(脐带血干细胞的来源)。

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科·我Golubic Cepulic B

(脐带血干细胞的来源)。

Acta地中海Croatica。2006年6月;60(3):215 - 25所示。

PubMed ID
16933834 (在PubMed
]
文摘

脐带血(UCB)是一种罕见而珍贵的原始来源的造血干细胞(HSC)和祖细胞能重建造血系统的恶性和非恶性的疾病患者接受骨髓疗法。UCB细胞具有一个增强的祖细胞体外增殖和自我更新的能力。UCB通常是废弃的,它存在于几乎无限的供应。交付的胎盘的血液剩余安全、容易收集和储存。目前实践的主要收集过程涉及到一个相对简单的静脉穿刺,紧随其后的是重力排水标准无菌anti-coagulant-filled血包,使用一个封闭的系统,类似于一个使用全血收集。整除后常规测试已被移除,单位是低温贮藏和存储在液氮中。联合银行被建立在世界各地收集和联合单位为同种异体无关的和相关的造血干细胞移植。无关的脐带血银行捐赠UCB单位收集和存储用于同种异体的患者没有确定HLA匹配相对的。联合银行报告可用单位国家和国际捐赠登记。第二个模型的联合银行被称为家庭银行、UCB的存储位置,造福捐赠或他们的家庭成员。 After more than one decade of clinical experience, it is currently accepted that UCB transplants, related and unrelated, are equivalent to or might compare favorably with bone marrow (BM) transplants, especially in children. Initial studies of long-term survival in children with both malignant and non-malignant hematologic disorders, who were transplanted with UCB from a sibling donor, demonstrated comparable or superior survival to children who received BM transplantation. One factor that limits the use of UCB transplantation in adult patients is the relatively limited number of HSC that may be harvested from umbilical cord, resulting in a slower time to engraftment and higher transplant related mortality, mainly due to the long aplasia period after transplantation and susceptibility to viral and fungal infections. Despite prolonged periods of aplasia, the apparent reduction in the incidence and severity of graft versus host disease (GVHD) may in turn underline comparable rates of survival in some series comparing UCB to adult-donor sources. The "naive" nature of UCB lymphocytes may explain the lower incidence and severity of GVHD encountered in UCB transplantation compared to the allogeneic BM transplant setting. UCB transplantation does not seem to be associated with increased rates of disease relapse. The available data suggest that nucleated cell dose in UK unit should be the primary criterion for donor selection. In 1991, the UCB transplantation program was established at the Zagreb University Hospital Center for related transplants, and until now 4 UCB transplantations have been performed successfully. In order to speed up the engraftment rate, several strategies such as multiple UCB transplants and ex vivo expansion of HSC have been assayed. The current strategies are focused on the development of much more efficient technologies for ex vivo production of progenitor cells, but whether expansion will speed engraftment and improve outcome after UCB remains to be determined. UCB is known to contain extremely immature stem cells. Consequently, such pluripotent or, perhaps, multipotent stem cells have been proposed as elements suitable for cellular therapy and regenerative medicine. Up to date there are no conclusive data regarding these possibilities but preliminary in vitro and animal studies in the field of tissue regeneration suggest some degree of plasticity and/or transdifferentiation. UCB cells are showing their unique qualities and potential, and consequently UCB banks might dramatically increase the scope of their clinical application.

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