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Angaben zur Quelle [Bearbeiten]

Autor     Asok Mukhopadhyay, T. Madhusudhan, Rajat Kumar
Titel    Hematopoietic Stem Cells: Clinical Requirements and Developments in Ex-Vivo Culture
Sammlung    New Trends and Developments in Biochemical Engineering
Herausgeber    Thomas Scheper
Ort    Berlin, Heidelberg
Verlag    Springer
Ausgabe    Volume 86
Jahr    2004
Seiten    215-253
Reihe    Advances in Biochemical Engineering
URL    http://link.springer.com/chapter/10.1007/b12444

Literaturverz.   

no
Fußnoten    no
Fragmente    2


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[1.] Analyse:Rsi/Fragment 017 10 - Diskussion
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Fragment, Mukhopadhyay et al. 2004, Rsi, SMWFragment, Schutzlevel, Unfertig, Verschleierung

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1.5 The clinical demand on HSC:

Bone Marrow Transplantation (BMT) is a life saving procedure for a number of malignant and non-malignant life threatening diseases [68]. Ever since the first successful BMT in the late 1960s, an increasing number of BMT and related procedures are being performed world wide. Allogeneic stem cell (unrelated human leucocyte antigen, HLA identical donor) transplantation is now a curative treatment modality for a number of disorders, including malignant diseases, dyserythropoiesis, bone marrow aplasia, immunodeficiency states, and a number of inherited disorders [69].

The indications for hematopoietic stem cell transplantation [69] can be conveniently divided into two groups: (a) Malignant disorders: like leukemias, lymphomas, multiple myeloma and solid tumors like breast cancer, testicular cancer. In all these indications, the cure or palliation is by the high doses of chemotherapy or radiation therapy, while the transplant serves to rescue the patient from the myelotoxic effects of the anti-cancer therapy. In allogeneic type of transplants, there is an additional immunological advantage of graft vs cancer effect, which contributes to the disease relief; (b) Non-malignant diseases: like aplastic anemia, thalassemia, Gaucher's disease, etc. In these conditions the abnormal marrow is deliberately destroyed and replaced by the healthy donor marrow. In this setting autologous (patient's own stem cells) transplantation cannot be effective for obvious reasons.


68. Armitage JO., N Engl J Med 1994, 330:827

69 Gratwohl A, Passweg J, Baldomero H,Urbano-Ispizua A., Bone Marrow Transplant, 2001, 27,899

3 Clinical Applications of Hematopoietic Stem Cells

Bone Marrow Transplantation (BMT) is a life saving procedure for a number of malignant and non-malignant life threatening diseases [46]. Ever since the first successful BMT in the late 1960s, an increasing number of BMT and related procedures are being performed worldwide. Allogeneic stem cell (unrelated human leucocyte antigen, HLA identical donor) transplantation is now a curative treatment modality for a number of disorders, including malignant diseases, dyserythropoiesis, bone marrow aplasia, immunodeficiency states, and a number of inherited disorders [47].

The indications for hematopoietic stem cell transplantation [47] can be conveniently divided into two groups: (a) Malignant disorders: like leukemias, lymphomas, multiple myeloma and solid tumors like breast cancer, testicular cancer. In all these indications, the cure or palliation is by the high doses of chemotherapy or radiation therapy, while the transplant serves to rescue the patient from the myelotoxic effects of the anti-cancer therapy. In allogeneic type of transplants, there is an additional immunological advantage of graft vs cancer effect, which contributes to the disease relief; (b) Non-malignant diseases: like aplastic anemia, thalassemia, Gaucher’s disease, etc. In these conditions the abnormal marrow is deliberately destroyed and replaced by the healthy donor marrow. In this setting autologous (patient’s own stem cells) transplantation cannot be effective for obvious reasons.


46. Armitage JO (1994) N Engl J Med 330:827

47. Gratwohl A, Passweg J, Baldomero H, Urbano-Ispizua A (2001) Bone Marrow Transplant 27,899

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[2.] Analyse:Rsi/Fragment 018 01 - Diskussion
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Fragment, Mukhopadhyay et al. 2004, Rsi, SMWFragment, Schutzlevel, Unfertig, Verschleierung

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Bone marrow and stem cell transplantation is curative in many potentially fatal conditions. The graft vs tumor effect seen after allogeneic transplants for human malignancies represents the clearest example of the power of the human immune system to eradicate cancer [70, 71]. It is likely that in future the high dose preparative regimens used in allogeneic bone marrow and stem cell transplants will be replaced with less toxic therapy leading to a safer transplant procedure. Autologous transplants are mainly done for lymphomas, solid malignancies like neuroblastoma and germinal cancers, hematological malignancies like multiple myeloma [72], and in patients with acute leukemia who do not have an HLA identical donor. The advantage of autologous transplant over allogeneic transplant is that there is no graft vs host disease (GVHD), and once engraftment occurs then graft rejection is unlikely. Thus there is a significant decrease in the complication rate as compared to the allogenic transplantation; however risk of tumor relapse is higher as compared to the allogeneic transplantation.

70 McSweeney PA,Niederwieser D, Shizuru JA et al., Blood, 2001, 97:3390

71 Appelbaum FR., Nature 2001, 411:385

72 Rajkumar SV, Fonesca R,Dispenzieri A et al., Bone Marrow Transplant 2000, 26:979

Bone marrow and stem cell transplantation is curative in many potentially fatal conditions. [...] The graft vs tumor effect seen after allogeneic transplants for human malignancies represents the clearest example of the power of the human immune system to eradicate cancer [50, 51]. It is likely that in future the high dose preparative regimens used in allogeneic bone marrow and stem cell transplants will be replaced with less toxic therapy leading to a safer transplant procedure. Autologous transplants are mainly done for lymphomas, solid malignancies like neuroblastoma and germinal cancers, hematological malignancies like multiple myeloma [52], and in patients with acute leukemia who do not have an HLA identical donor. The advantage of autologous transplant over allogeneic transplant is that there is no graft vs host disease (GVHD), and once engraftment occurs then graft rejection is unlikely. Thus there is a significant decrease in the complication rate as compared to the allogenic transplantation; however risk of tumor relapse is higher as compared to the allogeneic transplantation.

50. McSweeney PA, Niederwieser D, Shizuru JA et al. (2001) Blood 97:3390

51. Appelbaum FR (2001) Nature 411:385

52. Rajkumar SV, Fonesca R, Dispenzieri A et al. (2000) Bone Marrow Transplant 26:979

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