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Hematopoietic stem cell transplantation TISSUE SPECIFIC TRANSPLANTATION



contents : 

???????????? Introduction to HSCs Hematopoietic stem cell transplantation (HSCT) Types of Hematopoietic Stem Cell Transplantation What Are the Sources of Hematopoietic Stem Cells? contents ????????????

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Conditioning regimens Engraftment Complications and side effects General prognosis Work on HSCT in Pakistan HSCT and HIV Future of HSCT

Hematopoietic stem cells (HSCs) : 

cells that form blood and immune cells are known as hematopoietic stem cells It’s in 1:10.000 of cells in myeloid tissue. Four actions 1) renew itself, 2) differentiate, 3) mobilize out into circulation 4) it can undergo apoptosis. Hematopoietic stem cells (HSCs)

Hematopoietic stem cell transplantation (HSCT) : 

Stem cell transplantation is a medical procedure in the fields of hematology and oncology. To treat diseases of the blood, bone marrow, or certain types of cancer. E.g. aplastic anemia, sickle-cell disease, Hodgkin's lymphoma, leukemia. Hematopoietic stem cell transplantation (HSCT)

Types of Hematopoietic Stem Cell Transplantation : 

Types of Hematopoietic Stem Cell Transplantation 1)Autologous

2.)Allogeneic : 


Sources of Hematopoietic Stem Cells : 

Bone marrow Drawing out typically from hipbone with a syringe. Peripheral blood stem cells donor's blood is withdrawn through a sterile needle in one arm & passed through a machine that removes CD34+ WBCs. Umbilical cord blood Sources of Hematopoietic Stem Cells

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The peripherally harvested cells contain twice as many HSCs as taken from bone marrow . Umbilical cord blood mother donates her infant's umbilical cord and placenta after birth. a small quantity of blood obtained from an umbilical cord (~ 50 ml) it is more suitable for transplantation into small children than into adults

Conditioning regimens : 

Treatments used before transplantation. Myeloablative transplants Bone marrow ablation using chemo and radio therapy, Non- myeloablative (or "mini")transplants transplant relies on the donor's immune cells to fight disease This treatment is used now a days. Conditioning regimens

ENGRAFTMENT(animation) : 


Complications and side effects : 

Infection Graft-versus-host disease (GVHD) Graft-versus-tumor effect Complications and side effects


Bone marrow transplantation usually requires ("myeloablation"). Prior to "engraftment" patients may go for several weeks without appreciable numbers of white blood cells to help fight infection. This puts a patient at high risk of infections, sepsis and septic shock, despite prophylactic antibiotics, and accounts for a large share of treatment-related mortality. INFECTION

Graft-versus-host disease (GVHD): : 

GVHD is an inflammatory disease that is unique to allogeneic transplantation It is an attack of the "new" bone marrow's immune cells against the recipient's tissues occurs in the first 3 months after transplantation and may involve the skin, intestine, or the liver, and is often fatal High-dose corticosteroids such as prednisone are a standard treatment Graft-versus-host disease (GVHD):

Graft-versus-tumor effect : 

This is beneficial aspect of the Graft-versus-Host phenomenon For example, HSCT patients with graft-versus-host disease after an allogeneic transplant tend to have a lower risk of cancer relapse. This is due to a therapeutic immune reaction of the grafted donor T lymphocytes against the diseased bone marrow of the recipient. Graft-versus-tumor effect

General prognosis : 

widely dependent upon disease type, stage, stem cell source, HLA-matched status (for allogeneic HCST) conditioning regimen General prognosis


In Pakistan, SCT was started in October 1995 at Dr Ziauddin Hospital by Dr Tahir Shamsi and his team. The first case was of a young man suffering from AML (Acute myeloid leukemia). In 1999, allogeneic BMT (bone marrow transplantation) was started at Bismillah Taqee Institute of Health Sciences and Blood Diseases Centre, Karachi. In 2001, the Armed Forces Bone Marrow Transplant Centre started functioning. STEM CELLTRANSPLANTATION IN PAKISTAN:

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over 350 allogeneic stem cell transplants have been carried out in these latter centers. Another 50 autologous procedures were carried out in all centers. In 2004, a third center started transplants at the Aga Khan Hospital. Cure2Children Foundation is also doing their seminars and projects for the successful SCT in Pakistan. The main indications for transplant are aplastic anemia, -thalassemia major and hematological malignancies.


A bone marrow transplant performed on an American man residing in Germany appears to have successfully cured him of both leukemia as well as HIV, the virus that causes AIDS. Researchers emphasize that this is an unusual case in that the donor marrow possessed an inherited genetic mutation rendering an inability for HIV to attach itself to cells. Roughly 1:1000 Europeans and Americans have this inherited mutation. HSCT & HIV

Future of Hematopoietic Stem Cell Transplantation : 

(HSCT)provide only cure for a large number of malignant and nonmalignant disorders. Future research will focus on decreasing the transplantation-related morbidity and mortality and on increasing relapse-free survival. The work will include designing effective, reduced-intensity conditioning regimens; discovering targeted therapies to prevent and treat graft versus host disease Future of Hematopoietic Stem Cell Transplantation

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