The role of hematopoietic stem cells in the treatment of ovarian cancer.

In recent years hematopoietic stem cells (HSC) have been the object of new research efforts and scientific advances. Therapeutic strategies have been set up using HSC for the treatment of solid tumors such as ovarian cancer. In this context different approaches have been proposed and clinically investigated. The "autologous" approach refers to the use of HSC as hematologic support to high-dose chemotherapy regimens, and to the use of HSC as an abundant source of den tic cells for cancer vaccination protocols. Our institution has developed a long-term experience in high-dose chemotherapy with autologous HSC transplantation as first-line treatment of advanced ovarian cancer, and in the use of cytokines both for the HSC collection and for the post-transplantation hematopoietic recovery. Moreover, the "allogeneic" approach with HSC consists of the allogeneic transplantation with both myeloablative/standard or nonmyeloablative/reduced conditioning regimens, which has been proposed as a new adoptive immunotherapeutic treatment for different nonhematologic malignancies. Perspectives in the use of HSC in oncology comprise the possibility of an HSC ex vivo expansion, the use of umbilical cord blood HSC, and the development of future HSC-based gene-therapy programs.