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Archives of Disease in Childhood 2005;90:1259-1263; doi:10.1136/adc.2005.074278
Copyright © 2005 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health

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REVIEW

Haemopoietic stem cell transplantation for genetic disorders

C G Steward, A Jarisch

Bone Marrow Transplant Unit, Royal Hospital for Children, Bristol, UK

Correspondence to:
Correspondence to:
Dr C G Steward
Bone Marrow Transplant Unit, Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK; colin.steward{at}bristol.ac.uk


ABSTRACT
Stem cell transplantation (SCT) is used to cure or greatly ameliorate a wide variety of genetic diseases, ranging from inherent defects of haemopoietic cell production or function to metabolic diseases mostly affecting solid organs. It ranks as one of the most remarkable therapeutic advances of the past 40 years. Despite rapid technological improvements, however, there are still many short term risks and potential long term toxicities. As a consequence, the rapid emergence of alternative therapies (including new drugs, enzyme and gene therapies), necessitate constant re-evaluation of the risk/benefit ratio for each disease and hence the appropriateness of SCT. This review describes the major aspects of the transplant process, indications for transplantation, outcome statistics, and areas where alternative therapies are becoming available.


Abbreviations: GVHD, graft versus host disease; MSD, matched sibling donor; MUD, matched unrelated donor; PCR, polymerase chain reaction; SCID, severe combined immunodeficiency; SCT, stem cell transplantation; TCD, T-cell depletion

Keywords: haematopoietic stem cell transplantation; genetic diseases; inborn; severe combined immunodeficiency; metabolism; inborn errors; chimerism




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