Stem Cell Transplantation

Abstract

Stem cell transplantation in pediatric patients with leukemia has been a matter of debate since the first successful transplantation in a child with aplastic anemia in Germany in 1975. Since then, there has been a long way to implement fully stem cell transplantation strategies into the treatment studies organized within BFM Groups for first line or second line treatment of acute and chronic leukemias and myelodysplastic syndrome. The role of different risk groups, different donors, stem cell sources and alternative approaches as haploidentical transplantation as well have been studied as the impact of chimerism and minimal residual disease. Finally, for all leukemias and myelosdysplastic syndromes integrated treatment pathways have been developed, which integrate stem cell transplantation on an evidence base into the treatment of the patient.

Zusammenfassung

Die Rolle der Stammzelltransplantation für die Behandlung von Kindern mit Leukämien ist Gegenstand intensiver Debatten, seit 1975 in Deutschland das erste Kind mit einer aplastischen Anämie erfolgreich mit einer Knochenmarktransplantation behandelt wurde. Seitdem ist ein langer Weg zurückgelegt worden bis zu vollständigen Integration der Stammzelltransplantation in die Behandlungsstudien, die von BFM-Gruppen für die Erst- oder Zweitlinien-therapie von Kindern mit akuten und chronischen Leukämien und myelodysplastischen Syndromen organisiert werden. In zahlreichen Studien wurden die Rolle der Risikogruppen, der möglichen verschiedenen Spender, der verschiedenen Stammzellquellen und alternativer Ansätze wie der haploidentischen Transplantation ebenso untersucht wie der Einfluss von Chimärismus und minimaler Restkrankheit auf das Ergebnis der Transplantation. Heute existieren für alle Leukämien und myelodysplatischen Syndrome im Kindesalter integrierte Behandlungspfade, die auf einer Evidenz-basierten Grundlage die Stammzelltransplantion in die Behandlung des Patienten integrieren.

Key words

acute lymphoblastic leukemia - acute myelogeneic leukemia - chronic myeloid leukemia - myelodysplastic syndrome - stem cell transplantation - history - actual results

Schlüsselwörter

akute lymphoblaste Leukämie - chronische myelogene Leukämie - myelodysplatisches Syndrom - Stammzelltransplantation - Historie

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