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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitřní Lékařství, 46, 2000, č. 11, s. 785 - 793 |
Will Transplantation of Peripheral Blood Stem Haematopoietic Cells Replace
Definitely Bone Marrow Transplantation? Mayer J. Interní hematoonkologická klinika FN Brno, pracoviště Bohunice, přednosta prof. MUDr. J. Vorlíček, CSc. |
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Summary: Findigs 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 periphe-
ral 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. Restoraion 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 isd vrey 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.
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