골수이식의 근황

Abstract

Early clinical attempts of allogeneic bone marrow transplantation(BMT) were generally unsuccessful, mostly due to a lack of knowledge of histocompatibility antigen and appropriate supportive care. DUring 1970's these area developed rather rapidly, and for almost two decades, clinical allgeneic BMT has been carried out with increasing success and has expanded quickly to incorporate HLA identical siblings, HLA nonidentical related donors and recently marr9ow from unrelated volunteer donors. Allogeneic BMT have been included in the treatment of stem cell disorders such as acute and chronic leukemia, aplastic anemia, severe combined immune deficiency, Wiskott Aldrich syndrom, Fanconi's anemia, thalassemia, and sickle cell anemia, etc.

In early 1970's there was growing interest in using patient's own(autologous) bone marrow and peropheral blood stem cells in the management of malignant diseases. Now with the improvement of supportive care and technique of cryopreservation of stem cells, autologous BMT and peripheral blood stem cell transplantation(PBSCT) can be done after high dose chomotherapy in patients with chemosensitive tumors such as acute leukemia, breast cancer, testicular tumor, Ewing's sarcoma, lymphoma, neuroblastoma, ovarian cancer and small cell lung cancer. These autologous BMT and PBSCT have advantage of lack of rejection and GVHD, no need of sibling donor, and no need of anesthesia in case of PBSCT, and these approach has increased the cure rate of malignant hematologic and solid tumors.

Early clinical attempts of allogeneic bone marrow transplantation(BMT) were generally unsuccessful, mostly due to a lack of knowledge of histocompatibility antigen and appropriate supportive care. DUring 1970's these area developed rather rapidly, and for almost two decades, clinical allgeneic BMT has been carried out with increasing success and has expanded quickly to incorporate HLA identical siblings, HLA nonidentical related donors and recently marr9ow from unrelated volunteer donors. Allogeneic BMT have been included in the treatment of stem cell disorders such as acute and chronic leukemia, aplastic anemia, severe combined immune deficiency, Wiskott Aldrich syndrom, Fanconi's anemia, thalassemia, and sickle cell anemia, etc.

In early 1970's there was growing interest in using patient's own(autologous) bone marrow and peropheral blood stem cells in the management of malignant diseases. Now with the improvement of supportive care and technique of cryopreservation of stem cells, autologous BMT and peripheral blood stem cell transplantation(PBSCT) can be done after high dose chomotherapy in patients with chemosensitive tumors such as acute leukemia, breast cancer, testicular tumor, Ewing's sarcoma, lymphoma, neuroblastoma, ovarian cancer and small cell lung cancer. These autologous BMT and PBSCT have advantage of lack of rejection and GVHD, no need of sibling donor, and no need of anesthesia in case of PBSCT, and these approach has increased the cure rate of malignant hematologic and solid tumors.