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Curr Opin Immunol. 2012 Oct;24(5):640-8. doi: 10.1016/j.coi.2012.08.002. Epub 2012 Aug 29.

The road to purified hematopoietic stem cell transplants is paved with antibodies.

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Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, CA, United States.


Hematopoietic progenitor cell replacement therapy remains a surprisingly unrefined process. In general, unmanipulated bone marrow or mobilized peripheral blood (MPB) grafts which carry potentially harmful passenger cells are administered after treating recipients with high-dose chemotherapy and/or radiotherapy to eradicate malignant disease, eliminate immunologic barriers to allogeneic cell engraftment, and to 'make space' for rare donor stem cells within the stem cell niche. The sequalae of such treatments are substantial, including direct organ toxicity and nonspecific inflammation that contribute to the development of graft-versus-host disease (GVHD) and poor immune reconstitution. Passenger tumor cells that contaminate autologous hematopoietic grafts may contribute to relapse post-transplant. Use of antibodies to rid grafts of unwanted cell populations, and to eliminate or minimize the need for nonspecifically cytotoxic therapies used to condition transplant recipients, will dramatically improve the safety profile of allogeneic and gene-modified autologous hematopoietic stem cell therapies.

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Conflict of interest statement

ILW co-founded SyStemix, Inc., which performed the CD34+CD90+ HSC selection in the trials discussed in this review, but currently has no financial interest in the technology as SyStemix, Inc., is now a wholly owned subsidiary of Novartis, Inc. ACL and JAS have no relevant conflicts of interest to disclose.

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