Fetal hematopoietic stem cell transplantation: a challenge for the twenty-first century.
Successful in utero hematopoietic stem cell transplantation will likely represent a major step forward in the management of patients with congenital hematological, metabolic, and immunological disorders. We review the naturally occurring models of hematopoietic chimerism in animals and humans, as well as available experimental animal data and human clinical attempts of fetal transplantation. Data available from naturally occurring models and experimental models of fetal transplantation suggest that this technique should be translatable to the human fetus. However, to date, the success of human fetal hematopoietic stem cell therapy has been limited to fetuses with severe immunologic defects. Evaluation of successful attempts of human transplantation, the ontogeny of fetal immune development, and data available from animals provide insights into innovative approaches to fetal therapy that may bring the reality of successful fetal transplantation closer.
Shields
Laurence E
LE
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle WA 98195-6460, USA. lshields@u.washington.edu
Lindton
Bim
B
Andrews
Robert G
RG
Westgren
Magnus
M
D000818:Animals; D016332:Fetal Tissue Transplantation / Q000379:methods / Q000502:physiology* / Q000639:trends; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D007154:Immune System Diseases / Q000628:therapy; D008659:Metabolic Diseases / Q000628:therapy; D023421:Models, Animal; D033581:Stem Cell Transplantation / Q000379:methods* / Q000639:trends