Transplantacija matičnih ćelija – pregled podataka iz kliničke prakse u eri novih lekova

  • Milena Todorović Balint University Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia; †University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Marija Vraneš ; University Clinical Center Kragujevac, ‡Blood Bank Department, Department of Surgery, Kragujevac, Serbia
  • Mirjana Pavlović Florida Atlantic University, Department of Electrical Engineering and Computer Science, Boca Raton, USA
  • Olivera Šerbić Blood Transfusion Department, Institute for Mother and Child Health Care of Serbia “Dr. Vukan Čupić” Belgrade, Belgrade, Serbia
  • Andrej Pešić University Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia
  • Aleksandar Lazović University Clinical Center Kragujevac, Department of Surgery, Kragujevac, Serbia
  • Bela Balint Serbian Academy of Sciences and Arts, Department of Medical Sciences, Belgrade, Serbia; ‡‡Hungarian Academy of Sciences, Department of Medical Sciences, Budapest, Hungary; ††University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP250822002T
Ključne reči: alograft;, kriokonzervacija;, hematološke bolesti;, imunoterapija;, multipli mijelom;, ćelije, matične;, transplantacija, autologa.

Sažetak


Transplantacija hematopoetskih matičnih ćelija (hematopoietic stem cell transplantion – HSCT) već decenijama predstavlja terapiju izbora u lečenju pojedinih hematoloških maligniteta i nekih nemalignih poremećaja. Uvođenjem novih imunoterapijskih i ćelijama-posredovanih pristupa trebalo bi da bude redefinisana uloga autologne HSCT (auto-HSCT) i alogene HSCT (alo-HSCT). Auto-HSCT i dalje ostaje standard u lečenju multiplog mijeloma, Hočkinovog limfoma i ne-Hočkinovog limfoma. Primena novih medikamenata, uključujući inhibitore proteazoma, imunomodulacijske lekove, monoklonska i bispecifična antitela, povećava intenzitet i efikasnost terapijskog odgovora na HSCT i otvara raspravu o optimalnom vremenu za primenu HSCT. Alo-HSCT predstavlja najefikasniji oblik adoptivne imunoterapije, obezbeđujući kompletnu i dugotrajnu hematopoetsku rekonstituciju, neretko praćenu efektom “kalem protiv leukemije” (graft-versus-leukemia). Ona ostaje primarni kurativni vid lečenja akutnih leukemija, visoko-rizičnih mijelodisplastičnih i mijeloproliferativnih sindroma, kao i teške aplastične anemije. Poboljšanja u izboru donora matičnih ćelija (stem cell – SC), ex vivo manipulaciji prikupljenih ćelija, kao i inženjering grafta uz napredni imunski monitoring, proširila su i unapredila primenljivost ove terapije uz istovremeno povećanje bezbednosti i poboljšanje kliničkog ishoda. Uprkos brzom napretku u oblasti ćelijama posredovane i drugim agensima posredovane imunoterapije, HSCT i dalje ima ključnu ulogu u lečenju pojedinih hematoloških poremećaja. Kombinacija HSCT sa novim lekovima i drugim vidovima imunoterapije pruža mogućnost personalizovanog i bezbednijeg lečenja sa dugotrajnim povoljnim kliničkim ishodima, i obezbeđuje da HSCT ostane visoko relevantan metod u savremenoj medicini. Cilj ovog rada bio je da se sumiraju trenutni biološki koncepti SC, kao i bitna dostignuća na istraživačkim poljima u oblasti SC koja se brzo razvijaju, i da se odredi mesto i efikasnost HSCT danas, u eri novih terapijskih pristupa i agenasa.

 

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2026/01/30
Broj časopisa
Vol. 83 Br. 01 (2026): Vojnosanitetski pregled
Rubrika
Pregledni članak