Hematopoietic Stem Cell Transplantation (HSCT)

Hematopoietic stem cell transplantation (HSCT) is a medical procedure that involves the infusion of hematopoietic stem cells to restore normal blood cell production in patients with certain blood disorders. This process is critical for treating various conditions, including hematologic cancers (such as leukemia and lymphoma), bone marrow disorders, and some genetic diseases.

Key Aspects of Hematopoietic Stem Cell Transplantation

Types of HSCT:

• Autologous HSCT: The patient’s own stem cells are collected and reintroduced after intensive treatment (like chemotherapy) to eliminate diseased cells.
• Allogeneic HSCT: Stem cells are obtained from a donor, which can be a sibling, unrelated donor, or umbilical cord blood. This type is often used when the patient’s own stem cells are not viable or when a genetic disease is involved.
• Syngeneic HSCT: Stem cells are harvested from an identical twin.

Sources of Hematopoietic Stem Cells:

• Bone Marrow: Traditionally the primary source, harvested from the donor’s pelvic bones.
• Peripheral Blood: Stem cells can also be collected from the bloodstream after stimulating their release from the bone marrow using growth factors.
• Umbilical Cord Blood: Collected from the umbilical cord at birth, it contains a rich source of hematopoietic stem cells and is increasingly used in transplants.

Indications for HSCT:

• HSCT is commonly performed for conditions such as:
  • Acute myeloid leukemia (AML)
  • Acute lymphoblastic leukemia (ALL)
  • Chronic myeloid leukemia (CML)
  • Lymphomas
  • Aplastic anemia (AA)
  • Sickle cell disease (SCD)
  • Thalassemia

Procedure Overview:

• Prior to transplantation, patients typically undergo conditioning therapy, which may include chemotherapy and/or radiation to destroy diseased cells and suppress the immune system to prevent rejection of the transplanted cells.
• The actual transplant involves intravenous infusion of the harvested stem cells into the patient.

Complications and Risks:

• Major complications can include infections due to immunosuppression, graft-versus-host disease (GVHD) when donor cells attack the recipient’s tissues, and organ damage. Long-term follow-up is essential for monitoring potential late effects.

Prognosis:

• The success of HSCT depends on various factors including the type of disease, patient age, overall health, and how well the donor’s and recipient’s tissues match.

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References

For further reading on hematopoietic stem cell transplantation, you can refer to the following sources:

1. Hematopoietic Stem Cell Transplantation – Wikipedia
   This entry provides a comprehensive overview of HSCT, including its definition, types, indications, and complications.
   DOI: 10.1016/j.cell.2013.05.029
2. Principles and Overview of Allogeneic Hematopoietic Stem Cell Transplantation
   This article discusses the principles behind HSCT and its application in treating various blood disorders.
   DOI: 10.3390/cells8020148
3. Hematopoietic Stem Cell Transplantation Overview – MSD Manuals
   This resource outlines the procedure, indications, risks, and benefits associated with HSCT.
   DOI: 10.1016/j.jpsychores.2009.02.001