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Current Stem Cell Reports

, Volume 4, Issue 1, pp 74–80 | Cite as

In Utero Hematopoietic Cell Transplantation: Past Clinical Experience and Future Clinical Trials

  • Russell G. Witt
  • Quoc-Hung L. Nguyen
  • Tippi C. MacKenzie
Prenatal Therapies (WH Peranteau, Section Editor)
  • 24 Downloads
Part of the following topical collections:
  1. Topical Collection on Prenatal Therapies

Abstract

Purpose of Review

In utero hematopoietic stem cell transplantation is an evolving therapy with possible implications for the treatment of many fetal disorders. Here, we present the past clinical experience and current clinical trials and discuss future directions for in utero therapy.

Recent Findings

Barriers to clinically meaningful in utero hematopoietic stem cell transplantation have been identified including maternal T cell-mediated graft rejection, achieving adequate space within the fetal bone marrow niche, and delivering adequate stem cells intravascularly. In a canine model of hematopoietic stem cell transplantation, high chimerism levels were achieved with maternal stem cells delivered intravascularly. Chimerism remained stable over a 2-year period without any evidence of graft-versus-host disease. Current clinical trials such as one for alpha thalassemia seek to apply these results in human diseases.

Summary

The field of in utero stem cell transplantation continues to improve and expand on the possible diseases that can be treated. The reasons for limited success in previous trials have been identified and current trials utilizing maternally derived stem cells at high doses are underway.

Keywords

In utero hematopoietic stem cell transplantation Immune tolerance Fetal therapy Chimerism Stem cell niche 

Notes

Compliance with Ethical Standards

Conflict of Interest

Russell G. Witt, Quoc-Hung L. Nguyen, and Tippi C. MacKenzie declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Russell G. Witt
    • 1
    • 2
  • Quoc-Hung L. Nguyen
    • 1
    • 2
  • Tippi C. MacKenzie
    • 1
    • 2
  1. 1.The Center for Maternal-Fetal Precision MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.The Department of SurgeryUniversity of CaliforniaSan FranciscoUSA

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