Hematopoietic Stem Cell Transplantation (HSCT)

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Presentation transcript:

Hematopoietic Stem Cell Transplantation (HSCT)

Definitions Stem cell: An immature cell that can differentiate into a more specific cell Hematopoietic Stem Cell: An immature cell that will become a cell of the blood-forming system Scanning electron micrograph image of a human T lymphocyte. National Institute of Allergy and Infectious Diseases (NIAID). Public Domain

Diseases Treated by HSCT Leukemia Lymphoma Multiple Myeloma Myelodysplasia Some non-cancerous diseases (multiple sclerosis, aplastic anemia) KEY POINT: These are all diseases that involve the blood- forming (Hematopoietic) or immune system

What is a stem cell transplant? Removal of a person’s cancerous blood-forming system Replacement with a new disease-free blood-forming system https://www.flickr.com/photos/34936009@N03/4988403544/in/set-72157624826247815; no changes made (CC BY-ND 2.0)

Why a stem cell transplant? Aggressive or advanced disease Disease unresponsive to traditional treatment “Cure” or prolonged remission

Types of HSCT Allogeneic – Stem cells donated from another person Used for: Leukemia and advanced lymphoma Autologous – Stem cells harvested from your own body Used for: Lymphoma and multiple myeloma Syngeneic – Stem cells from an identical twin

Day 0 = Stem cell infusion (Happy Birthday!)

Day +1 to Engraftment Complete immunosuppression Prophylaxis: Antibiotics, Antivirals, and Antifungals Supportive therapy WASH HANDS! Day +28 bone marrow biopsy By Own work (ISO 7010) [Public domain], via Wikimedia Commons

Risks and Side Effects Infection Chemo SE Acute or chronic graft vs. host disease (GVHD) GI tract, skin Graft vs. host effect Graft Failure

When it works… “Curative” Produces prolonged or indefinite remission First successful BMT’s were done in the late 1960s, and some have now lived for 30+ years in remission HOPE World Health Organization. Public Domain