Bone Marrow and Stem Cell Transplant
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- 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 following delivery.
- 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 2–4 weeks differentiate into mature blood components.
- In 2010, 1,479 pediatric allogeneic (and 782 autologous) HSCTs were performed in the United States. 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/PBSCT has remained stable. The use of unrelated BMT has been steadily decreasing.