Question

Explain haemopoietic stem cell transplantation.

Hint:

HSCT is a potentially curative treatment for various blood-related disorders, but it requires careful patient selection, conditioning, and monitoring for complications.

Answer 1

Haemopoietic stem cell transplantation (HSCT), also known as bone marrow transplant, is a medical procedure in which hematopoietic stem cells (the cells that form blood and immune cells) are infused into a patient to restore bone marrow function after it has been damaged or destroyed.
Step 1: Indications for HSCT:
1. Leukemia and Lymphoma: HSCT is commonly used in patients with blood cancers, such as leukemia, lymphoma, and myelodysplastic syndromes.
2. Aplastic Anemia: In conditions like aplastic anemia, where the bone marrow is unable to produce enough blood cells, HSCT can restore hematopoiesis.
3. Inherited Blood Disorders: Conditions like sickle cell anemia and thalassemia can be treated by HSCT, which aims to replace defective stem cells with healthy ones.
Step 2: Types of Haemopoietic Stem Cell Transplantation:
1. Autologous Transplant: In an autologous transplant, the patient's own stem cells are collected, processed, and reinfused after chemotherapy or radiation. This approach avoids immune rejection.
2. Allogeneic Transplant: An allogeneic transplant involves stem cells from a genetically matched donor. This approach is often used for diseases like leukemia, but requires careful matching to prevent graft-versus-host disease (GVHD).
Step 3: Procedure and Risks:
1. Preparation: The patient typically undergoes chemotherapy and/or radiation to destroy diseased bone marrow.
2. Infusion: The healthy stem cells are infused into the patient's bloodstream, where they migrate to the bone marrow and begin to produce blood cells.
3. Complications: Risks include infection, graft-versus-host disease (in allogeneic transplants), organ toxicity, and relapse of the disease.