Stem cell transplantation (SCT) involves eliminating the patient’s hemopoietic and immune system by chemotherapy and/or radiotherapy and replacing it with stem cells either from another individual or with a previously harvested portion of the patient’s own hemopoietic stem cells.

HLA system

Stands for human leukocyte antigen system; highly polymorphic, coding for the MHC complexes.

  • MHC I are found on every nucleated cell (self-presenting antigen) - HLA-A, HLA-B, HLA-C
  • MHC II are found on antigen-presenting cells - HLA-DR, HLA-DQ, HLA-DP
  • MHC III are soluble components - HSP70, TNF

Classification

According to the source

  • Bone marrow transplantation (BMT)
  • Peripheral blood stem cell (PBSC) transplantation
  • Umbilical cord transplantation

According to the donor

AutologousAllogenic
Donor typesFrom selfSynergenic (identical twins)
HLA-matching siblings
Haploidentical (parent to child)
Unrelated HLA-matching donor
Umbilical cord blood
IndicationsLymphomas, MM, amyloidosisAML, ALL, CML, MDS, lymphomas, MM, myelofibrosis
Hemoglobinopathies, PNH, aplastic anemia
ConditioningMyeloablative
Lymphoablative		Myeloablative
Reduced-intensity
Non-myeloablative

Steps

  • Collection
    • PBSC collection is preferred nowadays.
      • The donor is








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