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Archives de pédiatrie
Volume 20, n° 4
pages 405-411 (avril 2013)
Doi : 10.1016/j.arcped.2013.01.021
Received : 27 January 2012 ;  accepted : 21 January 2013
L’allogreffe de cellules souches hématopoïétiques en 2012 : pour qui ? Comment ? Dans quelles conditions ?
Hematopoietic stem cell transplantation in 2012: Who? Where? How?
 

J.-H. Dalle
Service d’hématologie et immunologie pédiatrique, université Paris Denis-Diderot, hôpital Robert-Debré, 48, boulevard Serurier, 75935 Paris cedex 19, France 

Résumé

L’allogreffe de cellules souches hématopoïétiques a beaucoup évolué depuis ses origines, multipliant les sources cellulaires utilisables (moelle, cellules souches périphériques, sang placentaire), les donneurs mobilisables (intrafamiliaux, non apparentés, totalement ou partiellement compatibles) et les modalités thérapeutiques entourant la greffe (immunosuppresseurs, manipulations du greffon, soins de support), ouvrant la voie à un ensemble vaste de thérapies cellulaires. Les pathologies pour lesquelles une greffe est indiquée sont de plus en plus nombreuses : hémopathies malignes, hémopathies bénignes sévères telles que les aplasies médullaires congénitales ou acquises, les hémoglobinopathies ou encore les déficits immunitaires sévères et certaines maladies de surcharge. Cet article se propose d’offrir un tour d’horizon complet de cette technique pour l’enfant en 2012.

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Summary

Allogeneic bone marrow transplantation has dramatically changed over the years since its beginnings. The diseases treated with transplantation (malignant hemopathies, severe benign hemopathies such as congenital or acquired congenital medullary aplasia, hemoglobinopathies, as well as severe immune system deficiencies and certain overload diseases), stem cell sources (bone marrow, peripheral stem cells, placental blood), donor types (intrafamilial, nonrelated, totally or partially compatible), conditioning regimen (immunosuppressors, graft manipulation), and supportive care increasingly vary. Allogeneic stem cell transplantation and more widely cellular therapies now need to be discussed. In this paper, we propose an overview of these therapies in 2012 for pediatric patients.

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