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Allogeneic hematopoietic stem cell transplantation for inherited metabolic disorders

  • Progress in Hematology
  • Current status and future perspectives of allogeneic hematopoietic cell transplantation for non-malignant diseases
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Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) has been used to treat patients with inherited metabolic disorders (IMDs) for more than 40 years. In the first two decades, various IMDs were treated by HSCT with a wide variety of donor sources and conditioning regimens selected at the institutional level. However, HSCT was not always successful due to post-transplant complications such as graft failure. In the third decade, myeloablative conditioning with targeted busulfan-based pharmacokinetic monitoring was established as an optimal conditioning regimen, and unrelated cord blood was recognized as an excellent donor source. During the fourth decade, further improvements were made to transplant procedures, including modification of the conditioning regimen, and the survival rate after HSCT markedly improved. Simultaneously, several long-term observational studies for patients after HSCT clarified its therapeutic effects on growth and development of cognitive function, fine motor skills, and activities of daily living when compared with enzyme replacement therapy. Although immune-mediated cytopenia was newly highlighted as a problematic morbidity after HSCT for IMDs, especially in younger patients who received unrelated cord blood, a recent study with rituximab added to the conditioning raised expectations that this issue can be overcome.

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Quoted from Bone Marrow Transplantation 2021; 56: 1238–1247. Copyright 2021 by Springer Nature. Reprinted with permission (License number 5276540342735)

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  1. Department of Innovative Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan

    Hiromasa Yabe

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Yabe, H. Allogeneic hematopoietic stem cell transplantation for inherited metabolic disorders. Int J Hematol 116, 28–40 (2022). https://doi.org/10.1007/s12185-022-03383-z

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