[Will transplantation of peripheral blood stem haematopoietic cells definitively replace bone marrow transplantation?].
Findings assembled for a long time, practically from the end of the Second World War along with modern technology of genetic engineering which brought mass production of growth factors led at the beginning of the nineties of the 20th century to a rapid rise of transplantations of peripheral stem cells. Without exaggeration it may be said that the last decade of the 20th century is the decade of transplantations of peripheral stem cells. Peripheral stem cells comprise a wide range of haematopoietic cells incl. stem cells which are after a stimulus (antitumour chemotherapy or growth factors) released from bone marrow in high concentrations into the peripheral blood stream from where they can be obtained very simply by modern blood cell separators. They are suitable for autologous as well as allogenic transplantations. In autologous applications they have almost replaced bone marrow. Restoration of haematopoiesis is after their use more rapid as the transplant is richer. As regards allogenic application caution is still apparent, although even their ratio is very significant. However a higher rate of reactions of the graft to the host is feared. It seems however that this fear is not justified and that the richer transplant of peripheral stem cells can ensure a higher anti-tumourous effect of the transplantation. Peripheral stem cells are also used successfully in transplantations after so-called non-myeloablative regimes. It is beyond doubt that the use of peripheral stem cells will increase further. We may expect application of other growth factors with a higher mobilizing capacity. Peripheral stem cells will be subjected to further modifications in vitro. It will be also possible to increase their amount. A rich transplant makes it also possible to use it in transplantations from haploidentic donors. No doubt stem cell suspensions will become the objective of gene therapy.
Mayer
J
J
Interní hematoonkologická klinika FN Brno.
D016026:Bone Marrow Transplantation; D006801:Humans; D036102:Peripheral Blood Stem Cell Transplantation; D019172:Transplantation Conditioning