De rol van stamcelinfusie bij de behandeling van leukemie

In the past 7 years, about 20% of the children with leukemia in the Netherlands received autologous or allogeneic stem cell infusion. Based on the literature, the survival advantage of stem cell infusion in comparison with chemotherapy is reviewed. Autologous stem cell infusion is seldom indicated meanwhile. Nowadays, the most important indications for allogeneic sibling stem cell infusion are high risk acute lymphoblastic leukemia (ALL) with chromosomal abnormalities, bone marrow relapse of ALL within 60 months of the first complete remission and standard or high risk acute non-lymphoblastic leukemia (ANLL) in first remission. The most frequently reported late effects after stem cell infusion are leukemic relapse, retarded linear height, gonadal damage, cataract, restricted pulmonary function and the occurrence of second malignancies. Contemporaneous developments which may optimize the role of stem cell infusions in the near future include peripheral blood stem cell infusion, cord blood stem cell infusion, haploidentical stem cell infusion, detection of minimal residual disease and donor lymphocyte infusion.