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Cell therapy: A basis for new therapeutic strategies in internal medicine

par Toungouz Nevessignsky, Michel ;Lambermont, Micheline ;Velu, Thierry
Référence Drug news & perspectives, 12, 1, page (12-20)
Publication Publié, 1999

Article révisé par les pairs

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Résumé :

Two rapidly evolving areas of cell therapy are the use of stem cells and cancer immunotherapy. The primitive pluripotent hematopoietic stem cells (HSCs), which have the capacity to self-renew and to repopulate the different blood cell lineages, are responsible for the maintenance of the hematopoietic system. Two major sources of stem cells are bone marrow and apheresis products of peripheral blood after mobilization with G-CSF and/or chemotherapy. HSC transplantation allows for the restoration of the hematopoietic and immune systems in cancer therapy. Immunotherapy has been classified as 'active' or 'passive' depending on whether the immunotherapy is designed to activate the patient's immune system to mount an immune response towards his/her own tumor or designed to transfer immune components 'already' directed against the patient's cancer. This latter approach, also termed 'adoptive immunotherapy,' includes the use of lymphokine-activated killer cells and tumor-infiltrating lymphocytes, tumor-specific lymphokine-activated killer cells and autolymphocyte therapy, stem cell transplantation in leukemic relapse, adoptive immunotherapy of Epstein-Barr virus (EBV) lymphoma using EBV-specific cytotoxic T lymphocytes, and activated monocytes- macrophages. Another approach for cancer immunotherapy, termed 'active immunotherapy,' is based on the induction of an antitumor response in the patient by, e.g., the use of manipulated tumor cells or professional antigen- presenting cells loaded with tumor antigens. In addition to its use in cancer treatment, cell therapy is also being explored as a treatment strategy for other disorders of the hematolymphoid system, such as autoimmune diseases (AIDs). It has also been proposed that HSCs may be useful in creating tolerance in patients requiring solid organ transplantation. As cell therapy becomes more common, regulatory decisions must be made concerning whether to give cellular products the status of drugs or biological products.