Abstract

HAEMOPOIETIC STEM CELL TRASPLANTATION (HSCT)

Kamal Pandey, Sonu Thapa, Prem Bhusal and Rabindra Chaudhary

Abstract

Haematopoietic stem cells transplantation (HSCT) is an established therapy firstly developed by E. Donnall Thomas in 1956 AD has seen rapid expansion over the last decade in the treatment modality for haematological, oncological, hereditary and immunological diseases, which consists in the intravenous infusion of hematopoietic stem cells to re-establish the patients’ medullary and immune function. Depending upon the donor, the transplantation is classified as autologous, allogeneic, or syngeneic. BMT has been performed for a large number of conditions. The five most frequent ones include CML, Thalassaemia Major, Aplastic Anemia, Multiple Myeloma and Acute Leukaemia. Development of infrastructure and human resource has lead to more and more patients being given the benefit of this potentially curative mode of therapy. The major sources for stem cell transplantations bone marrow, Peripheral blood stem cells and umbilical cord blood or hematopoietic stem cells. Selection of donor depend upon the types of malignancy, availability of suitable donor ,types of malignancy, status of disease, a tumour free autograft and malignancy susceptibility to GVM. Conditioning (preparative) regimens are given with main aim of preparing the space in bone marrow space for the incoming graft, suppressing immunity of to prevent GvHD, and eradicate tumor cells when patients are treated for malignant disease. The most common complications of the procedure may be due include mucosititis, Hepatic veno-occlusive disease, haemorrhagic cystitis, convulsions, infections, bleeding, viral, bacterial or fungal infections,Graft Versus Host Disease in allogeneic transplantations only.

Keywords: Transplantation, Graft versus host Disease, Complication, Mobilization, Apheresi.