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Concept
Hematopoietic stem cell transplantation
Summary
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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