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Cited by 209Hematopoietic Stem Cell TransplantationTransplantation: Methods and OutcomesOrgan and Tissue Transplantation Research

Hematopoietic stem cell transplantation-50 years of evolution and future perspectives

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Henig, Israel, Zuckerman, Tsila·2014·Rambam Maimonides Medical Journal
DOI 10.5041/rmmj.10162PMC PMC4222417
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Abstract

Hematopoietic stem cell transplantation is a highly specialized and unique medical procedure. Autologous transplantation allows the administration of high-dose chemotherapy without prolonged bone marrow aplasia. In allogeneic transplantation, donor-derived stem cells provide alloimmunity that enables a graft-versus-tumor effect to eradicate residual disease and prevent relapse. The first allogeneic transplantation was performed by E. Donnall Thomas in 1957. Since then the field has evolved and expanded worldwide. New indications beside acute leukemia and aplastic anemia have been constantly explored and now include congenital disorders of the hematopoietic system, metabolic disorders, and autoimmune disease. The use of matched unrelated donors, umbilical cord blood units, and partially matched related donors has dramatically extended the availability of allogeneic transplantation. Transplant-related mortality has decreased due to improved supportive care, including better strategies to prevent severe infections and with the incorporation of reduced-intensity conditioning protocols that lowered the toxicity and allowed for transplantation in older patients. However, disease relapse and graft-versus-host disease remain the two major causes of mortality with unsatisfactory progress. Intense research aiming to improve adoptive immunotherapy and increase graft-versus-leukemia response while decreasing graft-versus-host response might bring the next breakthrough in allogeneic transplantation. Strategies of graft manipulation, tumor-associated antigen vaccinations, monoclonal antibodies, and adoptive cellular immunotherapy have already proved clinically efficient. In the following years, allogeneic transplantation is likely to become more complex, more individualized, and more efficient.

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Sorted by citations

Authors
Henig, I., & Zuckerman, T.
Affiliations
  • Rambam Health Care Campus (IL)
  • Technion – Israel Institute of Technology (IL)
Corresponding author
Zuckerman, Tsila
ORCID
Venue
Rambam Maimonides Medical Journal
Publisher
Rambam Health Corporation
Published
2014-10-29
Volume
5
Issue
4
Pages
e0028
ISSN
2076-9172 (ISSN-L)
DOI
10.5041/rmmj.10162
PMC
PMC4222417
OpenAlex
W2070112625
Cited by
209
References
3
Citations by year
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FWCI
3.31
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Rambam Maimonides Medical Journal (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
Keywords
hematopoietic stem cell transplantation, allogeneic transplantation, autologous transplantation, graft-versus-tumor effect, graft-versus-host disease, recurrence, non-relapse mortality, reduced-intensity conditioning, cord blood transplantation, matched unrelated donor, adoptive immunotherapy, monoclonal antibodies, acute leukemia, aplastic anemia, history of transplantation

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