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Die Bedeutung der Stammzelltherapie in der Hämatologie und Onkologie

The impact of stem cell therapy in hematology and oncology

  • Schwerpunkt: Stammzelltherapie
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Zusammenfassung

Die Transplantation von hämatopoetischen Stammzellen ist mittlerweile ein fester Bestandteil in der Therapie verschiedener hämatologischer Neoplasien und einiger solider Tumoren. Hierbei werden hämatopoetische Stammzellen von freiwilligen Spendern als allogene Transplantate oder vom Patienten selbst gewonnene autologe Präparate übertragen. Grundlegend für beide Verfahren ist die hochdosierte Chemotherapie zur Verbesserung der kompletten Remissionsraten. Dient die autologe Stammzelltransplantation nach Hochdosischemotherapie der Regeneration der Hämatopoese, vermitteln in der allogenen Stammzelltransplantation Immunzellen des Spenders eine zusätzliche Alloreaktivität, die sich gegen Gewebe des Empfängers, aber auch gegen residuelle maligne Zellen richtet. Indikationen für das autologe Verfahren sind vor allem Rezidive von hochmalignen Lymphomen. Der Einsatz der allogenen Stammzelltransplantation ermöglicht in einem hohen Prozentsatz die Heilung von Patienten mit akuten Leukämien und ungünstiger Prognose. Neue Entwicklungen dienen der Ausweitung des allogenen Spenderpools sowie der Reduktion der Toxizität der Chemotherapie bei erhaltener antileukämischer Wirkung des allogenen Transplantats.

Abstract

The transplantation of hematopoietic stem cells (HSCT) is an established part of the therapy of hematologic neoplasia and certain solid tumors. In the allogeneic approach hematopoietic stem cells are harvested from healthy donors, while in the autologous setting preparations originating from the patient himself are being used. Both therapies use high dose cytotoxic medication for the induction of higher remission rates in malignant diseases. While autologous HSCT rescues hematopoiesis after high dose chemotherapy, in allogeneic HSCT donor immune cells exert an additional allo-reactivity towards recipient tissue and residual malignant cells. Autologous HSCT is mainly used in relapsed malignant high-grade lymphoma. Allogeneic HSCT results in cure from acute leukemia with unfavorable prognosis in a high percentage of patients. Recent developments target the expansion of the donor pool for allogeneic stem cells and want to reduce chemotherapeutic toxicity of allogeneic transplantation with sustained anti-leukemia efficacy.

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  1. Medizinische Klinik I, Albert-Ludwigs-Universität, Hugstetter Straße 55, 79106, Freiburg

    R. Marks &  J. Finke

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  1. R. Marks
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Correspondence to J. Finke.

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Marks, R., Finke, J. Die Bedeutung der Stammzelltherapie in der Hämatologie und Onkologie. Internist 47, 467–478 (2006). https://doi.org/10.1007/s00108-006-1601-3

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