Graft of hematopoietic stem cells in the treatment of acute leukemia
Vernant, J.P.
La Revue du Praticien 46(1): 69-75
1996
ISSN/ISBN: 0035-2640 PMID: 8596895 Document Number: 464665
Formerly an exceptional treatment, transplantation of haematopoietic stem cells from an HLA (major histocompatibility complex) identical sibling donor is now an effective treatment of acute leukaemia, with well established indications. It still entails the drawback of severe toxicity, but progress has been made in the last 15 years, particularly with regard to improved prevention and treatment of host-versus-graft disease and severe cytomegalovirus infection. Given the improvement in registries of volunteer donors and the reliability of HLA typing using molecular biology, in some cases transplantation can be made using unrelated donors. Autologous transplantation of haematopoietic stem cells entails less toxicity. On the other hand, the autologous transplanted patient does not benefit from the "graft versus leukaemia" reaction observed after an allogeneic graft, and relapses are thus much more common than after allografting. The indications of autologous transplantation are still debated and are the subject of numerous prospective studies.