Hematopoietic stem cell transplantation is a type of treatment for many indications especially Blood disorders where Hematopoietic stem cells (Blood cells) are been transplanted in patients' bodies as a part of the treatment procedure. HSCT involves the intravenous infusion of hematopoietic stem cells in order to reestablish blood cell production in patients whose bone marrow or immune system is damaged or defective. Over the past half-century, this technique has been used with increasing frequency to treat numerous malignant and nonmalignant diseases.
Major indications are Blood cancers and Immunodeficiency disorders, U.S. FDA approved list of Indications is mentioned below:
- Acute lymphoblastic leukemia (ALL)
- Acute myeloid leukemia (AML)
- Chronic lymphocytic leukemia (CLL)
- Chronic myelogenous leukemia (CML)
- Hodgkin lymphoma
- Multiple myeloma
- Myelodysplastic syndromes (MDS)
- Non-Hodgkin lymphoma (NHL)
Blood disorders, immune system disorders, inherited metabolic disorders
- Adrenoleukodystrophy (ALD)
- Hurler syndrome
- Krabbe disease (Globoid-Cell Leukodystrophy)
- Metachromatic Leukodystrophy (MLD)
- Severe aplastic anemia
- Severe Combined Immunodeficiency (SCID)
- Sickle cell disease (SCD)
- Wiskott-Aldrich syndrome (WAS)
- Other diseases
Sources of HSCs for HSCT:
There are different types of blood stem cell transplants. The type of transplant varies according to the source of blood stem cells.
- Bone marrow transplants (BMT) use blood stem cells collected from the bone marrow.
- Peripheral blood stem cell transplants (PBSCT) use blood stem cells collected from the bloodstream.
- Cord blood transplants (CBT) use blood stem cells collected from the discarded placenta and umbilical cord of a new born baby.
The type of transplant also varies according to who provides the cells for the transplant:
The type of transplant also varies according to who provides the cells for the transplant, like:
Autologous transplants use cells previously (before high dose chemotherapy/radiation therapy) collected from the patient.
Allogeneic transplants use cells provided by a donor (only after HLA mapping).
Syngeneic transplants use cells provided by an identical twin (after HLA mapping).
Prior to transplant, patients receive high dosages of chemotherapy and/or radiation to destroy their disease and make room for healthy new blood stem cells.
If the dosage of chemotherapy and/or radiation is high enough to completely suppress the patient's immune system, the procedure is called a myeloablative transplant.
If a patient receives less intensive dosages of chemotherapy and/or radiation, the procedure is called a reduced intensity or nonmyeloablative transplant.