Stammzelltransplantationen aus Nabelschnurblut verwandter und nicht verwandter Spender bei Kindern und Erwachsenen - eine Übersicht zum Stammzelltransplantationswesen aus Nabelschnurblut

Zusammenfassung

Nabelschnurblut wird zunehmend zur Gewinnung von Stammzellen benutzt. In den letzten Jahren wurden neben allogenen Stammzelltransplantationen an Kindern mit malignen und nicht-malignen Erkrankungen auch an Erwachsenen Transplantationen aus Nabelschnurblut nicht verwandter Spender durchgeführt. Diese Ergebnisse sind vielversprechend und geben vor allem solchen Patienten Hoffnung, die keinen HLA-kompatiblen Knochenmarkspender finden.

Das Stammzelltransplantationswesen, das sich in den letzten zehn Jahren zu einem weltumspannenden Netz mit entsprechenden Nabelschnurblutbanken etabliert hat, wird durch zum Teil kommerzielle Interessen privater Stammzellbanken beeinträchtigt. So wird die Suche nach einem passenden Transplantat gerade für ethnische Gruppen mit einer hohen HLA-Diversität erschwert.

Als weitere Verwendungsmöglichkeit rückt die Stammzelle aus Nabelschnurblut für zukünftige therapeutische Entwicklungen auf dem Gebiet der regenerativen Medizin aufgrund ihrer Pluripotenz in den Mittelpunkt wissenschaftlichen Interesses.

Abstract

Umbilical cord blood is being increasingly used as an alternative stem cell source in the treatment of children and adults with malignant and non-malignant diseases. Data regarding the outcome of children show promise. Furthermore, transplantation of cord blood from an unrelated donor should be considered as an acceptable alternative for adults in the absence of an HLA-matched bone marrow donor.

In the past 10 years cord blood banking has become a world-wide reality. However, problems in cord blood banking are caused by the controversial and conflicting interests of public and private cord blood banks. The financial gains of certain private banks hinders the growth of stored units for public use and makes it difficult to find full matches for some patients, especially those groups with a high diversity of HLA types.

Future trends should implement an increased capacity for multilineage differentiation of cord blood stem cells. Pluripotentiality might lead to therapeutic applications in regenerative medicine.

Schlüsselwörter

Stammzelle - Nabelschnurblut - Transplantation - Nabelschnurblutbank

Key words

Stem cells - umbilical cord blood - transplantation - cord blood banking

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