In the last 30 years, allogeneic bone marrow transplantation has become the treatment of choice for many hematologic malignancies or inherited disorders and a number of changes have been registered in terms of long-term survival rate of transplanted patients as well as of available sources of hematopoietic stem cell (HSC). In parallel to the publication of better results in HSC transplantation, several recent discoveries have opened a scientific and ethical debate on the therapeutical potential of stem cells isolated from adult or embryonic tissues. One of the major discoveries in this field is the capacity of bone marrow-derived stem cells to treat a genetic liver disease in a mouse model, thus justifying the concept of transdifferentiation of adult stem cell and raising hopes on its possible therapeutical applications. We have tried here to summarise the advances in this field and to discuss the limits of these biological data.
Depuis 30 ans, la greffe de moelle osseuse allogenique represente le traitement de choix des hemopathies malignes et de certaines maladies hereditaires. Parallelement a des ameliorations notables en termes de survie a long terme, les sources de cellules souches hematopoietiques (CSH) possibles se sont multipliees. Des decouvertes recentes sont a l'origine d'un debat a la fois scientifique et ethique sur le potentiel therapeutique des cellules souches isolees a partir de tissus embryonnaires et adultes. Parmi elles, la mise en evidence de la capacite des cellules souches de la moelle osseuse a guerir une maladie genetique du foie dans un modele murin constitue une decouverte majeure, justifiant le concept de plasticite de la cellule souche adulte et laissant esperer de possibles applications therapeutiques. Nous avons tente de resumer les avancees dans ce domaine et de discuter les limites des resultats publies.