
| DOI: 10.1016/j.transproceed.2005.06.087 |
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| | | | | | | | | Record from Web of Science® | | | | | | | | | |