Hematopoietic stem cell transplantation

Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient and to produce additional normal blood cells. It may be autologous (the patient's own stem cells are used), allogeneic (the stem cells come from a donor) or syngeneic (from an identical twin). It is most often performed for patients with certain cancers of the blood or bone marrow, such as multiple myeloma or leukemia. In these cases, the recipient's immune system is usually destroyed with radiation or chemotherapy before the transplantation. Infection and graft-versus-host disease are major complications of allogeneic HSCT. HSCT remains a dangerous procedure with many possible complications; it is reserved for patients with life-threatening diseases. As survival following the procedure has increased, its use has expanded beyond cancer to autoimmune diseases and hereditary skeletal dysplasias, notably malignant infantile osteopetrosis and mucopolysaccharidosis. List of conditions treated with hematopoietic stem cell transplantation Indications for stem-cell transplantation are: Acute myeloid leukemia Chronic myeloid leukemia Acute lymphoblastic leukemia Juvenile myelomonocytic leukemia Hodgkin lymphoma (relapsed, refractory) Non-Hodgkin lymphoma (relapsed, refractory) Neuroblastoma Ewing sarcoma Multiple myeloma Myelodysplastic syndromes Gliomas, other solid tumors Thalassemia Sickle cell anemia Aplastic anemia Fanconi anemia Malignant infantile osteopetrosis Mucopolysaccharidosis Paroxysmal nocturnal hemoglobinuria Pyruvate kinase deficiency Immune deficiency syndromes Autoimmune diseases, including multiple sclerosis Many recipients of HSCTs are multiple myeloma or leukemia patients who would not benefit from prolonged treatment with, or are already resistant to, chemotherapy.

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