Allogeneic hematopoietic stem transplantation

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only potential cure for SCD. The best candidates are children with SCD who are younger than 16 years of age with severe complications who have an identical H LA-matched donor, usually a sibling. The transplant-related mortality rate is between 5% and 10%, and graft rejection is approximately 10%. Other risks include secondary malignancies, development of seizures or intracranial bleeding, and infection in the immediate posttransplant period.6,25,32,33... 

Allogeneic hematopoietic stem cell transplantation (HSCT) has been used in the treatment of pediatric AML in first complete remission. In most clinical trials, the availability of HLA-matched sibling donors determined whether patients underwent HSCT as postremission treatment. To facilitate this process, it is important to obtain HLA typing on all younger patients with AML and siblings shortly after diagnosis. Patients who do not have an HLA-matched sibling will proceed to postremission therapy. 

Allogeneic hematopoietic stem cell transplantation is the only therapy that is curative. The best candidates are younger than 16 years of age, have severe complications, and have human leukocyte antigen-matched donors. Risks must be carefully considered and include mortality, graft rejection, and secondary malignancies. 

Ades L, Guardiola P, Socle G Second 12 malignancies after allogeneic hematopoietic stem cell transplantation new insight and current problems. Blood Rev 2002 16 135-146. 

Up until the 1970s, CML was incurable. The development of allogeneic hematopoietic stem cell transplantation (HSCT) was subsequently shown to provide long-term disease eradication with prolonged disease-free survival (14). However, allogeneic HSCT is available to only a minority of patients because of the necessity of finding a suitable donor for transplantation and the toxicity of the procedure. 

Ferry C, Socie G. 2003. Busulfan-cyclophosphamide versus total body irradiation-cyclophosphamide as preparative regimen before allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia What have we learned Exp Hematol. 31 1182-1186. 

Fukuda T, Boeckh M, Carter RA, Sandmaier BM, Maris MB, Maloney DG, Martin PJ, Storb RF, Marr KA. Risks and outcomes of invasive fungal infections in recipients of allogenic hematopoietic stem cell transplants after nonmyeloablative conditioning. Blood 2003 102 827-33. 

Kaiser T, Kamal H, Rank A, et al. Proteomics applied to the clinical follow-up of patients after allogeneic hematopoietic stem cell transplantation. Blood 2004 104(2) 340-349. 

Ringden, O. and Le Blanc, K. (2005). Allogeneic hematopoietic stem cell transplantation state of the art and new perspectives. APMIS 113 813-830. 

Welniak, L. A., Blazar B. R. and Murphy W. J. (2007). Immunobiology of allogeneic hematopoietic stem cell transplantation. Annu. Rev. Immunol. 25 139-170. 

Demirer, T., Barkholt, L., Blaise, D., Pedraz-zoli, P., Aglietta, M., Carella, A. M., Bay, J. O., Arpaci, F., Rosti, G., Gurman, G., Niederwieser, D. and Bregni, M. (2008). Transplantation of allogeneic hematopoietic stem cells an emerging treatment modality for solid tumors. Nat. Clin. Pract. Oncol. 5 256-267. 

Foss, F. M. (2006). The role of purine analogues in low-intensity regimens with allogeneic hematopoietic stem cell transplantation. Semin. Hematol. 43 S35-S43. 

Observations of metabolic cross-correction provided the rationale for cellular replacement, achieved primarily through allogeneic hematopoietic stem cell or bone transplantation (HSCT) (Prasad and Kurtzberg, 2008). More recently, the use of neural stem cells (NSC) implanted in the brain of patients with late-infantile neuronal ceroid lipofuscinosis has been contemplated (Pierret et al., 2008) but there are no reports as yet of its potential efficacy. Within the central nervous system there must be proper integration of donor cells, and differentiation into appropriate cell types. As specialized cell types within the nervous system elaborate neurotransmitters and are involved with conducting electrical impulses, functional differentiation may be a major hurdle for the neurodegenerative LSDs. 

Bosi A, Bartolozzi B, Vannucchi AM, Orsi A, Guidi S, Rossi Ferrini P. Polymerase chain reaction-based pre-emptive therapy with cidofovir for cytomegalovims reactivation in allogeneic hematopoietic stem cells transplantation recipients a prospective study. Haematologica 2002 87(4) 446-7. 

Winston DJ, MaziarzRT, Chandrasekar PH, etal. Intravenous and oral itraconazole versus intravenous and oral fluconazole for long-term antifungal prophylaxis in allogeneic hematopoietic stem-cell transplant recipients A multicenter, randomized trial. Ann Intern Med 2003 138 705-713. 

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only modality currently available that is known to cure CML, and it is increasingly used in patients who have failed imatinib therapy. 

Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the only therapy proven to cure patients with CML, with many patients alive and disease-free more than 10 years after transplant. A recent study from the International Bone Marrow Transplant Registry (IBMTR) reported a 5-year survival rate of 69% in patients undergoing matched sibling alloHSCT within the first year of diagnosis. As stated previously, patients who undergo matched-sibling alloHSCT... 

Giralt S, Sobocinski K, Horowitz MH. Impact of imatinib therapy on the use of allogeneic hematopoietic stem cell transplantation for treatment of chronic myelogenous leukemia. Blood 2003 102 473a. 

Kashyap A, Wingard J, Cagnoni P, et al. Intravenous versus oral busulfan as part of a busulfan/cyclophosphamide preparative regimen for allogeneic hematopoietic stem cell transplantation decreased incidence of hepatic venoocclusive disease (HVOD), HVOD-related mortality, and overall 100-day mortality. Biol Blood Marrow Transplant 2002 8 493-500. 

Tabbara lA, Ingram RM. Nonmyeloablative therapy and allogeneic hematopoietic stem cell transplantation. Exp Hematol 2003 31 559-566. 

Junghanss C, Marr KA, Carter RA, et al. Incidence and outcome of bacterial and fungal infections following nonmyeloablative compared with myeloablative allogeneic hematopoietic stem cell transplantation a matched control study. Biol Blood Marrow Transplant 2002 8 512-520. 

Fukuda T, Hackman RC, Guthrie KA, et al. Risks and outcomes of idiopathic pneumonia syndrome after nonmyeloablative compared to conventional conditioning regimens for allogeneic hematopoietic stem cell transplantation. Blood 2003 102 2777-2785. 

Ho VT, Mirza NQ, Junco DD, et al. The effect of hematopoietic growth factors on the risk of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation a meta-analysis. Bone Marrow Transplant 2003 32 771-775. 

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