PMID- 15549304 OWN - NLM STAT- MEDLINE DCOM- 20050613 LR - 20220801 IS - 0344-4325 (Print) IS - 0344-4325 (Linking) VI - 26 IP - 1-2 DP - 2004 Nov TI - Allogeneic hematopoietic cell transplantation as treatment for hematological malignancies: a review. PG - 71-94 AB - Allogeneic hematopoietic cell transplantation (HCT) was originally developed as a form of rescue from high-dose chemoradiotherapy, which is given both to eradicate malignancy and provide sufficient immunosuppression for allogeneic engraftment. The first attempts of allogeneic HCT in humans met with little success. However, a better understanding of the complexities of the human leukocyte antigen (HLA) system has allowed selecting compatible sibling donors, and the development of postgrafting immunosuppressive regimens has helped prevent serious graft-versus-host disease, thereby changing the role of allogeneic HCT from a desperate therapeutic maneuver to a curative treatment modality for many patients with malignant hematological diseases. In addition, the establishment of large registries of HLA-typed volunteers has permitted finding suitable unrelated donors for many patients without family donors. Further advances in the immunogenetics of HLA, especially typing by molecular techniques, have improved results after unrelated HCT, which have begun resembling those obtained with HLA-identical sibling grafts, at least in young patients. Important advances have also been made in the prevention and treatment of infectious complications and in other areas of supportive care. Since the late seventies, it has been recognized that allogeneic immunocompetent cells transplanted with the stem cells, or arising from them, mediated therapeutic anti-tumor effects independent of the action of the high-dose therapy, termed graft-versus-tumor (GVT) effects. This has prompted the recent development of non-myeloablative conditioning regimens for allogeneic HCT that have opened the way to include elderly patients and those with comorbid conditions. Remaining challenges include further advances in the prevention and treatment of both severe graft-versus-host disease and infections. Also, progress in adoptive transfer of T cells with relative tumor specificity and disease-targeted therapy with agents such as Imatinib, Rituximab or radiolabeled monoclonal antibodies would make allogeneic HCT even more effective. FAU - Baron, Frederic AU - Baron F AD - Fred Hutchinson Cancer Research Center and the University of Washington, 1100 Fairview Ave N, D1-100, PO Box 19024, Seattle, WA 98109-1024, USA. FAU - Storb, Rainer AU - Storb R LA - eng GR - CA18029/CA/NCI NIH HHS/United States GR - HL36444/HL/NHLBI NIH HHS/United States GR - CA78902/CA/NCI NIH HHS/United States GR - CA15704/CA/NCI NIH HHS/United States GR - DK42716/DK/NIDDK NIH HHS/United States GR - P01 CA078902/CA/NCI NIH HHS/United States PT - Historical Article PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PT - Review DEP - 20040729 PL - Germany TA - Springer Semin Immunopathol JT - Springer seminars in immunopathology JID - 7910384 RN - 0 (HLA Antigens) SB - IM MH - Animals MH - Clinical Trials as Topic MH - Dogs MH - Graft vs Host Disease/etiology MH - Graft vs Tumor Effect MH - HLA Antigens MH - Hematologic Neoplasms/immunology/*therapy MH - *Hematopoietic Stem Cell Transplantation/adverse effects/history MH - History, 20th Century MH - History, 21st Century MH - Humans MH - Transplantation Conditioning MH - Transplantation, Homologous RF - 89 EDAT- 2004/11/19 09:00 MHDA- 2005/06/14 09:00 CRDT- 2004/11/19 09:00 PHST- 2004/04/21 00:00 [received] PHST- 2004/04/21 00:00 [accepted] PHST- 2004/11/19 09:00 [pubmed] PHST- 2005/06/14 09:00 [medline] PHST- 2004/11/19 09:00 [entrez] AID - 10.1007/s00281-004-0165-3 [doi] PST - ppublish SO - Springer Semin Immunopathol. 2004 Nov;26(1-2):71-94. doi: 10.1007/s00281-004-0165-3. Epub 2004 Jul 29.