Hematopoietic Stem Cell Transplantation
Summary of Key Points
• Hematopoietic cell transplantation (HCT) is a potentially curative treatment for a variety of hematopoietic, immune, metabolic, and malignant diseases.
• Hematopoietic stem cells for transplantation can be collected from bone marrow, peripheral blood, or umbilical cord blood.
• With the advent of unrelated donor, haploidentical, and cord blood transplantation, virtually every patient can now have a suitable donor.
• Reduced-intensity conditioning regimens are associated with lower treatment-related mortality and allow for transplantation in elderly and patients with comorbidities who are not candidates for myeloablative HCT.
• Allogeneic HCT is most frequently performed for patients with acute and chronic leukemias, myelodysplastic syndromes, immune deficiencies, metabolic disorders, and bone marrow failure states.
• Autologous HCT is usually performed as part of the initial treatment for multiple myeloma, relapsed Hodgkin and non-Hodgkin lymphoma, and select solid tumors.
• Common complications of HCT include regimen-related organ toxicity, graft rejection, graft-versus-host disease, infections, and secondary malignancies.
1. All of these conditions increase the risk of graft-versus-host disease (GVHD) except:
A Increasing human leukocyte antigen (HLA) disparity
B Use of a matching unrelated donor versus a matching sibling donor
