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Allogeneic hematopoietic cell transplantation: from experimental biology to clinical care

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  • 18 Citations

Abstract

Purpose

For more than half a century, researchers have explored myeloablative, high-dose chemo/radiotherapy followed by allogeneic hematopoietic stem cell transplantation (HCT) for therapy of malignant and nonmalignant hematological diseases. Continuous advances in the field have changed this approach from one that was initially thought to be fraught by insurmountable complications to one that is now considered standard therapy for many diseases.

Methods

In order to extend allogeneic HCT to include elderly patients, who represent the main population affected by hematological malignancies, and to those who are medically unfit to undergo conventional HCT, novel nonmyeloablative approaches have been developed. These approaches rely on graft-vs-tumor effects for tumor eradication rather than high-dose chemoradiotherapy, and, accordingly, have lower toxicities than conventional regimens.

Results

Results with nonmyeloablative regimens have been gratifying, and this may change the future of allogeneic HCT. Advances could not have been possible without basic research and studies in pre-clinical animal models.

Conclusion

Further work is focused on improving graft-vs-tumor effects while achieving better control of graft-vs-host disease.

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Acknowledgements. This work was supported in part by grants CA78902, CA18029, CA15704, and HL36444 from the NIH, Bethesda, Maryland.

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Correspondence to Rainer Storb.

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Diaconescu, R., Storb, R. Allogeneic hematopoietic cell transplantation: from experimental biology to clinical care. J Cancer Res Clin Oncol 131, 1–13 (2005). https://doi.org/10.1007/s00432-004-0611-6

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Keywords

  • Hematopoietic cell transplantation
  • Conditioning regimens
  • Graft-vs-host
  • Graft-vs-tumor