TAILIEUCHUNG - Chapter 108. Hematopoietic Cell Transplantation

Bone marrow transplantation was the original term used to describe the collection and transplantation of hematopoietic stem cells, but with the demonstration that the peripheral blood and umbilical cord blood are also useful sources of stem cells, hematopoietic cell transplantation has become the preferred generic term for this process. The procedure is usually carried out for one of two purposes: (1) to replace an abnormal but nonmalignant lymphohematopoietic system with one from a normal donor, or (2) to treat malignancy by allowing the administration of higher doses of myelosuppressive therapy than would otherwise be possible. The use of hematopoietic. | Chapter 108. Hematopoietic Cell Transplantation Bone marrow transplantation was the original term used to describe the collection and transplantation of hematopoietic stem cells but with the demonstration that the peripheral blood and umbilical cord blood are also useful sources of stem cells hematopoietic cell transplantation has become the preferred generic term for this process. The procedure is usually carried out for one of two purposes 1 to replace an abnormal but nonmalignant lymphohematopoietic system with one from a normal donor or 2 to treat malignancy by allowing the administration of higher doses of myelosuppressive therapy than would otherwise be possible. The use of hematopoietic cell transplantation has been increasing both because of its efficacy in selected diseases and because of increasing availability of donors. The International Bone Marrow Transplant Registry a href http title Linkification http http a estimates that about 50 000 transplants are performed each year. The Hematopoietic Stem Cell Several features of the hematopoietic stem cell make transplantation clinically feasible including its remarkable regenerative capacity its ability to home to the marrow space following intravenous injection and the ability of the stem cell to be cryopreserved. Transplantation of a single stem cell can replace the entire lymphohematopoietic system of an adult mouse. In humans transplantation of a few percent of a donor s bone marrow volume regularly results in complete and sustained replacement of the recipient s entire lymphohematopoietic system including all red cells granulocytes B and T lymphocytes and platelets as well as cells comprising the fixed macrophage population including Kupffer cells of the liver pulmonary alveolar macrophages osteoclasts Langerhans cells of the skin and brain microglial cells. The ability of the hematopoietic stem cell to home to the marrow following intravenous injection is .

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