Indikationen für die allogene Stammzelltransplantation

Zusammenfassung

Die allogene hämatopoetische Stammzelltransplantation (HSZT) von verwandten oder unverwandten Spendern ist eine kurative Option für viele maligne und nicht maligne hämatologische Systemerkrankungen. Das kurative Potenzial der allogenen Stammzelltransplantation beruht neben der bei der Konditionierung eingesetzten Chemo- oder Radiotherapie im Wesentlichen auf dem über Spender-T-Zellen vermittelten Transplantat-gegen-Leukämie-Effekt. Dieses kurative Potenzial muss gegenüber den Risiken der transplantationsbedingten Morbidität und Mortalität abgewogen werden. Bei dieser Abwägung spielen neben den krankheitsspezifischen Faktoren ebenfalls die Spenderverfügbarkeit sowie das Alter und die Komorbidität des Patienten eine große Rolle. Die Indikation und Wahl des optimalen Zeitpunkts für eine allogene Stammzelltransplantation ist stetig im Wandel, bedingt durch Verbesserung im Management der transplantationsspezifischen Komplikationen, der zunehmenden Verfügbarkeit alternativer Spender und vor allem durch neue medikamentöse Behandlungsmöglichkeiten.

Key words

allogene Stammzelltransplantation - hämatologische Neoplasie - Graft-versus-Leukämie-Effekt - Graft-versus-Host-Disease - Spender-gegen-Wirt-Erkrankung

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