[Nonmyeloablative allogeneic hematopoietic stem cell transplantation: minitransplantation].
Allogeneic hematopoietic stem cell transplantation (alloHCT) is considered as a treatment of choice for many malignant hematologic disorders and genetic diseases. Unfortunately toxicities of conventional alloHCT remain a major limitation to successful application of the procedure. A radically new approach for alloHCT has been developed. Nonmyeloablative preparative regimen allows to establish mixed hematopoietic chimerism after alloHCT. A state of stable mixed chimerism may represent a starting point for induction of full donor derived hematopoiesis. A published results of several clinical trials have confirmed potential benefits of this new approach such as less procedure--related toxicity, protection from severe acute GVHD (graft versus host disease), lower TRM (transplant related mortality). Intensive investigations are done to replace in the future pretransplant chemotherapy and/or radiation by nontoxic anti-T-cell agents. These include antibody to the T-cell receptor alpha beta and blockers of T-cell costimulation (e.g. CTLA4lg).
Machaczka
M
M
Katedry i Kliniki Hematologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. machaczka@endo.cm-uj.krakow.pl
Rucińska
M
M
Skotnicki
A B
AB
D006086:Graft vs Host Disease / Q000276:immunology; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D018183:Transplantation Chimera / Q000276:immunology; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods