Bone Marrow and Stem Cell Transplant

Basics

Hematopoietic stem cell transplantation (HSCT) is the infusion of progenitor stem cells with the intention of restoring hematopoiesis and immunity. HSCT can be classified by
- Donor type: syngeneic (derived from an identical twin), allogeneic (derived from a related or unrelated donor), or autologous (derived from the patient prior to stem cell-toxic therapy)
- Product type
  - Bone marrow transplantation (BMT): Stem cells are obtained by harvesting bone marrow under anesthesia.
  - Peripheral blood stem cell transplantation (PBSCT): Stem cells are mobilized to the periphery with cytokines (GCSF) and collected by apheresis.
  - Umbilical cord blood transplantation (UCBT): Stem cells are collected from the umbilical cord and placenta immediately after birth.
Stem cells are infused in the peripheral blood of the recipient using a central venous catheter, similar to a blood transfusion. They then home to the bone marrow niche and over the next 2 to 4 weeks differentiate into mature blood components.

In 2013, >1,900 pediatric allogeneic HSCTs were performed worldwide. Approximately 40% of allogeneic transplants are from matched related donors.
The use of unrelated PBSCT and unrelated UCBT has been gradually increasing since the late 1990s, whereas the use of related BMT has remained stable.

There's more to see -- the rest of this topic is available only to subscribers.