Prenatal Transplantation of Hematopoietic Stem Cells: Overview

In the last 25 years, extensive progress has been made in the prenatal diagnosis of congenital diseases using non-invasive and invasive techniques. In contrast to prenatal diagnosis, prenatal therapy has shown limited success so far. Therefore, if a severe congenital disease is diagnosed early in gestation, many parents choose to terminate pregnancy. Prenatal transfer of hematopoietic stem cells (HSC) is a promising approach to successfully treat fetuses affected by hematologic, immunologic, or metabolic diseases. Recently, clinical success has been achieved (Flake et al. 1996). The success, however, is limited to diseases where severe immunodeficiency is present in the fetus. This article aims to provide an overview of the current experience in animals and humans and to identify strategies to overcome the current obstacles.